Effects Of Optimal Prescription Of Jiashen On Myocardial Infarction And Cardiac Function With The Suppression Of Inflammatory Response

With the development of economy and society in China,the lifestyle of Chinesehave been changing.Then the incidence rate of coronary heart disease (CHD) isincreasingly raising. HF resulting from myocardial infarction (MI) have been acommon type. Heart failure (HF) is the end-result of the majority of angicardiopathy,which has a high prevalence rate and poor prognosis, and prones to result in maligantventricular arrhythmias and abrupt death.In2010, the survey of the AmericanEpidemiology showed the number of patients of HF was more than5.8million in theUnited States, and the number23million in the world. And the trend towardsincreasingly rise. Nowadays,it is believed that ventricular remodeling is the mainlypathological process of HF. Inflammatory factors play an important role via cascadereaction after MI, which can induce apoptosis among myocardial cells、collagendeposition and matrix degradation, that result in myocardial fibrosis and contribute tothe process of ventricular remodeling. Mononuclear macrophages are significantinflammatory infiltration cells, which mainly secrete multi-inflammatory factors, suchas tumor necrosis factor-a (TNF-a)、interleukin-lβ (IL-lβ) and so on. And monocytechemoattractant protein-1(MCP-1) promotes monocytes to immigrate the necrotic area,stimulate and secrete inflammatory factors, and mediate inflammation.Therefore,inhibiting ventricular remodeling is the key to the treatment of MI at present.And to probe the action of inflammation response in the progress of ventricularremodeling is of great significance in the aspect of prevention and treatment of MI.The treatment of MI with traditional Chinese medicine has some advantages, such asmulti-channel and multi-targated intervention of diseases,the low side effects and soon. At present, the study of TCM on the treatment of MI are mainly designed toevaluate the clinical curative effects,but the research of the medical mechanism needfuther investigation. Therefore,in the study of the treatment of MI,it is of importanceto probe the mechanism of TCM in the aspect of HF intervention with TCM.In the TCM theory, the basic pathogenesis after MI is the root of asthenia type and the tip of sthenia type.The former mainly shows qi deficiency (yang deficiency)and yin deficiency,and the latter blood stasis and exuberance of turbid phlegm.Thestudy explores TCM,especially qi-tonifying medicine and blood-activating andstasis-resolving medicine. Jiashen Optimal Medicine is experiential prescription of anold noted physician on the treatment of CHF, which has significant clinical curativeeffects on xinqi-tonifying,blood-activating and stasis-resolving. By clinical andenperimental optima,the prescription consists of Xiangjia pi and Sanqi. Thepre-clinical study in the early stage shows that Jiashen Medicine can regulateendocrine,resist hypoxia and improve cardiac function.On the basis of the earlystudy,it should be futher explored the action mechanism of Jiashen Optimal Medicineinterferes ventricular remodeling after MI in the aspect of inflammatory response. Andwe should deeper investigate effects of Jiashen Optimal Medicine on ventricularremodeling and myocardial TNF-a、 IL-lβ and MCP-1expression in rats withmyocardial infarction, in order to provide experimental evidence of the medicalmechanism and the clinical application on the defence of MI with TCM.Objective: To evaluate effects of Jiashen Optimal Medicine on Infarction sideand the myocardial IL-lβ and MCP-1expressionon post-MI rats,and to probe themedicine partial mechanism on the treatment of MI.Methods:One hundred healthy SPF male SD rats were randomly divided intothe operated group(n=70), the sham-operated group(n=15) and the normal controlgroup(n=15). The operated group was induced by left anterior descending coronaryartery liation; The sham-operated group underwent the same method, but the suturewas not tied; And the normal group was not deal with.53surviwed to the first dayafter MI were randomly divided into four groups: The model group(n=15), two groupsof Jiashen Optimal Medicine (3g/kg,n=13;6g/kg,n=12), the losartan group (n=13). Themedicine-treated groups were administrated drugs by intragastrical perfusion once aday, and the normal group、the sham-operated group and the model group wereadministrated equivalent pure water by the same method. Then we observed generalcondition of all of rats such as activity、diet、pelage and so on. The double stainingmethod0f Even’s Blue and TTC was used to determine the MI size for5rats in everygroup. After one week, the rats were weighed by the electronic scale and examined byColor Doppler Ultrasound. Then we collected specimen. The expression of TNF-a、IL-lβ and MCP-1in myocardium was measured by enzymeimmunoassay. Results: The method of left anterior descending coronary artery liation cansucceed in duplicating the MI model,and the model was well stable and stronglycomparable. By comparison with the model group, general condition、MI size andLVEF0f the rats improved in the medicine-treated groups. In the operated group, thelevel of TNF-a、IL-lβ and MCP-1was raised, and inflammatory factors of the modelgroup raised markdly; By comparison with the model group,the expression of TNF-a、IL-lβ and MCP-1down-regulated in the medicine-treated groups. And the high dosegroup of Jiashen Optimal Medicine and the losartan group were markdlydown-regulated. Compare the two groups with the sham-operated group, thestatistical significance was not obvious.Conclusions: Jiashen Optimal Medicine can reduce MI size and improvecardiac function on post-MI rats. The expression of TNF-a、IL-lβ and MCP-1inmyocardium up-regulated on post-MI rats; Jiashen Optimal Medicine candown-regulate the expression of inflammatory factors and mitigate inflammationresponse.Jiashen Optimal Medicine can improve cardiac function by mitigatinginflammation response.