Experimental And Clinical Research On Effects Of Inflammatory Response Of Hypertension Carotid Atherosclerosis By Yiqiqufengtongluo Therapy

Objective: To provide a basis primary prevention for ischemicstroke, by observing effects on hypertension carotid atherosclerosis’inflammatory factors in rabbits with Yiqiqufngtongluo,and researching itsclinical efficacy and safety in patients.Methods:1Experimental Part: Thehypertension carotid atherosclerosis rabbits model be established by bilateralrenal artery stenosis and high-fat diet combined with immune injury. HealthNew Zealand white rabbits46, male and female are not limited, randomlydivided into sham-operation group (n=6), hypertension carotidatherosclerosis group (n=40)was randomly divided into five groups, eachgroup contained8rabbits,those groups were model group, low dose ZhilongHuoxue Tongyu capsule(ZHTC) group, moderate dose ZHTC group, highdose ZHTC group and Simvastatin group. Bovine serum albumin (250mg/kg)was by eaer-edge intravenous injection to these rabbits once a week for threeweeks after the operation, fed it high-fat diet8weeks. Then random access3rabbits in the8th weekend only confirm that the model is successful. Rabbitof each treatment groups were feed with crude drug of ZHTC0.78g/kg/d,1.56g/kg/d,3.12g/kg/d,Simvastatin0.51mg/kg/d,waste weight, mersure theblood pressure and serum lipid level on0,8and12week, test the Hcy、CRP and observation of the nuclear factor κB (NF-κB) and intercellular adhesionmolecule-1(ICAM-1) expression on the rabbit carotid arteries in the12thweekend.2Clinical Observation: Take a randomized, double-blind,placebo-controlled experiment method.90cases consistent with the caseinclusion criteria are randomly divided into control group、test group1、andtest group2，while each group contained30cases. The treatment of controlgroup was foundation therapy combined with Simvastatin and Placebo-a, thetreatment of test group1was foundation therapy combined with ZHTCcapsule and placebo-b，the treatment of test group2was foundation therapycombined with ZHTC capsule and Simvastatin. Observation before and after12weeks of carotid intima-media thickness (IMT) and atheroscleroticplaque and serum CRP, Hcy, VEGF, the Fib change and syndrome of TCMefficacy clinical score before and after treatment with TCM and drug safetymonitoring.Results:1The experiment results: Successful preparation ofhypertension carotid atherosclerosis model in rabbit.(1)at the end ofexperimental，the weight of each groups rabbit significantly increased thanbefore the experiment (P＜0.05), but no significant differences between thegroups (P＞0.05).at the8th weekend the blood pressure has a significantincrease than the beginning. at the12th weekend high-dose group,simvastatin group effects on blood pressure, but not statistically significant(P＞0.05).(2) At the8th weekend the model groups TC, TG, LDL-Csignificantly higher than the sham-operation group（P＜0.01）, TC, LDL-C, TG in high doses of group, moderate dose group, simvastatin groupcompared with model group are significantly different（P＜0.05）.The effecfin moderate dose group is lower than in high doses group and simvastatingroup.（3）at the12th weekend, Hcy and CRP levels in model groupsignificantly higher than the sham-operation group(P＜0.01）, compared tothe model group, the high dose group,moderate dose group,Simvastatingroup has a significantly reduce. There is not difference between high dosegroup and simvastatin group (P＞0.05).(4)the expression of NF-κB,ICAM-1in carotid artery in rabbits model group are significantly more thanthe sham-operation group, there are significant differences (P＜0.05)，Compared with the model group, high,moderate dose group, simvastatingroup in the carotid artery of rabbits has a significantly reduced expressionof NF-κB, ICAM-1, there are significant differences (P<0.05), there is notdifference between high dose group with simvastatin group (P>0.05).2TheClinical results:(1) The total effective rate of clinical therapeutic effect oftest group2was96.7%, which was80.0%of control group, and which is76.7%of test group1. Compared with the test group1and control group, thedifferences had no statistical significance（P＞0.05). Compared with the testgroup1or control group, the test group2has a significant difference(P<0.05).(2)After therapy in the test1and test2group, headache, irritability,dizziness, head wrap, shortness of breath, and general lassitude, tongue andpulse are clearly improved, there is significant difference(P<0.05), the control group only improved the headache, irritability and vertigo(P<0.05).compared with the test group1and control group, other majorclinical symptoms in the test2has even more pronounced improvement.(3)The IMT and plaque total points in each group was reduced than before thetreatment (P<0.05). compared with the test1group and control group, test2group’ reduce was obvious (P <0.01)（.4）After treating, the blood fat TC, TG,LDL-C level and serum CRP, Hcy, VEGF, Fib level in each group is dropthan before the treatment (P＜0.05), the test2group decline morepronounced and has a significant difference (P <0.05).(5) During the entiretreatment, there was no adverse effect. Conclusion:(1)By Yiqi qufengtongluo therapy can significantly reduce carotid artery lesions of thehypertension carotid atherosclerosis in rabbits. The mechanism may beassociated with decreasing the serum TG, TC, LDL-C, and inflammatoryfactors contents of CRP, Hcy, restrain the expression of NF-κB, ICAM-1onthe carotid artery.(2)The therapy can significantly improve the symptom ofhypertension carotid atherosclerosis in patients,such as headache, dizziness,head wrap, general lassitude. Regulation of blood lipid and reduced serumCRP, Hcy, VEGF, Fib levels, reduced the carotid artery IMT and total pointsof plaque in patients, and effect more pronounced of clinical efficacycombined with simvastatin.