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Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of AS. The theory highlights that the occurrence and development of AS are closely related to abnormal lipid metabolism, with the essence of the pathological reaction caused by the invasion of lipids into arterial intima from plasma. Phlegm and blood stasis are physiologically homologous and subject to pathological co-existence. Phlegm-blood stasis correlation is the basic theory to explain the pathogenesis characteristics of CHD and has important guiding significance for revealing the mecha-nism of lipid infiltration of CHD. Phlegm is the pathological product of abnormal metabolism of Qi, blood, and body fluid, and a gene-ral summary of a series of abnormally expressed lipid substances. Among them, turbid phlegm invades the heart vessels, gradually accumulates, and condenses to achieve the qualitative change from "invisible pathogen" to "tangible pathogen", which corresponds to the mechanism of lipid migration and deposition in the intima of blood vessels, and is the starting factor of the disease. Blood stasis is the continuous development of phlegm, and it is a result of pathological states such as decreased blood fluidity, increased blood coagulation, and abnormal rheology. The fact that blood stasis caused by phlegm accords with the pathological process of "lipid abnormality-circulatory disturbance" and is the central link of the disease. Phlegm and blood stasis aggravate each other and lead to indissoluble cementation. The phlegm-blood stasis combination serves as common pathogen to trigger the disease, which is the inevitable outcome of the disease. Based on the phlegm-blood stasis correlation theory, the simultaneous treatment of phlegm and blood stasis is established. It is found that this therapy can simultaneously regulate blood lipid, reduce blood viscosity, and improve blood circulation, which can fundamentally cut off the biological material basis of the reciprocal transformation between phlegm and blood stasis, thus exerting a significant curative effect.
Subject(s)
Humans , Medicine, Chinese Traditional , Coronary Disease , Mucus , Atherosclerosis , LipidsABSTRACT
ObjectiveTo observe the clinical efficacy of Gandou Fumu granules （GDFM） in the treatment of Wilson disease （WD） with liver-kidney deficiency and phlegm-blood stasis. MethodNinety WD patients in The First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into a control group （45 cases） and a treatment group （45 cases）. All patients were treated with sodium 2，3-dimercaptopropane-1-sulfonate （DMPS）， while those in the treatment group received additional GDFM. All patients were treated for four courses （32 days）. The traditional Chinese medicine （TCM） syndrome scores，clinical effective rate，24 h urinary copper，ceruloplasmin （CER），tumor necrosis factor-α（TNF-α），interleukin-1β（IL-1β），interleukin-6 （IL-6），superoxide dismutase （SOD），glutathione peroxidase （GSH-Px） and malondialdehyde （MDA） levels of the two groups before and after treatment were observed. ResultAfter treatment， the TCM syndrome scores of the two groups decreased （P<0.01），and the score of TCM syndrome in the treatment group was lower than that of the control group （P<0.01）. The total effective rate of the treatment group was 82.22% （37/45）， higher than 57.78% （26/45） of the control group （χ2=6.402，P<0.05）. There was no significant difference in CER before and after treatment in both groups. The post-treatment 24 hour urinary copper increased （P<0.01）， which was higher in the treatment group than that in the control group （P<0.05）. The TNF-α，IL-1β， and IL-6 levels were significantly reduced in both groups after treatment（P<0.01），and the above indicators in the treatment group were significantly lower than those in the control group （P<0.01）. After treatment，the SOD level increased and the MDA level decreased in the control group （P<0.01）， while no significant difference in GSH-Px level was observed. The SOD and GSH-Px levels increased and the MDA level decreased in the treatment group （P<0.01）. After treatment， SOD and GSH-Px levels of the treatment group were higher than those in the control group， while the MDA level was lower than that in the control group（P<0.05，P<0.01）. ConclusionGDFM can improve the TCM syndrome score and clinical efficacy，enhance the copper removing effect，and inhibit the inflammatory response and antioxidative stress in the treatment of WD with liver and kidney deficiency and phlegm-blood stasis.
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Objective: To explore the pathogenesis of phlegm-blood stasis syndrome in mice model of coronary heart disease based on PPAR gamma pathway. Methods: Healthy SPF C57BL/6J mice were used in the control group and the sham operation group, and ApoE-/-mice were used in the blood stasis group, phlegm turbid group and phlegm-blood stasis group. The phlegm turbid group and the phlegm-blood stasis group were fed with high-fat diet for 12 weeks, and the other groups were fed with normal feed for 12 weeks. At the end of the 8th week, the left anterior descending coronary artery was ligated in the blood stasis group and the phlegm-blood stasis group. The sham operation group was not ligated. The levels of IL-6, ET, Ang II and PPARγ in serum were measured by enzyme linked immunosorbent assay, the levels of PPARγ, ABCA1 and CD36 protein in liver tissue were detected by Western blotting, and the levels of CD40, MMP-9 and NF-κB protein in aorta were detected by immunohistochemistry. Results: Compared with sham operation group, there was no significant change in serum IL-6, the content of serum ET in the group of phlegm and blood stasis was increased significantly (P < 0.01), the content of Ang II in blood stasis group was increased significantly (P < 0.05), the content of serum Ang II in phlegm turbid group and phlegm-blood stasis group was increased significantly (P < 0.01), and the content of PPARγ was decreased. In liver tissue, the expression levels of PPARγ and ABCA1 protein in blood stasis group, phlegm turbid group and phlegm-blood stasis group were decreased significantly (P < 0.01), the expression of CD36 protein was increased. CD40, MMP-9 and NF-κB levels in aorta tissue were increased significantly (P < 0.01). Conclusion: The phlegm-blood stasis syndrome of coronary heart disease can cause more serious atherosclerotic plaque in the course of its onset. Its mechanism may be through activating PPARγ pathway.
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There exits a trend of treatment for coronary heart disease(CHD) in terms of Chinese medicine(CM) in history,from warming Yang and dispelling cold,moving Qi and dissolving phlegm to invigorating blood and dissolving stasis,whose time-space development accords to the theory of complex system.Targeting the contemporary population of CHD,phlegm-blood stasis-stagnation-deficiency theory is proposed to direct clinical application to further improve effectiveness.From the perspective of theory,blood stasis-stagnation is the basic pathogenesis of CHD that runs through the whole period in the advance of CHD,while phlegm has been changing the feature of CM Zheng of CHD population with the development of the society,and nourishing the body according to the type of deficiency might delay the process of growing older,postpone the occur of disease and hinder the advance of disease,which genuinely differs from modern medicine to render the superiority of CM to work out the challenges of CHD.As for the clinical application,the treatment options could consider invigorating blood,dissolving stasis and removing stagnation as the basic method,such as CHD formula 2,Xuefu Zhuyutang,Zhizi Chitang and Danggui Niantongtang could be used in varied period of CHD.Moreover,boosting the body by herbal medicine could regulate the routine of body,then to prevent CHD and fear down the advance of CHD,for instance,Codonopsis Radix,Astragali Radix,Liuwei Dihuang pills,Zuoguiyin and Youguiyin.Furthermore,balmiest herbs could not only dissolve phlegm,unblock the meridian and relieve pain,but also calm the mind and eliminate the anxiety.For example,Aquilariae Lignum Resinatum,Santali Albi Lignum and Moschus could be used handily in the treatment of CHD.
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ObjectiveToestablishadiseasesyndromecombinedanimalmodel,theminiaturepigmodelof chronic myocardial ischemia of phlegm-blood stasis syndrome type , by high fat/cholesterol diet feeding and intravenous injection with VD3 and isoproterenol.Methods Miniature pigs were randomly divided into the control (Ctr) group, high fat/cholesterol diet ( HFC) group and chronic myocardial ischemia model of phlegm-blood stasis syndrome ( CMI) group, 5 pigs in each group .The Ctr group was fed with normal regular chow diet , HFC group was fed with high fat/cholesterol diet , while the CMI group was fed with high fat/cholesterol diet and intravenous injection with VD 3 and isoproterenol .The experiment lasted for 24 weeks.The model establishment and its pathological process of phlegm-blood stasis syndrome were evaluated by examinations of body weight , electrocardiogram, activity, blood lipid, myocardial enzymes, hemorheology, inflammation, cardiac index(CI) and myocardial ischemia size (MIS).Results Compared with the Ctr group, the body weight, heart rate(HR), Total cholesterol(TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol ( HDL-C ) , atherosclerosis index ( AI ) , low/middle/high shear rate of whole blood viscosity and reduced viscosity, erythrocyte electrophoresis time(EPT), high-sensitivity C-reactive protein (hs-CRP) and IL-6 levels in the HFC group were significantly increased (P <0.05, P <0.01), while the body weight, heart rate, total ST, ST_average, activity, TC, TG, LDL-C, HDL-C, AI, CK, LDH, cTn-1, low/middle/high shear rate of whole blood viscosity and reduced viscosity, EPT, Casson viscosity(CV), hs-CRP, IL-6, CI and MIS in the CMI group were significantly increased (P<0.05, P<0.01), and APN level in the CMI group was significantly decreased (P<0.05).Moreover, AI, CK, LDH, cTn-1, low/middle/high shear rate of whole blood viscosity , EPT, CI and MIS in the CMI group were significantly higher than those of HFC group (P<0.05, P<0.01), while APN in the CMI group was significantly lower than that of HFC group (P<0.05).Correlation analysis showed that MIS was closely correlated to TC , LDL-C, AI, CK, LDH, cTn-1, APN, high/middle/low shear rate of whole blood viscosity , EPT, CV, hs-CRP and IL-6 (P<0.05, P<0.01).The linear regression analysis also showed that phlegm-blood stasis was closely correlated to TC , LDL-C, AI, CK, LDH, cTn-1, APN, CV, EPT, hs-CRP, and IL-6 ( P <0.01), and further linear stepwise regression analysis showed that the evolution of phlegm-blood stasis was closely related to TC , CK and IL-6.Conclusions Minipig model of chronic myocardial ischemia of phlegm-blood stasis syndrome type can be established by high fat /cholesterol diet feeding and intravenous injection with VD 3 and isoproterenol .Their blood lipid metabolism , hemorheology , myocardial enzymes and inflammatory indexes can be used as external biochemical basis of phlegm-blood stasis syndrome type , which may reflect related biological basis of the traditional Chinese medicine theory of “phlegm and stasis cementation , blood-stasis & toxin causing catastrophe”.
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Mild Cognitive Impairment(MCI)is a transitional stage during the progress of cognitive Impairment. Through the analysis of the relativity of apolipoprotein E(apoE),apoE genetic polymorphism,phlegm stagnation and blood stasis,hyperlipemia and MCI,we got this conclusion:syndrome of phlegm stagnation and blood stasis is an important underlying pathogenesis of MCI:the syndrome of phlegm stagnation and blood stasis has a close relation to apoFe4 allele,and lipid-metabolism disturbance is a key link to this relation.
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Objective To study the clinical efficacy of Reinforcing Kidney Decoction for the treatment of metabolic syndrome diagnosed as traditional Chinese medicine (TCM) syndrome of phlegm-blood stasis due to kidney deficiency. Method 42 recipients who volunteered to accept the TCM therapy were up to the inclusion criteria and finally fulfilled this study. Of all the cases, there were 26 males and 16 females, their old years ranged from 39 to 60, which were divided into obesity type diabetics group and metabolic syndrome group, both of which were treated with oral Reinforcing Kidney Decoction combined with western medicine therapy, with a course of 4 weeks. The changes of clinical symptoms, body weight index (BMI), fasting blood glucose (FBG), 2 h post prandial glucose (2hFBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C) levels, and serum uric acid were analyzed. Results Therapeutic effect in two groups ranked as significant, general and null effect, 14/5/2 vs 8/11/2, respectively. Dizziness and heaviness feeling of limbs have been improved. Rate of syndrome scores and laboratory parameters descended great significant, Hotelling's Trace, F =16.51, P =0.00. Compared with pretreatment, the levels of TC, TG, SUA obviously descended (P
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Objective To study the correlation of multiple factors with phlegm blood-stasis syndrome(PBSS) of coronary heart disease(CHD),and to explore the objective evidence for the clinical research.Methods A total of 135 cases was enrolled,which were divided into PBSS group(N=87) and non-PBSS group(N=48).Meanwhile,28 healthy volunteers served as the normal control.Five aspects including symptom scoring,hazard factor,basic laboratory examination,inflammatory factors and the result of coronarography were compared in the three groups.Results PBSS was the dominated syndrome of CHD.Symptom score in PBSS was higher.The analysis results of hazard factors of CHD showed that the body weight index,hypertension and the abnormal level of blood lipid were closely related with PBSS of CHD.The incidence of PBSS of CHD had a close relationship with the increased levels of total cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C) in blood lipid examination.Of the inflammatory factors,C-reactive protein(CRP),tumor necrosis factor ?(TNF-?),interleukin 6(IL-6),soluble CD40 ligand(SCD40L) and intercellular adhesion molecule 1(ICAM-1) levels were closely related with PBSS of CHD.The pathological changes of coronary artery of PBSS involved multiple vessels,and were severe.Conclusion Phlegm blood-stasis syndrome of coronary heart disease is relevant with multiple factors.