| Objective:To explore the therapeutic effect of Xuefu Zhuyu Capsule on patients with qi stagnation and blood stasis syndrome of coronary heart disease and angina pectoris;To analyze the specific genes and pathways related to qi stagnation and blood stasis syndrome in angina pectoris of coronary heart disease;Explain the mechanism of Xuefu Zhuyu Capsule in the treatment of qi stagnation and blood stasis syndrome of coronary heart disease and angina pectoris.Methods:1.Clinical study on Xuefu Zhuyu Capsule in the treatment of coronary heart disease and angina pectoris: using a prospective,multicenter clinical trial design,according to whether to take Xuefu Zhuyu Capsule,patients with qi stagnation and blood stasis syndrome of coronary heart disease and angina pectoris were divided into exposure group(Xuefu Zhuyu Capsule Combined with routine treatment of Western Medicine)and non exposure group(routine treatment of Western Medicine),with 262 cases in each group for 8 weeks;The Seattle angina pectoris questionnaire(SAQ)was collected at 0 and 8 weeks to evaluate the clinical efficacy of Xuefu Zhuyu Capsule in the treatment of coronary heart disease and angina pectoris.2.Transcriptomic study of Xuefu Zhuyu Capsule on patients with qi stagnation and blood stasis syndrome of coronary heart disease: select 20 typical patients(10 cases in Xuefu Zhuyu Capsule treatment group and 10 cases in western medicine routine treatment group),and select 10 cases in healthy control group to complete RNA sequencing(RNA SEQ).The fasting blood samples of 0 and 8 weeks in Xuefu Zhuyu Capsule treatment group and Western medicine routine treatment group and 0 week fasting blood samples of healthy people were collected,and the total RNA of blood was extracted by Trizol reagent.RNA SEQ was used for library construction and sequencing,genome sequence alignment,identification of differentially expressed genes and bioinformatics analysis.Analyze the specific genes and pathways of patients with qi stagnation and blood stasis syndrome of coronary heart disease,reasonably speculate the therapeutic mechanism of Xuefu Zhuyu Capsule on coronary heart disease,and verify it by molecular docking method.Results:1.There was no significant difference between the exposed group and the non exposed group in gender,age,BMI,smoking and alcohol history and complications(P > 0.05).Compared with the SAQ score of the exposure group at week 0,the scores of five items of SAQ scale in the exposure group increased in varying degrees at week 8,and the symptoms of angina pectoris were significantly improved(P < 0.05).Compared with the SAQ score of the non exposed group at week 0,the scores of five items of the SAQ scale in the non exposed group also increased in varying degrees at week 8,and the symptoms of angina pectoris were significantly improved,and there were also significant differences between the two groups(P< 0.05).At 8 weeks,the scores of five items in the exposed group were higher than those in the non exposed group,and there was significant difference between the two groups(P <0.05).2.Compared with the control group of healthy people,patients with qi stagnation and blood stasis syndrome of coronary heart disease angina pectoris obtained 12591 differential genes,which were enriched in 1290 go entries and 54 KEGG pathways.The results of go enrichment analysis showed that the occurrence of qi stagnation and blood stasis syndrome of coronary heart disease angina pectoris could cause the structural composition of ribosome,cytoplasmic ribosome Biological changes such as ribosomal subunit and intracellular.KEGG enrichment analysis showed that the occurrence of qi stagnation and blood stasis syndrome of coronary heart disease mainly affected the following pathways,such as m TOR signaling pathway and HIF-1 signaling pathway,which were related to apoptosis and autophagy.The PPI network diagram of coronary heart disease angina pectoris with qi stagnation and blood stasis syndrome is composed of 4326 nodes and 51889 edges.The core genes of degree top20 are rps27,polr2 f,snu13,polr2 l,RPS6,polr2 e,RPS27a,polr2 j,PIK3CA,polr2 g,UBA52,rbx1,ppp2r1 a,polr2h,polr2 i,ncbp1,Rac1,polr2 b,UBC and Cdc20.The PPI map of the above 20 core genes is composed of 209 lines.Among them,the differentially expressed genes related to coronary heart disease are enriched in HIF-1 signal pathway and m TOR signal pathway.There are three genes,one up-regulated gene: PIK3 CA,and two downregulated genes: RPS6 and rbx1.3.Xuefu Zhuyu Capsule Combined with conventional western medicine can reverse the high expression of 34 genes,such as cmya5,rbfox2,PTPRG,GABRE,c4orf48,traj34,carnmt1-as1,cotl1p2,actg1p19 and pa2g4p5;Xuefu Zhuyu Capsule Combined with conventional western medicine can reverse the low expression of 26 genes,such as rpl12p6,COL1A2,mt2p1,col14a1,mt1xp1,ppp1r1 b,hmcn2,cbsl,baat and mycnos.Molecular docking results showed that among the above 60 callback genes,the proteins expressed by 11 target genes(3qnt,2yvq,6bw3,2cq3,3e0 g,1gq5,4frw,2h4 v,2dnh,1zkk and 1jbq)were respectively related to the active components of Xuefu Zhuyu Capsule(raffinose,CIS dihydroquercetin,stachyose,semi isoflavone B,glycyrrhizin a,glycyrrhizin isoflavone,stachyose,glycyrrhizin isoflavone B,kaempferol and stachyose)It can be combined well and has a stable structure after combination.4.Xuefu Zhuyu Capsule Combined with conventional western medicine may play a role in the intervention of coronary heart disease through multi-target genes such as NPC1L1,CPS1,MECom,rbfox2,GABRE,lifr and PDGFRA,which have been verified by molecular docking.It reflects that Xuefu Zhuyu Capsule Combined with conventional western medicine has the characteristics of multi-target and multi-channel in the intervention of qi stagnation and blood stasis syndrome of coronary heart disease angina pectoris.Conclusions:1.Through clinical research,it is found that Xuefu Zhuyu Capsule Combined with conventional western medicine is effective in the treatment of angina pectoris of coronary heart disease,which can significantly improve the symptoms of angina pectoris,and provide a basis for clinical evaluation of Xuefu Zhuyu Capsule in the improvement of angina pectoris in patients with qi stagnation and blood stasis syndrome.2.Transcriptomic study found that after patients with coronary heart disease angina pectoris with qi stagnation and blood stasis syndrome,HIF-1 signaling pathway and m TOR signaling pathway may be activated.3.It was found that there were multiple target genes of pdlfc1,NFB4,phlegmy,and phlegmy,which may be related to the transcription of coronary heart disease,phlegmy,and phlegmy.It was found that there were multiple target genes of pdlfc1,phlegmy,phlegmy,and phlegmy. |
PDF Full Text Request