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Coronary microvascular dysfunction （CMD） is one of the important causes of myocardial ischemia and non-obstructive coronary artery ischemic symptoms. However， effective diagnostic methods and targeted treatment strategies for CMD are currently lacking. According to traditional Chinese medicine （TCM）， the comorbidity theory of "blood-vessel-cardiac collaterals" plays a central role throughout the entire development process of CMD. It suggests that in the clinical diagnosis and treatment of CMD， the treatment of blood， vessels， and cardiac collaterals should not be neglected. In light of this， insect medicines， known for their efficacy in promoting blood circulation， resolving stasis， and alleviating spasms， hold promise as a potential treatment for CMD. However， there is currently no research or summary on the use of insect medicines for the treatment of CMD. Therefore， this article took the comorbidity theory of "blood-vessel-cardiac collaterals" as the starting point and divided the pathogenesis of CMD into five evolution stages： Beginning in the blood （changes in blood components and hemorheology）， progressing in the vessels （atheromatous plaque formation and unstable plaques）， occurring in the cardiac collaterals （microvascular endothelial damage and microvascular constriction and spasms）， ending in the cardiac collaterals （microvascular remodeling）， and resulting in energy metabolism disorders throughout the process， so as to explore the pathogenesis and evolution of CMD. In addition， based on the modern pharmacological research on insect medicines， this article discussed the clinical application of insect medicines in the treatment of CMD from four aspects： Promoting blood circulation and removing blood stasis to relieve vessels' obstruction， relieving spasms to alleviate pain， combating poison with poison to disperse stagnation， and tonifying cardiac collaterals to nourish the heart， which aims to provide a theoretical basis for the use of TCM in treating CMD， broaden the scope of medication， and improve clinical efficacy.
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Objective:To evaluate the effect of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine on ischemic stroke.Methods:Prospective cohort study. According to random number table method, 120 patients with ischemic stroke who met inclusion criteria in the hospital were divided into control group and treatment group, 60 in each group. The control group was given routine western medicine, while the treatment group was additionally given Banxia Baizhu Tianma Decoction and modified Buyang Huanwu Decoction. All were treated for 4 weeks. The severity of neurological deficits was evaluated by National Institute of Health Stroke Scale (NIHSS). The activities of daily living were evaluated by Barthel index. The high blood shear viscosity (HWBV), low blood shear viscosity (LWBV), plasma fibrinogen (FIB) and plasma viscosity (PV) were detected by full-automatic blood rheometer. The levels of MDA, SOD and NO were detected by ELISA. The clinical responsive rate was assessed.Results:The differences in total response rate between treatment group and control group were statistically significant [93.3% (56/60) vs. 75.0% (45/60), χ2=7.56, P=0.006]. After treatment, NIHSS score in treatment group was significantly lower than that in control group ( t=2.38, P=0.019), while Barthel index was significantly higher than that in control group ( t=13.28, P<0.01). After treatment, HWBV [(5.02±0.13) mPa?s vs. (6.18±0.28) mPa?s, t=29.11], LWBV [(1.18±0.21) mPa?s vs. (1.73±0.32) mPa?s, t=11.13], FIB [(2.26±0.28) g/L vs. (3.13±0.39) g/L, t=14.04] and PV [(8.87±1.44) mPa?s vs. (10.34±1.31) mPa?s, t=5.85] in treatment group were significantly lower than those in control group ( P<0.01), and the MDA [(4.14±1.23) mmol/L vs. (5.23±1.35) mmol/L, t=204.30] in treatment group was significantly lower than that in control group ( P<0.01), and levels of SOD [(113.34±0.28) mg/L vs. (96.59±0.57) mg/L, t=4.62] and NO [(26.01±3.26) μmol/L vs. (20.84±3.74) μmol/L, t=8.07] in treatment group were significantly higher than those in control group ( P<0.01). Conclusion:The Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine can repair nerve function, improve hemorheology, oxidative stress indexes, clinical curative effect and activities of daily living in patients with ischemic stroke.
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Objective:To investigate the clinical efficacy of alteplase combined with rosuvastatin calcium in the treatment of acute cerebral infarction.Methods:A total of 100 patients with acute cerebral infarction who received treatment in Zhejiang Xin'an International Hospital from October 2019 to October 2020 were included in this study. They were randomly assigned to undergo either rosuvastatin calcium (control group, n = 50) or alteplase combined with rosuvastatin calcium (study group, n = 50). The National Institute Health of Stroke Scale (NIHSS) score, serum viscosity, blood lipid change, and clinical efficacy were assessed before and after treatment. Results:Response rate was significantly higher in the study group than in the control group [90% (45/50) vs. 80% (40 /50), χ2 = 4.52, P < 0.05]. NIHSS score, soluble intercellular adhesion molecule-1 level, and soluble vascular cell adhesion molecule 1 level in the study group were (7.29 ± 1.46) points, (132.68 ± 15.20) μg/L, and (118.67 ± 112.60) μg/L, respectively, which were significantly lower than those in the control group [(11.47 ± 2.80) points, (189.22 ± 9.40) μg/L, (1 372.59±125.70) μg/L, t = 4.21, 3.21, 5.12, all P < 0.05]. Insulin-like growth factor 1 level was significantly higher in the study group than in the control group [(485.41 ± 51.30) μg/L vs. (364.23 ± 44.50) μg/L, t = 6.32, P < 0.05]. Total cholesterol and low density lipoprotein cholesterol levels in the study group were (3.29 ± 1.46) mmol/L and (3.04 ± 0.15) mmol/L, respectively, which were significantly lower than those in the control group [ (4.47 ± 2.80) mmol/L, (3.22 ± 0.41) mmol/L, t = 4.54, 3.87, both P < 0.05]. Conclusion:Alteplase combined with rosuvastatin calcium can greatly improve blood circulation, reduce blood viscosity, and restore neurological function in patients with acute cerebral infarction. This study is highly innovative and scientific.
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Objective:To investigate the clinical application effects of leukocyte-filtered blood transfusions.Methods:A total of 120 patients with massive bleeding who received transfusions of a large amount of blood in the First People's Hospital of Yongkang, China from January 2017 to December 2018 were included in this study. They were divided into a control group (even numbers) and an observation group (odd numbers) according to registration numbers. The control group was subjected to direct blood transfusion. The observation group was given leukocyte-filtered blood transfusions. Coagulation function index, hemorheological index, cellular immune function, immunoglobulin level, body temperature, and the incidence of febrile non-hemolytic transfusion reactions were compared between the two groups.Results:After blood transfusions, prothrombin time, activated partial thromboplastin time, thrombin time in the observation group were (12.39 ± 1.41) seconds, (26.84 ± 6.47) seconds, and (14.32 ± 3.14) seconds, which were significantly shorter than those in the control group [(15.54 ± 2.03) seconds, (34.23 ± 7.59) seconds, (20.98 ± 4.27) seconds, t = 9.872, 5.740, 9.733, all P < 0.05]. Hematocrit, erythrocyte sedimentation rate, and plasma viscosity in the observation group were (39.28 ± 2.17)%, (25.97 ± 4.10) mm/h, and (2.19 ± 0.45) mp·s respectively, and those in the control group were (34.64 ± 4.52)%, (21.85 ± 3.64) mm/h, and (1.76 ± 0.42) mp·s respectively. There were significant differences in these indices between the two groups ( t = 9.87, 5.74, 9.73, all P < 0.05). There were significant differences in CD 3+, CD 4/CD 8, immunoglobulin G, immunoglobulin A, and immunoglobulin M between before and after blood transfusions in the control group ( t = 5.99, 5.91, 5.77, 5.80, 5.85, all P < 0.05). There were no significant differences in these indices between before and after blood transfusions in the observation group (all P > 0.05). After blood transfusions, body temperature was significantly lower in the observation group than in the control group [(36.58 ± 0.50) ℃ vs. (37.16±0.57)℃, t = 5.95, P < 0.05]. The incidence of febrile non-hemolytic transfusion reactions was significantly lower in the observation group than in the control group (1.67% vs. 13.33%, χ2 = 5.88, P < 0.05). Conclusion:Leukocyte-filtered blood transfusions can effectively restore the patient's body temperature to normal, improve coagulation function index and hemorheological index, reduce the impact of blood transfusions on the patient's immune function, and reduce febrile non-hemolytic transfusion reactions.
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Objective:To investigate the effects of Buqi Huayu Tongluo recipe combined with quantitative rehabilitation training on upper extremity motor function and hemorheology in patients with post-stroke shoulder-hand syndrome. Methods:A total of 100 patients with post-stroke shoulder-hand syndrome who received treatment in Shengzhou Hospital of Traditional Chinese Medicine from January 2017 to December 2019 were included in this study. They were randomly divided into control ( n = 56) and study ( n = 44) groups. The control group was given routine drugs and quantitative rehabilitation training, and the study group was given Buqi Huatan Tongluo recipe combined with quantitative rehabilitation training based on the intervention applied to the control group. Before and after treatment, upper limb motor function and hemorpheology indexes were compared between the two groups. Results:Time to improvement in shoulder pain, wrist redness, swelling and thermal pain, limited wrist mobility and limited finger flexion in the study group was (3.44 ± 1.14) weeks, (2.96 ± 1.01) weeks, (3.38 ± 1.08) weeks, (3.76 ± 1.24) weeks, respectively, which were significantly shorter than (4.38 ± 1.19) weeks, (4.87 ± 1.26) weeks, (4.81 ± 1.04) weeks, (3.56 ± 1.05) weeks in the control group ( t = 3.99, 2.88, 6.71, 4.40, all P < 0.05). After treatment, Fugl-Meyer Assessment score in the study group was significantly higher than that in the control group [(50.47 ± 11.38) points vs. (42.21 ± 12.54) points, t = 2.94, P < 0.05). After treatment, plasma viscosity, hematocrit and platelet aggregation rate in the study group were (1.43 ± 0.15) mPa/s, (40.27 ± 3.12)%, (55.82 ± 3.30)%, which were significantly lower than (1.70 ± 0.14) mPa/s, (44.27 ± 3.49)%, (63.67 ± 4.29)% in the control group ( t = 7.80, 5.04 ,8.88, all P < 0.05). Conclusion:Buqi Huayu Tongluo recipe combined with quantitative rehabilitation training is highly effective on post-stroke shoulder-hand syndrome. The combined therapy can promote the improvement in clinical symptoms, accelerate the recovery of upper limb motor function, and improve hemorheology.
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Objective:To investigate the effects of deafness capsule combined with vinpocetine injection on hearing function, hemorheology and T lymphocyte subsets in patients with sudden deafness.Methods:Eighty patients with sudden deafness who received treatment in Wenzhou Central Hospital from April 2017 to October 2019 were included in this study. They were randomly assigned to undergo treatment either with vinpocetine injection (control group, n = 40) or with deafness capsule combined with vinpocetine injection (observation group, n = 40) for 1 month. Efficacy, hearing function, hemorheology, T lymphocyte subsets and adverse reactions were compared between the control and observation groups. Results:Total response rate in the observation group was significantly higher than that in the control group [90.00% (36/40) vs. 67.50% (27/40), χ2 = 6.050, P = 0.014). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). After 1 month of treatment, plasma viscosity, high-shear whole blood viscosity, low-shear whole blood viscosity in the observation group were (1.21 ± 0.29) mPa·s, (2.41 ± 0.31) mPa·s, (5.25 ± 1.29) mPa·s respectively, which were significantly lower than those in the control group [(1.65 ± 0.22) mPa·s, (4.94 ± 0.36) mPa·s, (8.64 ± 1.32) mPa·s, t = 7.64, 33.68, 11.61, all P < 0.001). The percentages of CD 8+, CD 4+, and CD 4+/CD 8+ T lymphocyte subsets in the observation group were (24.28 ± 2.16)%, (46.05 ± 6.52)% and (1.90 ± 0.28) respectively, and they were (27.41 ± 2.09)%, (40.54 ± 5.48)%, (1.48 ± 0.24) respectively in the control group ( t = 6.58, 4.09, 7.20, all P < 0.001). Pure tone threshold in the observation group was significantly lower than that in the control group [(38.07 ± 4.82) dB vs. (51.97 ± 5.96) dB, t = 11.46, P < 0.001). Conclusion:Deafness capsule combined with vinpocetine injection is highly effective on sudden deafness. The combined therapy can improve the hearing function, hemorheology, and the immunological function of T lymphocyte subsets in patients with sudden deafness.
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AIM: To explore the efficacy of Danshen injection iontophoresis in the treatment of retinal vein occlusion(RVO).METHODS: The clinical data of 90 patients(90 eyes)with RVO treated in our hospital from January 2020 to December 2021 were analyzed retrospectively, and they were divided into control group and observation group according to treatment methods. A total of 38 patients(38 eyes)in the control group were treated with intravenous Xueshuantong+oral compound Xueshuantong capsule+enteric-coated aspirin, and 52 patients(52 eyes)in the observation group were treated with Danshen injection iontophoresis on this basis. The treatment time of the two groups was 3mo. The clinical efficacy, best corrected visual acuity, retinal condition and hemorheological indexes(whole blood low shear viscosity, fibrinogen)were compared between the two groups before and after treatment.RESULTS: The total effective rate of the observation group was significantly higher than that in the control group(87% vs 58%,P<0.05)at 3mo after treatment. The best corrected visual acuity in both groups was better than that before treatment, and the observation group was better than the control group(all P<0.05).The circulation time of retinal vein, the relative diameter of retinal vein and the relative area of retinal hemorrhage in the observation group were lower than those before treatment,and the observation group was lower than the control group(all P<0.05). The whole blood low shear viscosity and fibrinogen levels in the two groups were lower than those before treatment, and the observation group was lower than those in the control group(all P<0.05).CONCLUSION: Danshen injection iontophoresis is effective in the treatment of patients with RVO, which can effectively improve the visual acuity, treat fundus lesions and improve the abnormal blood flow.
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@#AIM: To explore the effects of ranibizumab and conbercept combined with photodynamic therapy(PDT)on vision and hemorheology of polypoid choroidal vascular(PCV)lesions. <p>METHODS: Prospective research. A total of 120(120 eyes)PCV patients who were admitted to our hospital from 2017-02/2020-06 were enrolled and divided into 61 cases(61 eyes)in the ranibizumab combined with PDT treatment group according to the random number table. Conbercept combined with PDT treatment group of 59 patients(59 eyes), compared the intraocular pressure, best corrected visual acuity(BCVA), central retinal thickness(CRT), blood flow, and the incidence of complications within 3mo of follow-up between the two groups before and after treatment.<p>RESULTS: There was no difference in intraocular pressure, CRT, and BCVA at 1 and 3mo after treatment between the two groups(all <i>P</i>>0.05). The whole blood high shear viscosity and whole blood of the ranibizumab combined with PDT treatment group were 1 and 3mo after treatment. The low-shear viscosity was lower than the conbercept combined with PDT treatment group(all <i>P</i><0.05). At the same time, the complication rate in the ranibizumab combined with PDT treatment group during the follow-up period of 3mo was lower than that in the conbercept combined with PDT treatment group(3.3% <i>vs</i> 16.9%, <i>P</i><0.05). <p>CONCLUSION: The treatment of ranibizumab combined with PDT for patients with PCV disease is more conducive to hemorheological stability and reduces the incidence of complications.
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Objective:To investigate Shenqi Fuzheng Injection combined with nimodipine in the treatment of convalescent-phase cerebral infarction and its effects on neurocognitive function, hemorheology and T cell subsets. Methods:A total of 108 patients with cerebral infarction in the convalescent phase who received treatment in Hangzhou Hospital of Traditional Chinese Medicine, China between April 2016 and December 2019 were included in this study. They were randomly assigned to receive either nimodipine treatment (control group, n = 54) or treatment with Shenqi Fuzheng Injection combined with nimodipine (study group, n = 54). Curative effects and changes in neurocognitive function, hemorheology and T cell subsets after treatment relative to before treatment were compared between the control and study groups. Results:Total effective rate in the study group was significantly higher than that in the control group [90.74% (49/54) vs. 75.93% (41/54), χ2 = 4.267, P = 0.039]. After 2 weeks of treatment, whole blood viscosity at a high shear rate, whole blood viscosity at a low shear rate, plasma viscosity in the study group were (4.17 ± 0.24) mPa/s, (9.27 ± 1.98) mPa/s, (1.07 ± 0.19) mPa/s, respectively, which were significantly lower than those in the control group [(4.52 ± 0.31) mPa/s, (13.69 ± 2.13) mPa/s, (1.34 ± 0.23) mPa/s, t = 6.560, 11.169, 6.651, all P < 0.05]. The proportion of CD 3+ cells, CD 4+ and CD 4+/CD 8+ in the study group was (48.59 ± 4.59) %, (44.24 ± 6.17) % and (1.91 ± 0.17) respectively, which were significantly higher than those in the control group [(44.97 ± 5.31) %, (39.55 ± 5.13) %, (1.47 ± 0.22), t = 3.790, 4.295, 11.629, all P < 0.05]. The proportion of CD 8+ cells in the study group was significantly lower than that in the control group [(23.13 ± 5.62) % vs. (26.97 ± 4.26) %, t = 4.001, P < 0.05]. Mini-Mental State Examination score in the study group was significantly higher than that in the control group [(28.87 ± 0.85) points vs. (27.91 ± 1.45) points, t = 4.197, P < 0.05]. National Institute Health of Stroke Scale score in the study group was significantly lower than that in the control group [(9.63 ± 2.19) points vs. (15.27 ± 1.97) points, t = 14.070, P < 0.05]. Conclusion:Shenqi Fuzheng Injection combined with nimodipine can remarkably improve the neurocognitive function, hemorheology and T cell subsets in patients with cerebral infarction in the convalescent phase. The combined method is safe and reliable, and its curative effect is stable.
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Objective:To investigate the efficacy of acupuncture combined with rehabilitation training in the treatment of cervical spondylotic radiculopathy and its effects on hemodynamics and cervical range of motion.Methods:A total of 120 patients with cervical spondylotic radiculopathy who received treatment in Ningbo Zhenhai District People's Hospital,China between February 2018 and February 2020 were included in this study. They were randomly assigned to receive either rehabilitation treatment alone, including cervical traction and functional exercise (control group, n = 60) or acupuncture + rehabilitation treatment (observation group, n = 60) for 4 weeks. Therapeutic efficacy, Visual Analog Scale score, Clinical Assessment Scale for Cervical Spondylosis score and Chinese Stroke Scale score, hemodynamics of basilar arteries (peak systolic velocity, mean flow velocity and resistance index) and cervical range of motion were compared between the two groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [91.67% (55/60) vs. 73.33% (44/60), χ2 = 6.984, P < 0.05]. Visual Analog Scale score and Chinese Stroke Scale score in the observation group were (1.48 ± 0.39) points and (10.53 ± 1.83) points, respectively, which were significantly lower than those in the control group [(2.30 ± 0.48) points, (13.26 ± 1.96) points, t = 10.270, 7.886]. The Clinical Assessment Scale for Cervical Spondylosis score in the observation group was significantly higher than that in the control group [(92.09 ± 5.42) points vs. (83.21 ± 3.78) points, t = 10.409, P < 0.05)]. After treatment, peak systolic velocity and mean flow velocity in the observation group were (67.18 ± 5.27) cm/s and (26.75 ± 3.02) cm/s, respectively, which were significantly higher than those in the control group [(56.01 ± 6.34) cm/s, (20.93 ± 2.87) cm/s, t = 10.495, 10.821, both P < 0.05]. Resistance index in the observation group was significantly lower than that in the control group [(0.72 ± 0.15) vs. (0.98 ± 0.17), t = 8.883, P < 0.05). After treatment, the ranges of cervical flexion, extension, left rotation and right rotation motions in the observation group were (45.68 ± 3.27) °, (48.26 ± 2.26) °, (74.01 ± 5.48) ° and (75.83 ± 4.89) °, respectively, which were significantly higher than those in the control group [(40.83 ± 2.16) °, (42.70 ± 2.80) °, (63.78 ± 4.29) ° and (66.58 ± 4.36) °, t = 9.586, 11.969, 11.386, 10.937, all P < 0.05). Conclusion:Acupuncture combined with rehabilitation training is effective in the treatment of cervical spondylotic radiculopathy because it can improve the hemodynamic index and cervical range of motion.
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Objective:To investigate the effects of a loading dose of clopidogrel hydrogen sulfate on hemorheology and neurological function in patients with acute progressive cerebral infarction.Methods:A total of 110 patients with acute progressive cerebral infarction who received treatment between January 2018 and January 2019 in the Affiliated Hospital of Shaoxing University, China were included in this study. They were randomly assigned to receive either conventional treatment (control group, n = 55) or treatment with a loading dose of clopidogrel hydrogen sulfate based on conventional treatment (study group, n = 55) for 2 weeks. Hemorheological parameters, National Institute Health of Stroke Scale (NIHSS) scores and adverse reactions were compared between the study and control groups. Results:After treatment, the levels of hemorheological parameters in both groups were obviously decreased. Plasma viscosity, high-shear whole blood viscosity, low-shear whole blood viscosity, fibrinogen level and hematocrit in the study group were (1.01± 0.37) mPa/s, (4.23 ± 0.35) mPa/s, (8.36 ± 1.64) mPa/s, (1.23 ± 0.28) g/L, (40.08 ± 5.04) %, respectively, which were significantly lower than those in the control group [(1.84 ± 0.52) mPa/s, (5.44 ± 0.39) mPa/s, (10.54 ± 1.79) mPa/s, (2.30 ± 0.37) g/L, (44.36 ± 5.12) %, t = 5.485, 8.594, 9.523, 7.789, 11.236, P = 0.019, 0.006, 0.004, 0.007, 0.001]. After treatment, NIHSS scores in the study group were significantly lower than those in the control group [(3.11 ± 1.17) points vs. (6.43 ± 2.25) points, t = 10.416, P = 0.003). There was no significant difference in the incidence of adverse reactions between study and control groups [5.45% (3/55) vs. 9.09% (5/55), χ2 = 0.539, P = 0.463). Conclusion:The loading dose of clopidogrel hydrogen sulfate is highly effective in the treatment of acute progressive cerebral infarction and it can greatly improve hemorheological parameters and neurological function.
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Objective:To investigate the clinical efficacy of alprostadil injection in the treatment of acute cerebral infarction.Methods:A total of 300 patients with acute cerebral infarction who received treatment in The First People's Hospital of Jiashan, China between August 2016 and August 2018 were included in this study. They were randomly divided into a control group and an observation group ( n = 150/group). Based on conventional treatment, patients in the control group received Xueshuantong power injection treatment and those in the observation group received alprostadil injection treatment. All patients were treated for 14 days. Clinical efficacy was compared between the control and observation groups. Results:In the observation group, infarct volume, plaque area, lumen area, intima-media thickness of the common carotid artery, Crouse score, recanalization rate, Barthel Index, National Institutes of Health Stroke Scale (NIHSS) score, hematocrit and plasma viscosity in the observation group were (3.16 ± 1.19) cm 3, (0.21 ± 0.05) mm 2, (0.30 ± 0.06) mm 2, (1.05 ± 0.23) mm, (2.18 ± 0.61) points, 98.67% (148/150), (96.38 ± 1.75) points, (6.31 ± 1.08) points, (41.03 ± 4.28)%, (1.12 ± 0.03) mPa/s, respectively, which were superior to those in the control group [ (2.25 ± 1.37) cm 3, (0.68 ± 0.46) mm 2, (0.89 ± 0.54) mm 2, (1.76 ± 0.85) mm, (3.29 ± 0.78) points, 72.00% (108/150), (85.22 ± 1.56) points, (10.18 ± 1.43) points, (50.76 ± 5.31)%, (1.54 ± 0.34) mPa/s, t = 1.869, 1.231, 1.452, 1.326, 2.285, χ2 = 12.528, t = 11.428, 4.28, 17.473, 15.071, all P < 0.05]. Conclusion:Based on conventional treatment, alprostadil injection exhibits good clinical efficacy in the treatment of acute cerebral infarction.
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Objective:To observe the efficacy of addition and subtraction therapy of Danshenyin combined with Wendantang in the treatment to stable angina pectoris （SAP） with stagnation of phlegm and blood stasis， and to explore its protection mechanism for myocardial ischemia. Method:One hundred and thirty-two patients were randomly divided into control group and observation group equally. Finished the 63 cases study both in control group and observation group after dropout， loss of follow-up and withdrawal. Patients in control group and observation group got antianginal drugs and the treatment of drug therapy to control the risk factors. All patients were treated with anti-angina drugs and risk factors control drugs. Patients in control group got Danlou Tablets by oral administration， 5 tablets/time， 3 times/day. Patients in observation group got dispensing decoction pieces of Danshenyin and Wendantang 1 dose/day. The treatment continued for 3 months in both groups. Scores of angina attack were graded every week. Before and after treatment， electrocardiogram treadmill exercise test was made to evaluate myocardial ischemia of coronary heart disease， and scores of phlegm stasis block syndrome and Seattle Angina questionnaire （SAQ） were graded for TCM symptoms and quality of life. Levels of hemorheology index， interleukin-6 （IL-6）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， intercellular adhesion molecule-1 （ICAM-1）， Cystatin C （CysC）， homocysteine （Hcy）， ischemic modified albumin （IMA） and macrophage migration inhibitory factor were detected. In addition， safety was evaluated. Result:After treatment， scores of times， duration， degree of angina pectoris， nitroglycerin dosage of angina pectoris and nitroglycerin dosage in the observation group were lower than those in the control group （<italic>P</italic><0.01）. Total exercise time， duration of ST depression for 1.0 mm， occurrence time of stable angina pectoris， metabolic equivalent and scores of Duke in the observation group were more than those in the control group （<italic>P</italic><0.01）. Score of stagnation of phlegm and blood stasis in the observation group was lower than that in the control group （<italic>P</italic><0.01）， while score of SAQ was higher than that in the control group （<italic>P</italic><0.01）. Levels of IL-6， TNF-<italic>α</italic>， ICAM-1， CysC， IMA， Hcy， MIF， whole blood viscosity （low cut， high cut）， whole blood reducing viscosity， plasma viscosity， platelet aggregation rate and fibrinogen （FIB） in the observation group were lower than those in the control group （<italic>P</italic><0.01）. Effect of angina pectoris in observation group was superior to that in control group （<italic>Z</italic>=2.091， <italic>P</italic><0.01）. No adverse reactions related to Danshenyin combined with Wendantang were found. Conclusion:Addition and subtraction therapy of Danshenyin combined with Wendantang based on the routine western medicine treatment can control the attack of angina pectoris， relieve the symptoms of phlegm and stasis block syndrome， and improve the quality of life for patients with SAP， showing superior clinical efficacy and safety. In addition， it can improve the hemorheology of patients， inhibit the inflammatory reaction， reduce the stenosis or obstruction of lumen in order to improve the degree of myocardial ischemia.
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【Objective】 To explore the difference of Hemorheological characteristics and the oxygen content of tissue on different levels of hemoglobin(Hb) which were from Tibetan plateau. 【Methods】 Volunteers with different Hb levels living in Tibetan plateau and normal Hb levels living in plain were selected and divided into 4 groups according to their source areas and different Hb levels. Group A was set as the control group, while B、C and D were set as the experimental group. In group A, 25 cases, who were required to live in plateau with Hb [male: (120~185)g·L-1, female: (115~165)g·L-1]. Group B: 17 cases, required habitat plateau with Hb [male: (185~210)g·L-1, female: (165~190)g·L-1]. In group C, 13 cases, who were required to live in plateau with Hb (male: >210 g·L-1, female: >190 g·L-1). Group D: 25 cases, who were required to live in plain with Hb [male: (120~185)g·L-1, female: (115~165)g·L-1]. 10mL of Venous blood was collected from each case, these blood samples were be tested for blood routine, hemorheology, tissue oxygen supply index, coagulation function and ATP content in erythrocyte, P50, 2, 3-DPG. 【Results】 Compared with group A, erythrocyte deformability index(TK) of group C decreased (P<0.05), while there was no significant difference between group B and D (P>0.05). Compared with group A, the blood shear rate 1 s-1, 5 s-1, and 200 s-1 of tissue oxygen supply index of group C decreased (P<0.05), the blood shear rate 50 s-1, 100 s-1 and 200 s-1of tissue oxygen supply index of group D increased (P<0.05), while there was no statistically significant difference in the blood shear rate 1 s-1, 5 s-1, 50 s-1, 100 s-1 and 200 s-1of tissue oxygen supply index of group B (P>0.05). There was no statistically significant difference in ATP, P50 and 2, 3-DPG of red blood cells among all groups(P>0.05). 【Conclusion】 In the plateau population, The tissue oxygen supply in patient with polycythemia was significantly lower than the people with normal Hb level. The tissue oxygen supply in the plain normal population was significantly higher than that in the plateau normal population.
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Objective:To observe the clinical efficacy of Jiwei Huangqi Guizhi Wuwutang combined with Xingnao Kaiqiao acupuncture on shouder-hand syndrome (SHS), and its effect on neurogenic inflammatory factors and hemorheology. Method:One hundred and forty-eight patients were randomly divided into control group and observation group (74 cases). Both groups' patients got rehabilitation measures, such as diclofenac sodium sustained release tablets for two to four weeks, 75 min/time, 1 time/day, and patients with apparent swelling got prednisone acetate tablets for one to two weeks, 10 min/time, 1 time/day. And patients in control group got Xingnao Kaiqiao acupuncture, 1 time/day, 6 times/week. Control grouporal Naoxintong capsule 4 tablets/time,3 times/day, patients in observation group were added with Jiwei Huangqi Guizhi Wuwutang, 1 dose/day. The courses of treatment were 4 weeks. Before and after treatment, shoulder hand syndrome scale (SHSS), the upperextremities of the Fugl-meyer movement assessment (U-FMA), ability of daily life activities (ADL), Qi deficiency and blood stasis syndrome and clinical efficacy were scored, disappearing time of pain and swelling were recorded, and levels of calcitonin gene related peptide (CGRP), substance P (SP), bradykinin (BK) and hemorheology were detected. Result:The clinical efficacy in observation group was better than that in control group (Z=2.106, P<0.05). And scores of sensory, autonomic, motion according to SHSS scale and the total scale of SHSS were all lower than those in control group (P<0.01). Disappearing time of pain and swelling were shorten than those in control group (P<0.01). After treatment, scores of U-FMA and ADL were higher than those in control group (P<0.01), while score of syndrome of Qi deficiency and blood stasis was lower than that in control group (P<0.01). And level CGRP was higher than that in control group (P<0.01), and levels of SP and BK were lower than those in control group (P<0.01). After treatment, whole blood viscosity (high cut, low cut), plasma viscosity, fibrinogen and platelet aggregation rate were all lower than those in control group (P<0.05). Conclusion:In addition to the conventional western medicine therapy, Jiwei Huangqi Guizhi Wuwutang combined with Xingnao Kaiqiao acupuncture can reduce the severity of SHS and clinical syndromes of traditional Chinese medicine, shorten the course of disease, improve the motor function of upper limbs, inhibit the neurogenic inflammatory reaction, and improve the blood flow, the ability of daily life and the clinical efficacy of patients..
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Objective:To observe the effects of adjuvant therapy of Huayu pills on neurological recovery of patients with acute cerebral infarction (ACI) and syndrome of Qi deficiency and blood stasis, and to investigate its mechanism of action for antioxidation, anti-inflammation and improvement of microcirculation. Method:One hundred and forty patients were randomly divided into control group (70 cases) and observation group (70 cases) by random number table. During the study period, there were 3 drop-out cases, 2 excluded cases, and 65 completed cases in the control group. There were 1 drop-out cases, 4 excluded case, and 65 completed cases in the observation group. Western medicine was given in both groups. Patients in control group additionally got oral administration of Xiaoshuang Tongluo tablets, 6 tablets/time, 3 times/day. The patients in observation group got oral administration of Huayu pills, 5 g/time, 2 times/days. The treatment course was 4 weeks in both groups. Before the treatment, and at the second and fourth week after treatment, scores of national institute of health stroke scale (NIHSS) were graded. Before and after treatment, scores of functional independent measures (FIM) scale, fugl-meyer assessment of motor function (FMA), Qi deficiency and blood stasis syndrome were graded. Disability/mortality and safety were discussed after treatment. Levels of the whole blood viscosity (BV), plasma viscosity (PV), platelet aggregation rate (PAG), fibrinogen (FIB), P-selectin (CD62p), D-dimer (D-D), superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), lipid peroxide (PLO), homocysteine (Hcy), tumor necrosis factor -α (TNF-α), serum cystatin C (Cys-C) and hypersensitive C-reactive protein (hs-CRP) were detected both before and after treatment. Result:In the analysis of rank sum test, clinical efficacy in observation group was better than that in control group (Z=2.131, P<0.05). At the second and fourth week after treatment, scores of NIHSS, Qi deficiency and blood stasis, as well as levels of NO, PLO, MDA, Hcy, Cys-C, hs-CRP, TNF-α, BV, PV, PAG, FIB, CD62 p and D-D in observation group were lower than those in control group (P<0.01), while levels of FIM, FMA and SOD were all higher than those in control group (P<0.01). Conclusion:Based on the comprehensive treatment of Western medicine, adjuvant therapy of Huayu pills can improve the degree of nerve function defect, improve the ability of exercise and daily life, reduce the degree of disability, improve the microcirculation and hemorheology, reduce the inflammatory reaction, eliminate oxygen free radicals, and relieve the oxidative stress injury in patients with ACI and Qi deficiency and blood stasis syndrome, and the clinical efficacy is better than that of Western medicine alone.
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Objective:To discuss the effect of Arisaema Rhizoma and Pinelliae Pedatisectae Rhizoma on water metabolism and hemorheolog in rats. Method:A total of 50 healthy SD rats were randomly divided into 5 groups, namely normal group, high-dose Arisaema Rhizoma group (1.2 g·kg·d-1), low-dose Arisaema Rhizoma group (1.2 g·kg·d-1), high-dose Pinelliae Pedatisectae Rhizoma group (1.2 g·kg·d-1) and low dose Pinelliae Pedatisectae Rhizoma group (0.3 g·kg·d-1), with 10 rats in each group. The effects of Arisaema Rhizoma and Pinelliae Pedatisectae Rhizoma on water metabolism and hemorheology were compared, with the micturition index, fecal volume, fecal water content, pathological morphology of submandibular gland, aquaporin (AQP2) content in kidney, adenosine cyclic 3′,5′-(hydrogen phosphate)/current good manufacture practices (cAMP/cGMP) and Na+-K+-ATP enzyme content in serum as the evaluation indexes of water metabolism, and the whole blood viscosity (WBV) and erythrocyte aggregation index (RE) as the evaluation indexes of hemorheolog. Result:Compared with normal group, the fecal volume, fecal water content and AQP2 expression decreased significantly， acinus of submandibular gland were atrophied， micturition index, cAMP/cGMP and Na+-K+-ATP enzyme content in serum were increased significantly， WBV and RE were increased significantly in high-dose Arisaema Rhizoma and Pinelliae Pedatisectae Rhizoma groups（P<0.05）, but with no significant difference between them. Conclusion:High-dose Arisaema Rhizoma and Pinelliae Pedatisectae Rhizoma groups had significant effects on water metabolism and hemorheology in rats, suggesting that attention shall be given to the safety of Arisaema Rhizoma and Pinelliae Pedatisectae Rhizoma. And this study provides a theoretical basis for the rational use of the two traditional Chinese medicines in clinic.
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Objective:To observe the changes of myocardial microvessel density， microvascular endothelial cell morphology and hemorheology in ovariectomized rats and explore the interventional effects of Erxian decoction. Method:Thirty-two healthy 10 week-old female SPF SD rats were randomly divided into sham operation group， model group， estrogen group （estradiol valerate， 0.18 mg·kg-1） and Erxian decoction group （9 g·kg-1）. The rats were intragastrically administered 2 weeks after ovariectomy， once a day for 16 weeks. Sham operation groups and model groups were given equal volumes of purified water. After 16 weeks of administration， the cardiac function was measured by noninvasive ultrasound cardiogram （UCG）， CD34 in the myocardial tissue was tested by immunofluorescence staining to measure the microvessel density， the morphological structure of microvessels of myocardial tissue were detected by transmission electron microscope， the levels of estrogen （E2） in rat plasma were detected by radioimmunoassay， the levels of endothelin-1 （ET-1）， prostacyclin I2 （PGI2）， thromboxane A2 （TXA2）， endothelial growth factor （VEGF）， and von Willebrand Factor （vWF） in rat plasma were detected by enzyme-linked immuno sorbent assay （ELISA）， four items of coagulation was detected by blood coagulation analyzer， whole blood viscosity and plasma viscosity were detected by hemorheology. Result:Compared with sham operation group， the ejection fraction （EF） decreased （P<0.01）， the left ventricular short axis shortening rate （FS） decreased （P<0.01）， and the left ventricular end systolic volume （LVVols） increased （P<0.01）， myocardial microvessel density significantly reduced （P<0.01）， the endothelial cells were swollen and the cytoplasm was cavitation， E2 in rat plasma decreased （P<0.01）， ET-1， VEGF， vWF increased （P<0.01）， prostacyclin I2 /thromboxane A2 （PGI2/TXA2） decreased （P<0.01）， plasma activated partial prothrombin time （APTT） decreased （P<0.01）， fibrinogen （FIB） increased （P<0.01）， whole blood viscosity， plasma viscosity， and cassone viscosity increased （P<0.01）， whole blood high-cut， low-cut index， and red blood cell （RBC） aggregation index increased （P<0.05） in model group. Compared with model group， EF and FS increased （P<0.05）， LVVols decreased （P<0.05）， myocardial microvessel density significantly increased （P<0.01）， the endothelial cell edema was improved， and transport vesicles were clearly visible， E2 in rat plasma increased （P<0.01）， ET-1， VEGF， decreased （P<0.01）， PGI2/TXA2 increased （P<0.01）， APTT increased （P<0.01）， whole blood viscosity， whole blood high shear relative index， RBC aggregation index decreased （P<0.05）， Kasson viscosity and plasma viscosity decreased （P<0.01） in Erxian decoction group. Conclusion:Erxian decoction increases myocardial microvessel density， protects the structural integrity of microvascular endothelial cells， improves its endothelial secretion function and hemorheology in ovariectomized rats， and protects heart function.
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AIM:To explore effect and meaning of Agkistrodon halys venom platelet inhibitor on GPVI expression and hemorheology in rats with acute myocardial ischemia reperfusion injury. METHODS: Thirty matched SD male rats were randomly divided into sham operation group (6 rats), myocardial ischemia-reperfusion injury(MIRI) model group(6 rats) and agkistrodon halys venom platelet inhibitor (AHV-PI) group(18 rats). The AHV-PI experimental group was divided into low, middle and high dose groups according to the dose of AHV-PI injected into sublingual vein (0.05, 0.1, 0.2 mg/kg), with 6 rats in each group. Electrocardiogram(ECG) changes of rats were monitored by RM6240 biological signal collection and processing system. Western blot was used to monitor the expression of platelet membrane glycoprotein VI (GPVI) in rats under the intervention of AHV-PI. Blood coagulation time (R), blood clots forming time (K), Alpha Angle (A), and maximum amplitude of blood coagulation (MA) were assayed by Thrombelastography (TEG5000).Platelet aggregation rate was measured by turbidimetry. RESULTS:Compared with MIRI model group, the expression level of GPVI AHV-PI medium dose experimental group and high dose experimental group were significantly decreased (P<0.05), and the R and K values were significantly prolonged, while the A value and MA values were significantly decreased (P<0.05). Platelet aggregation time, aggregation amplitude and aggregation rate were significantly decreased (P<0.05). CONCLUSION: AHV-PI can significantly inhibit the expression of GPVI in MIRI rats and improve the hemorheological properties related to myocardial injury in rats, thus weakening the injury process.
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Objective: To evaluate the therapeutic effect of Toutongning Dropping Pills in the treatment of migraine in various experimental models. Methods: The experimental model of nitroglycerin-induced migraine in rats was used to observe the preventive effect of Toutongning Dropping Pills. The analgesic effect of Toutongning Dropping Pills was observed by chemical stimulation, thermal stimulation in mice, mechanical stimulation and formalin stimulation in rats. The sedative effect of Toutongning Dropping Pills was observed by using the mice convulsion model induced by strychnine nitrate and the model of spontaneous activity in normal mice. The blood-activating effects of Toutongning Dropping Pills were observed in rats with hyperviscosity and mice with microcirculation disorder. Results: Five days after Toutongning Dropping Pills were given, compared with the model group, 1 g/kg and 2 g/kg drug dose group significantly reduced the number of climbing cage and scratching head in migraine rats, and shortened the fading time of pink ears. Toutongning Dropping Pills 1.5 g/kg and 3 g/kg dose group significantly reduced the number of writhing induced by acetic acid in mice; While it had no obvious effect on the thermal stimulation model. Toutongning Dropping Pills 1 g/kg and 2 g/kg dose group could significantly improve pain threshold of the mechanical stimulation of rats, and shorten the phase II time of formalin pain in rats; 1.5 g/kg and 3 g/kg drug dose group could significantly prolong the incubation period of convulsion and reduce the number of spontaneous activities in mice; 0.5 g/kg and 1 g/kg and 2 g /kg drug dose group significantly inhibited the increase of whole blood viscosity in rats; 1.5 g/kg and 3 g/kg drug dose group significantly improved the blood flow pattern in mice, reduced erythrocyte aggregation, and increased the number of capillary intersection points. Conclusion: Toutongning Dropping Pills have obvious analgesic, sedative, blood-activating functions, and have therapeutic effects on experimental migraine.