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Chen-Hao Zhang,1,* Xiao-Lan Su,2,* Yi-Ying Liu,1 Long Lin,1 Yin-Chun Wang,1 Xiao-Dong Li,1 Jin-Ze Zhang,1 Wei Wei2 1Department of Emergency, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, People’s Republic of China; 2Department of Gastroenterology, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chen-Hao ZhangDepartment of Emergency, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, People’s Republic of ChinaTel +86 136 7139 3316Email zhangch_dr@163.comWei WeiDepartment of Gastroenterology, Wangjing Hospital of China Academy of Chinese Medical Sciences, No. 6 of Wangjing Zhonghuan South Street, Chaoyang District, Beijing, 100102, People’s Republic of ChinaTel +86 13601233816Email weiweigrt@163.comBackground: To investigate the effects of Chinese herbal medicine in tonifying qi and attaining hemostasis caused by the metabolism of the drug clopidogrel and as a result of platelet and gastric mucosa injury in an ischemia-reperfusion rat model.Methods: A pharmacokinetic model was established to record the drug metabolism parameters of clopidogrel metabolites. Then, absorption of the drug was compared with approaches using the traditional Chinese medicine (TCM) approach of tonifying qi and establishing hemostasis, to using the drug pantoprazole and applying these approaches in combination with clopidogrel. Intragastric administration was performed, and all indicators were tested.Results: The area under the curve (AUC; 0–T, 300.342 ± 35.832 mg/L* h; AUC 0–∞, 320.462 ± 40.213 mg/L* h), the plasma peak concentration (30.622 ± 9.917 mg/L*), and the peak time and half-life (7.954 ± 1.121 h) in the clopidogrel and the TCM groups were higher than those in the clopidogrel and pantoprazole groups. In terms of antiplatelet aggregation, compared with model group, the platelet aggregation rate induced by arachidonic acid (AA) and adenosine diphosphate (ADP) was significantly decreased by the TCM approach of tonifying qi and stopping bleeding (p < 0.05). The ADP, thromboxane A2, GPII B/Pa-A, CD62P and platelet factor 4 content in the TCM yiqi decoction and hemostasis approach were significantly decreased (p < 0.01). Compared with the clopidogrel group, the gastrin and motilin in the serum, the cyclooxygenase (COX)-1 and prostaglandin E2 in gastric tissue, and expression of vascular endothelial growth factor messenger ribonucleic acid in the serum were all significantly increased using TCM approach to protect against gastric mucosal injury (p < 0.05).Conclusion: TCM invigorating qi and hemostasis has an inhibitory effect on platelet activation. It can reduce the local inflammatory reaction at the same time as protecting gastric mucosa.Keywords: supplementing qi and hemostasis herbs, proton pump inhibition, antiplatelet effect, gastric mucosal protection, traditional Chinese medicine |
