以氯吡格雷（Clo）为主的双联抗血小板药物是冠心病经皮冠脉介入（PCI）治疗的重要部分，国内外转化医学、循证医学和我们前期的证据表明，国人CYP2C19基因变异可达50%以上，这种基因变异与Clo抵抗密切相关，对携带这种基因变异的气虚血瘀体质和PCI者加补阳还五汤复方制剂步长脑心通胶囊（BNJ）有明显增效作用。本研究拟通过人肝微粒体模型和PXR共转染报告基因系统获取BNJ全方或单体成分对CYP3A4/CYP2C19/CYP3A5表达上调的信息，通过冠脉微栓塞鼠模、整合CYP2C19基因型启动Clo药物治疗的主流医学与CYP2C19基因变异PCI者加BNJ的非主流医学随机对照临床试验，探讨Clo加BNJ是否通过调控肝药酶和CD40/CD40L信号网络防治冠脉血栓形成，以便为国人携带CYP2C19基因变异者Clo治疗提供新的方案，为多靶点调控的整合医学模式提供理论和循证医学的依据。

Clopidogrel (Clo) based dual antiplatelet therapy is an important part of treatment after percutaneous coronary intervention (PCI). The translational medicine, evidence-based medicine and our previous evidence indicated that the mutation of CYP2C19 gene can reach more than 50% in China, which was closely related to Clopidogrel resistance. In the constitution of qi deficiency and blood stasis patients who carrying this gene variant, clopidogrel resistance might be significantly improved by taking Buchang Naoxintong Capsule (BNJ). This study proposed to get the information on how the CYP3A4/CYP2C19/CYP3A were upregulated by BNJ or its single component using human liver microsomes model and PXR cotransfect reporter gene system. Through the coronary microembolization rats model, the integration of mainstream medicine that promote Clopidogrel medication by CYP2C19 genotype and non-mainstream medical randomized controlled clinical trial combined application BNJ and Clopidogrel in CYP2C19 gene mutation patients after PCI, we proposed to discuss whether the preventional effetions on coronary artery thrombosis of BNJ were mediated by the regulation of hepatic enzymes and CD40/CD40L signal transduction pathway. Our purpose was to create a new scheme of clopidogrel therapy for patients carrying the CYP2C19 gene mutation, and to provide new theory and evidences for multiple target regulation based on integrated medical model.