1. Study on the correlation between SeGSHPx and coronary heart disease 1.1 Basic concept of SeGSHPx Glutathione peroxidase (GPx) is an important peroxidolytic enzyme widely present in the body and is one of the important indicators of the antioxidant effect of coronary endothelial function, which is related to cell damage hypoxia, intoxication, aging and the occurrence of many diseases. Glutathione peroxidase (GPx) was first discovered by MIlls in 1957, mainly in the cytoplasm of tissues and in erythrocytes [1-2], and it was the first selenium-containing enzyme found in mammals. However, it was not until 1973 that two research groups, Flohe and Rotluck, discovered that elemental selenium is an important component of GPx, and selenium plays a biological role in the body in the form of Sec [3-4], catalyzing the breakdown of hydroperoxides in the body by GSH, so glutathione peroxidase (GPx), also known as selenoglutathione peroxidase (Se-GSH-Px), GPx can GPx protects cell membranes and other biological tissues from peroxidative damage. It is an important enzyme for the removal of H2O2 and many organic hydrogen peroxides in vivo. 1.2 Relevance of SeGSHPx to coronary heart disease GPX is an antioxidant enzyme widely present in cardiovascular and other important organs, stored in the cytoplasm of cells and mitochondria, scavenging reactive oxygen radicals produced by the body. gSH-Px is involved in the reduction reaction of peroxides, catalyzing the conversion of hydrogen peroxide to water during normal metabolism, thus consuming the hydrogen peroxide produced by SOD dismutase GSH-PX is the most important scavenger of reactive oxygen radicals in the body [5]; GPx plays a biological role in the form of selenosemicarbazone (Se-Cys, Sec) catalyzing the breakdown of lipid peroxides in the body with glutathione (GSH) as a substrate, thus preventing cell membranes and other biological tissues from peroxidative damage, and the free radical scavenger protects the myocardium from oxidative stress damage at the same time, and can The free radical scavengers can significantly inhibit the increase of intracellular calcium while protecting myocardium from oxidative stress. In addition, oxidative stress also contributes to atherosclerosis (AS) by inducing inflammation-related gene expression [6], which is the underlying pathology of coronary artery disease, and therefore the presence of oxidative stress can be considered detrimental to patients with coronary artery disease. There is a dynamic balance between oxidation and antioxidation in the body, i.e., oxidation-antioxidation balance, and the metabolism of free radicals (Reactive ogen species, ROs) is an important factor to maintain this balance, when this balance is disrupted, i.e., when intracellular oxidative surrogates increase or when the antioxidant protection in the cells is insufficient, ROS will be generated and accumulate When this balance is disturbed, i.e., when intracellular oxidative surrogates increase or when antioxidant protection in the cell is insufficient, a buildup of ROS is generated and toxic effects are produced on the cell, resulting in a pathological state with multiple toxic effects on the cell, namely oxidative stress. Recent studies [7] have shown that oxidative stress is an important cause of structural and functional abnormalities in the cardiovascular system. Oxidative stress interacts with various pathophysiological mechanisms mentioned above and together promotes the development and progression of cardiovascular diseases. It has been suggested [8] that the evidence for myocardial damage caused by oxidative stress lies in the fact that excess oxygen radicals are produced in many pathological processes of myocardial diseases, while anti-oxidative radical defense mechanisms are inhibited; the more recognized mechanism of oxidative stress and myocardial cell damage is closely related to calcium dysregulation, perhaps because oxygen radicals alter the redox state of the cell membrane and affect the intra- and extracellular calcium ion This is probably due to the fact that oxygen free radicals alter the redox state of the cell membrane and affect the intracellular and extracellular calcium transport, thus leading to intracellular calcium overload. As oxidative stress and oxidative damage lead to protein damage, endothelial cells reduce their protective role and express some pro-inflammatory molecules, presenting early manifestations of atherosclerosis [9] and activating the inflammatory response [10], eventually leading to the progression of atherosclerosis and promoting the development of coronary atherosclerosis. The level of glutathione peroxidase (GPx,) its level in the body has a close correlation with angina pectoris in coronary heart disease. 2. Study on the treatment of coronary heart disease with Chinese medicine’s discriminative intervention of SeGSHPx level Coronary heart disease belongs to the category of “chest paralysis” and “true heart pain” in Chinese medicine, which refers to a disease with the main symptom of chest tightness and pain, or even chest pain through the back, wheezing and unable to lie down. In mild cases, the chest is stuffy like choking and breathing is not smooth, while in severe cases, the heart pain goes through the back and the back pain goes through the heart. According to modern Chinese medicine, the etiology of coronary heart disease is mainly due to the deficiency of internal organs, imbalance of yin and yang qi and blood, coupled with the internal invasion of cold, emotional and mental disorders, improper diet, old age and physical weakness, etc., resulting in qi stagnation and blood stagnation, heart yang failure, paralysis of heart veins and the development of this disease. According to the above theory, modern clinical classification of coronary heart disease into five common types of symptoms [11]. These are: qi deficiency and blood stasis, qi stagnation and phlegm stasis, heart vessel paralysis, heart and kidney deficiency, and yang deficiency and cold condensation. 2.1 Qi deficiency and blood stasis type: The symptoms include vague chest stabbing pain, aggravated by exertion, panic and shortness of breath, tiredness, laziness and laziness of speech, dark tongue and thin white fur. Yin Jianming and Zhu Jiangli et al [12] studied the effects of Tianxiang Dan granules on T-SOD, GSH-Px, MDA, and LD in the serum of patients with coronary angina. Sixty-two patients with angina pectoris of coronary heart disease with Qi deficiency, blood stasis and phlegm stasis were randomly divided into two groups: 30 patients in the treatment group and 32 patients in the control group. After taking Tianxiang Dan granules for one course (4 weeks), the patients’ clinical symptoms and the changes of serum superoxide dismutase (T-SOD), glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) and lactic acid (LD) levels were observed. The results showed that ① both groups could significantly improve the clinical symptoms. The improvement of symptoms of chest tightness, body fatigue, dull tongue petechiae and slippery pulse in the Tian Xiang Dan group was significantly better than that in the Xin Ke Shu group, and there was a significant difference between them. (2) The T-SOD and GSH-Px activities in the serum of both groups increased significantly after treatment, and the MDA and LD levels decreased significantly. The reduced MDA level in the Tian Xiang Dan group was better than that in the Xin Ke Shu group. (3) The serum T-SOD and GSH-Px activity increased significantly and MDA and LD levels decreased significantly in the Tianxiangdan group after treatment. There was no significant difference between the two types of symptoms. It is concluded that Tian Xiang Dan granules have the effect of blocking the damage of free radicals and inhibiting the formation of lactic acid. This may be one of the mechanisms of its treatment of angina pectoris in coronary heart disease. 2.2 Qi stagnation and phlegm stasis type: The symptoms are chest tightness and heavy pain, such as the things covered, breath is not smooth, shortness of breath and shortness of breath, pain and emotional changes, the patient’s body is more obese, more phlegm, tongue coating is more cloudy and greasy. Yan Lingyun and Zhang Yuquan et al [13] investigated the antioxidant mechanism of action of the composition of the formula for tonifying deficiency, eliminating phlegm and dispelling phlegm drink on the basis of the basic pathological mechanism of Chinese and Western medicine for coronary heart disease in the elderly. Sixty-six elderly patients with coronary heart disease were randomly divided into the Chinese medicine intervention group and the control group, and the conventional treatment was the same in both groups. The activity of superoxide dismutase (SOD), plasma lipid peroxide (LPO) level and the expression level of MnSOD gene mRNA in peripheral blood mononuclear cells were measured by biochemical and molecular biological methods before and after treatment. The plasma SOD activity and LPO content were not significantly different between the control group before and after treatment (P>0105), but the plasma SOD activity and LPO content were significantly higher and lower in the Chinese medicine intervention group (P<0101); the mRNA expression level of MnSOD gene in the Chinese medicine intervention group was significantly higher than that in the control group (P<0101). Conclusion: The MnSOD gene expression of single nucleus cells can be induced by tonic deficiency, resolving blood stasis and dispelling phlegm drink, which can interfere with the production of oxygen free radicals and enhance the function of eliminating oxygen free radicals. 2.3 Heart vein paralysis type: The symptoms include stabbing pain in the chest, which is fixed in position and does not move, and the pain occurs frequently and is aggravated by exertion, with a dark tongue and varicose veins under the tongue. After applying Tanshinone IIA sodium sulfonate injection intravenously to 56 patients with angina pectoris, we observed the relief of angina pectoris symptoms and electrocardiographic changes, and also measured the changes of glutathione peroxidase (GSH- Px), peroxidase dismutase (SOD) activity and malondialdehyde (MDA) content in their plasma. The results showed that after the treatment of angina pectoris with Tanshinone IIA sodium sulfonate injection, the angina pectoris symptoms were significantly relieved and the electrocardiogram performance improved, while the plasma GSH- Px and SOD activities increased (P<0.01) and the plasma MDA content decreased (P<0.05). It is concluded that the therapeutic effect of tanshinone IIA sodium sulfonate injection on angina pectoris patients may be related to the promotion of oxygen free radical scavenging in the body. 2.4 Heart and kidney deficiency type: Symptoms include chest tightness and vague pain, with pain occurring at times and aggravated by exertion, palpitation and shortness of breath, restless sleep at night, soreness and weakness of the waist and knees, dizziness and tinnitus, and a red tongue with little coating. Lin Wanjuan, Chen Dongfeng et al [15] observed the clinical efficacy of acupuncture in the treatment of angina pectoris in coronary heart disease and explored its mechanism of action from the perspective of oxidative stress. Sixty patients with coronary angina were randomly divided into 30 patients in the treatment group and 30 patients in the control group, and the treatment group was treated with acupuncture and moxibustion together with drugs; the control group was treated with drugs only, and the plasma SOD, GSH-PX activity and MDA levels were measured before and after treatment in both groups. In the control group, plasma SOD, GSH-PX vitality and MDA levels were measured before and after treatment. The main acupoints were Xin Yu, Han Zhong, Yu Ren, Zhi Yang and He Gu, and in the case of heart and kidney yin deficiency, San Yin Jiao and Foot San Li were used to nourish the yin of the liver, spleen and kidney. The results showed that the total effective rate was 90% in the treatment group and 70% in the control group, and the treatment group was significantly better than the control group in improving the clinical symptoms. The MDA level of patients in the treatment group decreased significantly, while SOD and GSH-PX vitality increased significantly (P<0.01); the SOD, GSH-PX vitality and MDA level of patients in the control group did not change significantly. Conclusion: Acupuncture and moxibustion together with drugs have significant efficacy in the treatment of angina pectoris in coronary heart disease. 2.5 Yang deficiency and cold condensation type: symptoms include severe chest pain, cold extremities, chest tightness, shortness of breath, palpitations, aggravated by exertion, sweating, blue claw nails, and a pale white tongue with watery coating. Xu Jinmei Yang Lianli et al [16] observed the clinical efficacy and explored the mechanism of action of the method of warming Yang and resolving turbidity in the treatment of angina pectoris in elderly people with coronary heart disease. Sixty patients were selected and randomly divided into 2 groups. In the control group, 30 cases were given Bay aspirin tablets and isosorbide mononitrate tablets (Xinkang) orally, and nitroglycerin could be added according to the condition; in the treatment group, 30 cases were given the traditional Chinese medicine Wenyang Huayu Tang on top of the treatment in the control group. The results showed that the treatment group was better than the control group in terms of efficacy of TCM symptoms, reduction of the number of angina attacks and reduction of FIB concentration, and the treatment group also had significant efficacy in improving blood lipid index. Conclusion: The efficacy of Wanyang and Huayu formula in the treatment of angina pectoris in the elderly with coronary heart disease may be related to its effects on coronary expansion, improvement of microcirculation, protection of cardiomyocytes, improvement of vascular endothelial function, lipid regulation, fibrin-lowering and anticoagulation, anti-aging and antioxidant. 3.Discussion and prospect More and more evidence from animal and clinical experiments prove that oxidative stress and oxygen free radicals play an important role in the evolution of coronary heart disease and damage process. In the organism, the antioxidant defense system composed of GPx, SOD and CAT [17] plays an important biological function in preventing cellular aberrations and protecting cell membranes and other biological tissues from peroxidative damage. At present, most of the therapeutic drugs for coronary heart disease are based on SOD, PLO and CAT to study their antioxidant mechanism of action, but the research on the mechanism of oxidative stress of GPx on coronary heart disease is rare or even incomplete. Chinese medicine has achieved good clinical efficacy in the treatment of coronary heart disease, and the mechanism of antioxidant in the treatment of coronary heart disease by Chinese medicine, group formula, acupuncture, gua sha and tui na is to regulate the GPx content through experimental research. Regardless of the treatment method can achieve the purpose of improving the symptoms of coronary heart disease by regulating the level of GPx, but the level of GPx decrease in various types of evidence and the level of GPx effect after treatment is not more systematic research, as to be further in-depth research.