Objective To observe the regulation of miRNA-126 and its downstream signal expression in mouse aorta and vascular endothelial cells by observation of phlegm and blood stasis method to study the mechanism of Chinese medicine in inhibiting atherosclerosis. Methods In the cell experiment, the vascular endothelial cells were randomly divided into 4 groups: control group, model group, high-dose Chinese medicine-containing serum group, and low-dose Chinese medicine-containing serum group. Different groups of vascular endothelial cells were treated with different drug-containing serum to observe cell proliferation and apoptosis. RT-PCR and Western-blot assay were used to detect miRNA-126, RGS16,CXCL12, CXCR4, VCAM-1, mRNA and protein expression in vascular endothelial cells. The aortic cross-sectional pathological damage was evaluated with HE staining in vivo. The aortic miRNA-126, RGS16, CXCL12, CXCR4, VCAM-1 mRNA and protein expression were measured with RT-PCR and Western-blot methods. Results The results of in vitro experiments showed that the apoptosis rates of VEC in the model group, high-dose group and low-dose group were significantly higher than that in the control group (P < 0.05), and the proliferation rate was significantly decreased (P < 0. 05). Compared with the model group, the apoptotic rate of VEC was significantly decreased in the high-dose group and the low-dose Chinese medicine-containing serum group (P < 0. 05), and the proliferation rate was significantly increased. Compared with the high-dose group, there was no significant difference in apoptotic rate and proliferation rate (P > 0. 0 5). After intervention, the expressions of miR-126 mRNA in the VEC of the model group, the high-dose group and the low-dose group were significantly lower than that of the control group (P < 0.05). Compared with the model group, the expression of the miR-126 mRNA in the VEC of the high-dose group and the low-dose group was significantly increased (P < 0. 05). Compared with the high-dose group, there was no significant difference in the expression of miR-126 mRNA in the low-dose group (P > 0. 05). After intervention, the expressions of RGS16, CXCL12, CXCR4, VCAM-1 mRNA and protein in the VEC of the model group, high-dose group and low-dose group were significantly higher than those of the control group (P < 0.05). Compared with the model group, the expressions of RGS16, CXCL12, CXCR4, VCAM-1 mRNA and protein were significantly decreased in high-dose group and low-dose group (P < 0. 05). Compared with high-dose group, there was no significant difference in RGS16, CXCL12, CXCR4, VCAM-1 mRNA and protein expression in low dose group VEC (P > 0. 05). The results of in vivo experiments showed that through HE staining, in the control group, the aortic vessels were even, the endometrium smooth and flat, and there was no atherosclerotic lesion; In the model group, the aortic vessels were uneven, plaque formed, and the thickness of the blood vessels and the cross-sectional area of the AS plaque were significantly larger than those of the other groups; In the high-dose group and the low-dose group, the aortic layers were normal, the inflammatory cells infiltrated lightly with mild lesions; the AS plaques were small and the lesion was significantly lighter than the model group. After intervention, the expressions of miR-126 mRNA in the arteries of the model group, high-dose group and low-dose group were significantly lower than that of the control group (P < 0.05). Compared with the model group, the expression of miR-126 mRNA in the arteries was significantly increased (P < 0.05). Compared with the high-dose group, there was no significant difference in the expression of miR-126 mRNA in the arteries of the low-dose group (P > 0. 0 5). After intervention, the expressions of RGS16, CXCL12, CXCR4, VCAM-1 mRNA and protein in the arteries of the model group, high-dose group and low-dose group were significantly increased compared with the control group (P < 0.05). Compared with the model group, the expressions of RGS16, CXCL12, CXCR4 and VCAM-1 mRNA and protein in the arteries of the high-dose group and the low-dose group were significantly decreased (P < 0. 05). Compared with the high-dose group, there was no significant difference in the RGS16 and CXCL12 CXCR4 and VCAM-1 mRNA and protein expression in the arteries of the low-dose group. (P > 0. 05). Conclusion The mechanism of action in inhibiting the formation of atherosclerotic plaque may be related to the regulation of miRNA-126 affecting the expression of downstream signals GRS16, CXCL12, CXCR4 and VCAM-1. [ABSTRACT FROM AUTHOR]