Efficacy of Danlou Tablet in the Treatment of Coronary Heart Disease with Phlegm and Blood Stasis Syndrome and Its Effects on Serum Inflammatory Factors

[Objectives] To explore the efficacy of Danlou Tablet( DLT) in the treatment of coronary heart disease( CHD) with phlegm and blood stasis syndrome and its effects on serum inflammatory factors. [Methods]One hundred and ninety-seven patients with CHD and phlegm and blood stasis syndrome in our hospital from January 2016 to January 2018 were selected and randomly divided into two groups: control group( n =98) treated with aspirin plus atorvastatin,and research group( n =99) treated with DLT and aspirin plus atorvastatin for one month. The clinical efficacy and incidence of adverse reactions were observed. Serum secretory phospholipase A2( s PLA2),lipoprotein-associated phospholipase A2( LP-PLA2),oxidized low-density lipoprotein( ox-LDL),monocyte chemoattractant protein-1( MCP-1) and World Health Organization Quality of Life( WHOQOL-100) scores were compared before and after one month of treatment. [Results] The total effective rate was93. 94% in the research group,which was higher than that in the control group( 79. 59%,P < 0. 05);the levels of serum s PLA2,LP-PLA2,ox-LDL and MCP-1 in the research group were lower than those in the control group after one month of treatment( P < 0. 05). There was no statistical significance of the difference in the total incidence of adverse reactions between the research group and the control group( P > 0. 05).After one month of treatment,WHOQOL-100 scores were higher in two groups,which were higher in the research group than that in the control group( P < 0. 05). [Conclusions]DLT can significantly reduce the level of serum inflammatory factors,improve the quality of life in patients with CHD and phlegm and blood stasis syndrome.

Efficacy of the method of tonifying Qi,resolving phlegm and eliminating stasis in thetreatment of AECOPD:A meta analysis

Objective:To systematically evaluate the efficacy and safety of the method of tonifying qi,resolving phlegm and eliminating stasis in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods:Search the China Knowledge Network(CNKI),VIP Chinese Science and Technology Journal Database(VIP),Wanfang Data Knowledge Service Platform,China Biomedical Literature Database(CBM),PubMed,Embase,Cochrane Library,and select the databases that meet the requirements for tonifying qi,resolving phlegm and eliminating stasis.The stasis method in the treatment of AECOPD was included in the standard literature,and RevMan 5.4 software was used for statistical analysis.Results:A total of 10 articles were included,with a total of 854 patients,435 in the treatment group and 419 in the control group.Systematic analysis shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of AECOPD is significantly different in total clinical effective rate than conventional Western medicine treatment alone[OR=3.98,95%CI(2.23,7.11),P<0.00001];In terms of lung function,FEV1/FVC[MD=6.08,95%CI(5.01,7.15),P<0.00001],FEV1[MD=0.07,95%CI(0.01,0.13),P=0.02],FEV1%[MD=4.56,95%CI(3.09,6.02),P<0.00001]is significantly higher than the control group;arterial oxygen partial pressure(PaO_(2))[MD=18.47,95%CI(16.77,20.16),P<0.00001]Significant improvement compared to the control group;arterial partial pressure of carbon dioxide(PaCO_(2))[MD=-7.48,95%CI(-8.7,-6.26),P<0.00001]was significantly lower than the control group.Conclusion:The current evidence shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of chronic obstructive pulmonary disease in acute exacerbations can improve clinical efficacy and improve the quality of life of patients.

Discussion on the Prevention and Treatment of COVID-19 Causing Lung Disease and Heart Damage Based on Lei Zhongyi's Theory of Intermingled Phlegm,Blood Stasis and Toxin

Novel coronavirus infection not only damages lung function,but also causes myocardial injury,elevated myocardial enzymes and heart failure,especially for patients with basic heart diseases who develop COVID-19,the first consideration should be the protection of cardiac function.Based on the theory of intermingled phlegm,blood stasis and toxin of heart disease put forward by Master Lei Zhongyi,the dialectical treatment thinking of COVID-19 patients from the concept of damage of phlegm,blood stasis and toxin to the heart were discussed.During the diagnosis,critical stage and recovery period of COVID-19,expectorant and blood-activating agents,heat and detoxification agents can be added to promote lung and asthma,free Bizheng and remove blood stasis,calm the heart and calm the mind,and promote the recovery of cardiopulmonary functions.

On the Treatment of Kidney Fibrosis from the Theory of Internal Deficiency of Qi and the Coexistence of Phlegm and Blood Stasis

Traditional Chinese medicine believes that the etiology and pathogenesis of renal fibrosis are characterized by deficiency of the lung,spleen and kidney,and phlegm,blood stasis,dampness and poison.The positive and the evil can influence each other and cause and effect each other,forming the pathological characteristics of the deficiency,the deficiency,the deficiency and the reality.Chinese medicine treatment of the disease has its unique advantages,external and internal injury equal emphasis,correction and dispelling evil and regulation.From the point of view of"deficiency of qi and coexistence of phlegm and blood stasis",the treatment of renal fibrosis can provide theoretical basis for the treatment of the disease.

Comparing the mechanism of four classic Gualou-Xiebai prescriptions for cardiovascular diseases with phlegm and blood stasis syndrome based on molecular network modeling

Background:Four classical Traditional Chinese Medicine prescriptions,namely Gualou Xiebai Baijiu decoction,Gualou Xiebai Banxia decoction(GLXBBX),Zhishi Xiebai Guizhi decoction(ZSXBGZ)and Danlou prescription(DL),have been frequently used for treatment of phlegm and blood stasis syndrome(PBSS)-related cardiovascular diseases.However,its therapeutic mechanism has not been clearly elucidated.This study aimed to explore PBSS and its molecular mechanism,clarify and compare the mechanisms of four prescriptions in treating PBSS-related diseases.Method:In this study,we collected four prescriptions’compounds,predicted therapeutic targets,and enriched pathways which were based on network pharmacology.Then,we analysed the commen and different mechanisms by combing the network of components,targets and pathways.Finally,molecular docking was engaged to assess the binding potential of key compounds and hub targets.Results:We showed that four prescriptions’intersection genes(VEGFA,SRC,EGFR,etc.)were commonly enriched in PI3K-AKT signaling pathway,HIF-1 signaling pathway,etc.In addition,platelet activation and cAMP signaling pathway were singly enriched from the GLXBBX through unique compounds 12,13-epoxy-9-hydroxynonadeca-7,10-dienoic acid and Cyclo(L-tyrosyl-L-phenylalanyl).These bioactive compounds may exert GLXBBX’s unique pharmacological pathways via involving in mediating PPARA,PTGER3,etc.Sphingolipid signaling pathway was singly enriched from the ZSXBGZ through unique compounds tetramethoxyluteolin,ergosterol peroxide,etc.These bioactive compounds could mediate ADORA1,ADORA3 and TNFRSF1A to regulate ZSXBGZ’s unique pharmacological pathways.AMPK signaling pathway was singly enriched from the DL through unique compounds kaempferol,evofolinb,ethyl acid and aureusidin.These bioactive compounds were involved in mediating the main targets of AMPK signaling pathway,such as TNF,TNFRSF1A,etc.Conclusions:Our research demonstrated that GLXB-prescriptions involved in almost all pathological stages of PBSS-related cardiovascular diseases by modulating high-frequency shared pathways and targets mainly through key compounds(quercetin,mandenol,sitosteryl acetate and luteolin,etc.),for example,participate in the process of atherosclerosis,lipid metabolism,inflammation,immune response,thrombosis,inhibit inflammatory factors and platelet aggregation,regulate immune function,vascular function,oxidative stress.In addition to common pharmacological efficacies,there could also be specificities among GLXB prescriptions due to different compounds.For example,GLXBBX tends to regulate the function of vascular and endothelial barrier,prevent thrombosis.ZSXBGZ tends to regulate lipid metabolism and protect the heart from lipid accumulation.DL tends to maintain energy homeostasis and improve inflammation.

Clinical study on Chuanxiong Hualiu Mixture in the treatment of blood stasis and phlegm stagnation type of ovarian cyst

Objective:To observe the clinical efficacy of Chuanxiong Hualiu Mixture in the treatment of blood stasis and phlegm stagnation type of ovarian cyst and the effects on physical and chemical indicators.Methods: A total of 80 patients with blood stasis and phlegm stagnation type of ovarian cyst were randomly divided into two groups, research group (n=40) took Chuanxiong Hualiu Mixture, control group (n=40) took Guizhi Fuling Capsule, 3 months was a course of treatment, and the curative effect was compared between two groups.Results:(1) The overall response rate of Chuanxiong Hualiu mixture group after 3 months of treatment was 82.5%, that of Guizhi Fuling Capsule group was 62.5%, the overall response rate of Chuanxiong Hualiu mixture group was higher than that of control group, and the difference was statistically significant;(2) before and after treatment, sex hormone and hemorheology index E2 of both groups decreased significantly, whole blood viscosity, whole blood reduced viscosity and plasma viscosity decreased significantly, the results were statistically significant, but there was no difference between two groups;(3) rank sum test of TCM symptom efficacy between two groups before and after treatment showed that the overall response rate of Chuanxiong Hualiu mixture group was 95%, the overall response rate of Guizhi Fuling Capsule group was 85%, the overall response rate of research group was better than that of control group, and the difference was statistically significant.Conclusion:Chuanxiong Hualiu mixture has good curative effect for the treatment of ovarian cyst, it can effectively improve the patients' blood stasis and phlegm stagnation constitution, and its mechanism of action is associated with lowering estrogen levels and improving hemorrheology.

Research progress of traditional Chinese medicine in the treatment of breast cancer based on “Binding of Phlegm and Stasis”

Breast cancer is a common malignancy in female,which seriously endangers women’s health.Chinese medicine believed that the incidence of breast cancer is related to“Stagnation of Liver-Qi”and“Phlegm,Disharmony of Thoroughfare and Conception Vessels”,“Stagnation of Qi and Blood Stasis”,constitution and other characteristics.Modern research believed that phlegm is related to abnormal energy metabolism of tumor cells,and stasis is the pathological change of tumor angiogenesis.How to combine tumor angiogenesis and energy replacement abnormality with the theory of“Binding of Phlegm and Stasis”has become a new direction of traditional Chinese medicine anti-tumor research.The drugs of“Activating Blood Circulation”and“Removing Blood Stasis”,“Resolving Phlegm”and“Dispersing Constipation”have a wide range of pharmacological effects and definite curative effect.They have the functions of anti-inflammatory,anti-tumor,anti-pathogenic microorganism and improving the immune ability of the body.In this paper,the effects and mechanisms of phlegm-reducing and stasis dispersing active ingredients and compound preparations in regulating angiogenesis and energy metabolism of breast cancer were reviewed,and the differences in efficacy,targets and pathways of Phlegm-Reducing and Stasis Dispersing drugs were summarized,so as to provide some reference for the research and development of traditional Chinese medicine for breast cancer.

The experiences of Zheng-ping Bai in treating gastric cancer based on qi,phlegm,and stasis

This paper will introduce the clinical experiences of Professor Zheng-pingBai in treating gastric cancer.In his diagnosis and treatment of this disease,Professor Bai advocates the integration of disease,symptom,and syndrome differentiation,pointing out that gastric cancer is caused by the accumulation of phlegm-dampness and blood stasis in the stomach due to qi stagnation.Therefore,the basic pathogenic mechanism involves the loss of harmonious descent in the stomach.This implies that treatment should prioritize qi activity by calming the stomach and suppressing the abnormal ascent of qi,as well as emphasizing the elimination of phlegm and stasis,and this has achieved significant therapeutic efficacy.

Comparative evaluation in treating qi-yin deficiency and phlegm stasis syndrome of type 2 diabetes mellitus in a rat model

Objective:To compare the efficacy of traditional Chinese medicine (TCM),western medicine and integrative medicine in treating type 2 diabetes mellitus (T2DM) in a rat model.Methods:The T2DM rat model was established with a high-fat diet (HFD) for 35 days and a single injection of streptozotocin (STZ,30 mg/kg).The T2DM-induced rats were divided into three groups,and treated with Yiqi Yangyin Huatan (YQYYHT) granules (3.84 g/kg per day),pioglitazone (1.35 mg/kg per day) or YQYYHT granules + pioglitazone (3.84 g/kg per day+1.35 mg/kg per day) respectively for 14 days.Clinical features and behavioral changes,as well as T2DM indicators,were recorded to evaluate therapeutics effects in each treatment group.Results:The T2DM rat model expressed insulin resistance (IR),with features similar to qi-yin deficiency and phlegm stasis syndrome,including decreased cyclic adenosine monophosphate/cyclic guanosine monophosphate (cAMP/cGMP) ratio,decreased levels of Na+-K+-ATPase,superoxide dismutase (SOD) and high density lipoprotein-cholesterol (HDL-C),and increased levels of serum triglyceride (TG),total cholesterol (TC) and low density lipoprotein (LDL-C).All three treatment groups showed significant decreases in fasting blood glucose (FBG) and fasting insulin (Fins),and improvement of TCM syndrome to different degrees.Importantly,YQYYHT improved the most of the indicators of T2DM,followed by integrative medicine and pioglitazone alone.Conclusion:Compared with western medicine or integrative medicine,prescription of TCM based on syndrome differentiation may offer more advantages in the prevention and treatment of T2DM.

Effect of Gualou Xiebai Banxia decoction combined with Danshen Decoction on clinical efficacy of unstable angina with phlegm and blood stasis syndrome

Objective:To observe the clinical efficacy and safety of Gualou Xiebai Banxia decoction combined with Danshen decoction on unstable angina(UA)with phlegm and blood stasis syndrome.Method:Eighty patients with UA were randomly divided into treatment group(40 cases)and control group(40 cases)by random number table.The control group was given conventional western medicine treatment,and the experimental group was given Gualou Xiebai Banxia decoction and Danshen decoction on the basis of the control group.Both groups were treated for 4 weeks.Before and after treatment,the angina attacks,dosage of nitroglycerin,traditional Chinese medicine syndrome score,quality of life score,blood lipid,coagulation index and clinical total efficacy were observed and recorded.Results:After 4 weeks of treatment,the attack times and duration of angina in the two groups were both decreased compared with those before treatment.And the treatment group was more significantly reduced than the control group,the difference was statistically significant(p<0.05);the consumption of nitroglycerin of the treatment group was 90.0%,which was better than 67.5%of the control group,the difference was statistically significant(p<0.05);the total effective rate of the treatment group was 90%,which was better than 65%of the control group,the difference was statistically significant(p<0.05);the traditional Chinese medicine(TCM)syndrome score of the experimental group was lower than that of the control group,the differences was significant(p<0.05).The improvement of low density lipoprotein(LDL-C),total cholesterol(TC)and prothrombin time(PT)in the experimental group was better than that in the control group(p<0.05).During the study,there were no obvious adverse reactions in both groups.Conclusion:Gualou Xiebai Banxia decoction combined with Danshen decoction can effectively relieve the attack of angina and the consumption of nitroglycerin,improve clinical symptoms,regulate blood lipid and blood flow state,and improve the quality of life of patients with UA,with good clinical efficacy and safety.

Professor Jun Li Treating Vascular Dementia from Mutual Conclusion of Phlegm and Blood Stasis

Professor Jun Li believes that the main etiology and pathogenesis of vascular dementia is the combination of phlegm and blood stasis.The symptoms include feeling faint and declined senses in organs of the head,caused by mystery reason.To cure phlegm and blood stasis simultaneously,the therapy promotes the notion of“resolving phlegm and stimulating the circulation of blood,liberate brain orifices,”and treatments with the addition and removal of“Naotaitong Decoction,”which has an amazing clinical curative effect.This paper examines Professor Jun Li’s theoretical foundations and ideas from the syndrome differentiation and treatment of phlegm and blood stasis,systematically examines the curative effect and mechanism of Naotaitong Decoction in the treatment of vascular dementia,and examines the prescription and medication of typical cases for readers,in the hopes of providing guidance to clinical diagnosis and treatment of this disease.

基于“坚者削之,结者散之”治疗消化道息肉理论探析

消化道息肉主要是指胃肠道息肉,目前本病临床上最常用的治疗方法为内镜下治疗,虽见效快,但并发症较多,且治疗后仍有较高的复发率。中医药对于预防本病复发有一定的优势,本课题组通过总结古今相关文献以及结合临床实践研究,认为消化道息肉的核心病机多以脾虚气滞为本,而脾胃气机壅滞进一步产生湿、痰、瘀等病理因素为标,故紧扣病机,根据“坚者削之,结者散之”理论,提出“消散法”辨治消化道息肉,临证时需灵活变通,随症加减,以期为中医药治疗消化道息肉提供新的见解。

升清降浊方联合常规西药治疗老年帕金森病疗效及对患者非运动症状的影响

目的:探讨升清降浊方联合常规西药治疗老年帕金森病(气虚痰瘀证)疗效及对患者非运动症状的影响。方法:选取90例老年帕金森病患者,采用随机数表法将患者分为升清降浊组(n=45)和西药组(n=45),西药组患者采用常规西药治疗,升清降浊组采用升清降浊方联合常规西药治疗,两组患者均持续治疗1个月。记录两组治疗前后中医证候评分、帕金森病症状[采用统一帕金森病评定量表(UPDRS)评估]、非运动症状[采用非运动症状量表(NMSS)评估]、生活质量[采用帕金森病生活质量评分量表(PDQ)评估]和不良反应[采用精神症状评定-不良反应量表(TESS)评估]。结果:治疗后,升清降浊组患者的中医证候评分较西药组低,差异有统计学意义(P<0.05);升清降浊组患者的UPDRS、NMSS和PDQ量表评分较西药组低,差异有统计学意义(P<0.05)。治疗过程中,升清降浊组患者TESS量表评分中自主神经症状的不良反应评分较西药组低,差异有统计学意义(P<0.05)。结论:升清降浊方联合常规西药治疗可以改善气虚痰瘀型老年帕金森病患者中医证候和非运动症状,提高患者生活质量,降低不良反应发生情况。

从虚、痰、瘀、毒论治肺部磨玻璃结节

随着体检中胸部CT的普及,肺部磨玻璃结节(ground-glass nodule,GGN)的检出率越来越高,其具有一定比例的恶性概率,容易引起患者的恐慌,值得临床重视。目前对于无手术适应症的肺部GGN西医只是随访观察,而中医学对肺部GGN的研究尚不足,并且未形成统一的认识。通过查阅文献以及临床上四诊合参发现磨玻璃结节的病机特点多以虚痰瘀毒夹杂为主,基于虚、痰、瘀、毒讨论肺部GGN的病机特点及治疗方法,希冀为肺部磨玻璃结节的诊疗提供一定的思路。

基于代谢重编程探讨肾小球硬化痰瘀互结病机

肾小球硬化是肾小球病变的一种病理形态学特点,也是各种肾脏疾病进展的后期表现。临床常见为蛋白尿和肾病综合征,多数患者病情为逐渐进展。激素、免疫抑制剂治疗带来的不良反应和肝肾毒性,为肾小球硬化病变在中医药治疗上带来更多6空间。代谢重编程作为一种重要的细胞适应机制,在肾小球硬化病变的病理过程中扮演着核心角色。本文通过分析代谢重编程在肾小球硬化病变中的作用机制,探讨了痰瘀互结的病理机制,并从现代医学和传统中医相结合的角度提出了治疗肾小球硬化的潜在新策略,旨在为肾小球疾病防治提供新思路和方向。

活血通窍法治疗儿童过敏性鼻炎临床观察

目的:观察活血通窍方治疗儿童痰瘀互结型过敏性鼻炎的临床疗效。方法:将60例符合纳入标准的过敏性鼻炎患儿随机分为两组各30例。对照组予口服盐酸西替利嗪片及糠酸莫米松喷鼻,治疗组在对照组基础上予活血通窍方,疗程均为28天。观察两组治疗前后中医各证候积分、鼻腔检查评分、PLT、EOS水平。结果:治疗组、对照组总有效率分别为96.67%、76.67%,两组比较差异无统计学意义(P﹥0.05),治疗组愈显率为70.00%高于对照组的40.00%(P﹤0.05);治疗后,两组患儿各主症、鼻腔检查积分、EOS水平均较治疗前明显下降(P﹤0.01),治疗组各次症积分、PLT水平较治疗前明显下降(P﹤0.01),对照组面色口唇、睡眠质量积分较治疗前下降(P﹤0.05)。治疗组主症、次症、鼻腔检查积分、PLT、EOS水平明显低于对照组(P﹤0.01,P﹤0.05)。结论:活血通窍方联合盐酸西替利嗪片、糠酸莫米松喷雾剂能有效改善过敏性鼻炎患儿的临床症状,同时可降低PLT、EOS水平。

醒脑开窍针刺法合并补肾化痰活血方治疗急性脑梗死风痰瘀阻证的临床研究

目的:探究醒脑开窍针刺法合并补肾化痰活血方治疗急性脑梗死风痰瘀阻证的临床效果。方法:选择北京中医药大学孙思邈医院2021年1月-2023年12月收治的急性脑梗死风痰瘀阻证患者106例,采用随机数字表法分为针刺组和联合组,每组53例。两组均给予抗凝、改善微循环、控制血压、神经保护、吸氧、心脏监测等常规西医治疗,针刺组给予醒脑开窍针刺法治疗,联合组在针刺组基础上给予补肾化痰活血方口服治疗。观察两组患者的中医证候积分、神经功能指标、血流动力学指标、神经功能与运动功能及日常生活能力评分、临床疗效、不良反应发生情况。结果:治疗后,两组中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、神经胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)、血流峰值时间(TTP)与阻力指数(RI)水平均较治疗前降低(P<0.05),且联合组低于针刺组(P<0.01);治疗后,两组血清神经生长因子(NGF)、脑血容量(CBV)、平均血流量(Qmean)水平、简式Fugl-Meyer评分(FMA)与Barthel指数(BI)评分均较治疗前升高(P<0.05),且联合组高于针刺组(P<0.01);联合组治疗总有效率高于针刺组(P<0.05);两组不良反应总发生率差异无统计学意义(P>0.05)。结论:醒脑开窍针刺法合并补肾化痰活血方治疗急性脑梗死风痰瘀阻证可降低中医证候积分,缓解临床症状,增加脑血流量,改善神经功能,提高临床疗效,且安全性较高。

针刺联合固本培元汤治疗肾虚痰瘀型阿尔茨海默病临床研究

目的:观察针刺联合固本培元汤治疗肾虚痰瘀型阿尔茨海默病的疗效。方法:选择2021年3月—2023年9月温州市第七人民医院收治的126例肾虚痰瘀型阿尔茨海默病患者为研究对象,按随机数字表法分为对照组及治疗组各63例。治疗过程中2组均剔除3例,2组均有60例完成研究。对照组采用西药联合针刺治疗,治疗组在对照组基础上给予固本培元汤治疗。2组均持续治疗2个月。比较2组临床疗效及不良反应发生率,比较2组治疗前后中医证候积分、认知功能评分(ADAS-cog)、日常生活能力评分(ADL)的变化。结果:治疗组临床疗效总有效率为96.67%(58/60),对照组临床疗效总有效率为78.33%(47/60),2组临床疗效比较,差异有统计学意义(P<0.05)。治疗后,2组智能减退、神情呆钝、双目无神、腰膝酸软、头晕耳鸣中医证候积分均较治疗前下降(P<0.05),治疗组上述5项中医证候积分均低于对照组(P<0.05)。治疗后,2组ADAS-cog评分、ADL评分均较治疗前升高(P<0.05),治疗组上述2项评分均高于对照组(P<0.05)。对照组不良反应发生率为12.77%(6/47),治疗组不良反应发生率为8.62%(5/58),2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:针刺联合固本培元汤治疗阿尔茨海默病疗效较好,能有效缓解患者躯体不适等症状,提升认知功能、日常生活能力,安全性高。

Study on Correspondence between Prescription and Syndrome and the Essence of Phlegm and Blood Stasis Syndrome in Coronary Heart Disease Based on Metabonomics

Studying the essence of a syndrome has been a key challenge in the field of Chinese medicine.Until now,due to limitations of the methods available,the progress towards understanding such complicated systems has been slow.Metabonomics encompasses the dynamics,composition and analysis of metabolites,enabling the observation of changes in the metabolic network of the human body associated with disease.Being from the point of view of the whole organism,metabonomics provides an opportunity to study the essence of a syndrome to an unprecedented level.Phlegm and blood stasis syndrome is the main syndrome associated with coronary heart disease（CHD）,which bring difficulties in clinical treatment due to difficulties associated with differentiation of symptoms and signs.The fundamental differences of material between the two also need to be interpreted.The authors consider that we can use the method of combining a disease（in this case CHD）with associated syndromes（phlegm and blood stasis syndrome）to select patients with phlegm and blood stasis syndrome of CHD,and utilize metabonomics to explore the essence of the syndrome by difference analysis of metabolite spectra.Meanwhile,we can study the syndrome in CM,observe the change regularity of metabolism spectra after the treatment of corresponding and non-corresponding prescription and syndrome,in order to validate the material fundament in the progress of syndrome formation and their differences.This will not only have great significance in enhancing the ability to identify syndrome of phlegm and blood stasis in CHD and to establish the clinical curative criteria,but will also offer a new approach of studying the essence for a syndrome using metabonomics.

Plasma metabolic biomarkers for syndrome of phlegm and blood stasis in hyperlipidemia and atherosclerosis

OBJECTIVE： To explore the plasma metabolite pro- files in patients with the syndrome of phlegm and blood stasis in hyperlipidemia and atherosclerosis （As）, and to search for the metabolic biomarkers of the syndrome. METHODS： The plasma metabolite profiles of 31 patients with the syndrome of phlegm and blood stasis in hyperlipidemia and As, 6 patients with syn- dromes without phlegm and blood stasis, and 10 healthy subjects were analyzed by gas chromatog- raphy-mass spectrometry （GC-MS）. Partial least squares-discriminant analyses （PLS-DA） were used to carry out the pattern-recognition analyses of the data. The plasma metabolic biomarkers of patients were obtained by variable importance plot value （VlP value） and Student＇s t-test. The structures ofbiomarkers were defined by the National Institute of Standards and Technology （NIST） database. RESULTS： PLS-DA score plots of plasma metabo- Iomes did not show overlap between the phlegm-blood stasis syndrome group and syn- dromes without phlegm and blood stasis group, whereas significant differences in the concentra- tions in the plasma of 5 metabolites were found （P〈 0.05）. They were identified as urine, isoleucine, gluc- uronic acid, palmitic acid and glycerol by searching in NIST database. The concentrations of four metab- olites in the plasma of patients with syndrome of phlegm and blood stasis were higher than those with syndromes without phlegm and blood stasis, whereas the glycerol concentration was lower. CONCLUSION： Compared with patients with syn- dromes without phlegm and blood stasis, five me- tabolites showed abnormal levels in patients with the syndrome of phlegm and blood stasis. These metabolites could be diagnostic and prognostic biomarkers.