Discussion On The Application Of "Stasis Toxin" Theory In The Diagnosis And Treatment Of Unstable Angina Pectoris From The Perspective Of Pro-inflammatory/Anti-inflammatory Balance

Coronary heart disease is a common cardiovascular disease.Unstable angina derived from coronary atherosclerotic plaque rupture and can result in chest pain under mild activity or resting state.Inflammation is one of the most important factors possibly causing atherosclerotic plaque rupture.The recent studies in traditional Chinese medicine(TCM)combined blood stasis theory with TCM understanding of "poison" evil,and the clinical characteristics of coronary heart disease in patients with unstable angina,putting forward the hypothesis"blood stasis causing poison" as the key to transformation of stable angina to unstable angina.Inspired with the conflict between vital energy and evil factors in the process of disease in TCM,the balance between pro-inflammatory factors and anti-inflammatory factors in patients with unstable angina pectoris are explored in our study.Therefore,we did a clinical research examining pro-inflammatory and anti-inflammatory factor equilibrium state in patients with unstable angina,expecting to revile the mechanism of "blood stasis causing poison" in unstable angina patients,as well as how vital energy and evil fluctuating in this process.Objective:to explore the equilibrium state of pro/anti-inflammatory factors in patients with unstable angina pectoris and the differences with patients with stable angina pectoris and healthy people.Methods:50 patients with unstable angina,50 patients with stable angina,50 cases of healthy people are included.The clinical basic situation,angina pectoris attack situation,toxic heat and blood stasis syndrome of TCM are observed.Measuring the blood glucose,total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)levels,and the serum levels of pro-inflammatory and anti-inflammatory factor equilibrium state,include:①pro-inflammatory factor hypersensitive c-reactive protein(hs-CRP),tumor necrosis factor a(TNF-α),interleukin 6(IL-6);② Anti-inflammatory factors:interleukin-10(IL-10),adiponectin;③ Inflammatory/anti-inflammatory factor balance:hs-CRP/IL-10,TNF-a/IL-10,IL-6/IL-10,hs-CRP/adiponectin,TNF-a/adiponectin,IL-6/adiponectin,(hs-CRP×TNF-α × IL-6)/(IL-10 × adiponectin).Results:The hs-CRP of unstable angina group and stable angina group was higher than that in the healthy group.The result of TNF-α shows that unstable angina group>stable angina group>healthy group.The difference is significant.Significant differences in the equilibrium state of inflammatory factors among the three groups have been observed in our study.Compared with patients with unstable angina pectoris,the ratio of pro/anti-inflammatory factors such as IL-6/IL-10 and TNF-α/adiponectin in patients with unstable angina pectoris was higher than that in patients of stability angina group.The difference was significant.Correlation between the TCM syndrome score and hs-CRP/IL-10,(hs-CRP X TNF-α ×IL-6)/(IL-10× adiponectin)is observed in our study.Conclusion:The ratio of pro/anti-inflammatory factors in patients with unstable angina is significantly increased,which indicates that there is a imbalance state of pro/anti-inflammatory factors in patients with unstable angina.And there is a correlation between the TCM syndrome and the imbalance of pro/anti-inflammatory factors in patients with unstable angina.