| ObjectiveTo analyze the medication rule of professor Zou Xu in treating premature ventricular complexes based on Traditional Chinese Medicine(TCM)inheritance support system.Analyze the medication characteristics and medication rule,and then summarize the experience of professor Zou Xu in treating premature ventricular complexes in combination with the analysis.Finally,the experienced prescription will be established on the basement of long-term clinical experience of professor Zou Xu and the data-mining results will be taken as an important reference.To observe the effects of the experienced prescription on arrhythmia induced by ischemia-reperfusion and to explore its mechanism.Methods1.The prescriptions professor Zou Xu used to treat premature ventricular complexes from January 2009 to January 2016 were collected and the medical information was standardized to establish a database.And the general information、high-frequency herbs、high-frequency core groups and new prescriptions were accepted into the database.Then the data was mined by the use of Traditional Chinese Medicine(TCM)inheritance support system.And the experience of professor Zou Xu in treating premature ventricular complexes was summarized,then established the experienced prescription.2.96 SD rats were divided randomly into sham-operated group(S group)、model group(C group)、verapamil group(V group)、wenxinkeli group(W group)、high dosage group(G group)、experienced prescription low dosage group(D group)、experienced prescription high dosage +LY294002 group(G+L group)、experienced prescription low dosage +LY294002 group(D+L group),each containing 12 rats.All groups were given corresponding medicines for 14 days.All the groups apart from sham-operated group were established MIRI model by ligating the left anterior descending coronary artery(LAD).The electrocardiogram was recorded during the processes of ischemia 30min/reperfusion 60min,scored the reperfusion arrhythmia.After the record,the peripheral blood and the myocardial tissues were collected for further study.The heart tissue was stained with HE,the apoptosis in cardio myocyte was detected by end labeling(TUNEL)assay,the NO levels of serum and SOD activity and MDA content of the myocardial tissue were measured.The protein expression of PI3K,AKT,p-AKT,eNOS in the myocardial tissue was determined by Western Blot,and the mRNA expression of PI3K,AKT was determined by PCR.Results1.Medication rule:By the analysis of the included 342 prescriptions,139 kinds of herbs appeared,the total frequency is 5284.Of which the most frequent herbs were rhizoma pinellinae praeparata,prepared radix glycyrrhizae,radix Ophiopogonis,rhizome atractylodis,acorus tatarinowii schott,radix rehmanniae,radix pseudostellariae and so on.The main effectiveness of high frequency herbs were tonify deficiency,clearing heat and reduce phlegm.The main flavors of high frequency herbs were sweet,bitter,pungent.The main gas of high frequency herbs were warm,peaceful,cold.The main channel tropism of high frequency herbs were Heart,Stomach,Spleen.Furthermore,17 core groups and 8 new prescriptions were mined.Summary of experience:Professor Zou Xu argued that premature ventricular complexes were syndrome of deficiency Ben and excessive Biao.In this Ben of Ying and Blood,Biao of and phlegm-dampness.And dialectics of arrhythmia should use the Ying-Yang theory as guiding line and the existence of Phlegm-dampness as key.Nourishing blood and restoring pulse,resolving phlegm and calming heart should be the basic treatment.And emphasized the importance of the theory of five viscera correlation.The establishment of the experienced prescription:Taken the classical prescription as the source,the result of data mining as a reference,the modern pharmacological research as support,and the long-term clinical experience of professor Zou Xu as basement,the experienced prescription was established.And radix rehmanniae was used as monarch herb,rhizoma pinellinae praeparata and rhizome atractylodis were used as ministerial herbs.The function of the experienced prescription was nourishing blood and restoring pulse,resolving phlegm and calming heart.2.The attack of ventricular arrhythmia:Contrast with model group(C group),the attack of premature ventricular complexes and ventricular tachycardia of the rats in high dosage group(G group)and low dosage group(D group)was significant decreased,as well as the scores of ventricular arrhythmias.All the difference was statistically significant(P<0.05).Contrast with verapamil group(V group)and wenxinkeli group(W group),the scores of ventricular arrhythmias of the rats in low dosage group(D group)decreased,and the difference was statistically significant(P<0.05).When add inhibitors,the scores of ventricular arrhythmias of rats in low dosage group(D group)and high dosage group(G group)increased,and the difference was also statistically significant(P<0.05).Apoptosis index:contrast with model group(C group),the myocardial apoptosis indexes of rats in high dosage group(G group)and low dosage group(D group)were significant decreased,and the difference was statistically significant(P<0.05).the apoptosis indexes increased when added inhibitors to low dosage group(D group),and the difference was statistically significant(P<0.05).The activity of SOD and the content of MDA in myocardial tissues:the activity of SOD in the experienced prescription low dosage group(D group)was more higher to compare with the model group(C group).There was a significant different between the two groups(P<0.05).the content of MDA in myocardial tissues was lower in the high dosage group(G group)and the experienced prescription low dosage group(D group)to compare with the model group(C group).The difference was significant(P<0.05).The protein content of PI3K,AKT,p-AKT,eNOS in Myocardial tissues:the protein content of PI3K was increased in high dosage group(G group)and experienced prescription low dosage group(D group),and the growth had a significant difference(P<0.05).The expression of p-AKT protein was increased in high dosage group(G group)and experienced prescription low dosage group(D group),and the growth had a significant difference(P<0.05)to compare with the model group(C group).The expression of eNOS protein was increased in high dosage group(G group)and experienced prescription low dosage group(D group),and the growth had a significant difference(P<0.05)to compare with the model group(C group).The genetic expression of PI3K and AKT in Myocardial tissues:To compare with model group(C group)the genetic expression of PI3K was increased in the experienced prescription low dosage group(D group)and experienced prescription low dosage +LY294002 group(D+L group),and the elevator had a significant difference(P<0.05).To compare with model group(C group),the genetic expression of AKT was increased in the experienced prescription high dosage group(G group)and experienced prescription low dosage group(D group),and the elevator had a significant difference(P<0.05).ConclusionsThe mining analysis of the medication rule of Professor Zou Xu in treating premature ventricular complexes shows the medication characteristics and medication rule,and also provides the data support for the summary of clinical experience.Taken the classical prescription as the source,the result of data mining as a reference,the modern pharmacological research as support,and the long-term clinical experience of Professor Zou Xu as basement,the experienced prescription was established.The therapeutic effects of the experienced prescription on premature ventricular complexes have been tested by animal experiments.It is proved that the experienced prescription can reduce the attack of reperfusion arrhythmia.Compared with the verapamil group and the wenxinkeli group,the low dose group has obvious advantages.The mechanisms of anti arrhythmic may be achieved by the activation of the PI3K/AKT signaling pathway,the reduction of myocardial cell apoptosis,and the increase of antioxidation capacity. |
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