| Objective:By observing the clinical efficacy of Modified Gualou Xiebai Banxia Decoction in the treatment of patients with stable angina pectoris(Stable angina pectoris,SAP)phlegm-turbid internal obstruction syndrome,and based on the theory of "heart and small intestine",using 16 SrDNA sequencing technology to explore Modified Gualou Xiebai Banxia Decoction the impact on the gut microbiota and provide new ideas for future research on the prevention and treatment of Coronary artery disease with traditional Chinese medicine.Methods:1.In this study,72 patients with SAP phlegm-turbid internal obstruction syndrome were selected and divided into a control group(n=36)and an observation group(n=36)according to the random number table.The control group was treated with standardized western medicine treatment(such as anti-platelet aggregation,coronary expansion,ester regulation,ventricular rate control,etc.);The observation group was combined with the addition and subtraction of Modified Gualou Xiebai Banxia Decoction on the basis of the control group,and the Chinese medicine decoction was taken once a day in the morning and evening;Observe the clinical symptoms,TCM syndromes,electrocardiogram,blood test,etc.before and after treatment of the two groups of patients.14 days is a course of treatment,and there are 2 courses in total.After the end of the study,the angina curative effect,electrocardiogram curative effect,TCM syndrome score,blood lipid level and other changes in control group and observation group were compared to evaluate the clinical curative effect of Modified Gualou Xiebai Banxia Decoction in the treatment of SAP patients with phlegm-turbid internal obstruction syndrome.2.According to the actual collection of stool samples and the final samples for examination,combined with the stool samples of healthy persons collected during the same period as the blank group(group A,n=6).By using16 SrDNA sequencing technology,the gut microbiota of the blank group(group A,n=6),the control group(group B,n=6),and the observation group(group C,n=6)were carried out.Sequencing identification,analysis of the structure,composition and abundance of the flora,to explore the influence of Modified Gualou Xiebai Banxia Decoction on the gut microbiota of patients with SAP phlegm-turbid internal obstruction syndrome.Finally,statistical analysis was performed on all data using SPSS 25.0 statistical software,and conclusions were drawn.Results:1.Clinical efficacy and safety: 1)Angina pectoris efficacy: The total effective rate of angina pectoris in the control group and the observation group is76.47% and 90.63%,and the observation group is better than the control group(P<0.05).2)ECG curative effect: The total effective rate of ECG curative effect in the control group and the observation group is 58.33% and59.38%,and there is no significant difference between the two groups(P>0.05).3)TCM syndrome scores: There is no significant difference in TCM syndrome scores between the control group and the observation group before treatment(P>0.05).The two groups are comparable;after the course of treatment,before and after treatment in the two groups The comparison of TCM syndrome scores was lower(P<0.05);the comparison of TCM syndrome scores between the two groups after treatment,the difference was statistically significant,and the observation group was better than the control group(P<0.05).4)Blood lipid curative effect: There was no significant difference in blood lipid levels(TC,TG,HDL-C,LDL-C)between the control group and the observation group before treatment(P>0.05).The two groups are comparable;the two groups Comparison of blood lipids before and after internal treatment,TG,TC,LDL-C all decreased,HDL-C increased,the difference was statistically significant(P<0.05).Comparing the effects of blood lipids between the two groups after treatment,it was found that LDL-C decreased and HDL-C increased in the observation group were better than those in the control group(P<0.05),but there was no significant difference between TC and TG(P>0.05).5)Safety evaluation: There were no obvious adverse reactions and exacerbations during the treatment of the two groups,indicating that the safety of this study is better.2.Analysis of the difference in the gut microbiota of patients with SAP phlegm-turbid internal obstruction syndrome in this study: Before treatment,there was no significant difference in α diversity analysis among the three groups before treatment(P>0.05).At the level of Phylum,Family,and Genus,the abundance levels of Bacteroidota,Ruminococcaceae,Bacteroidaceae,Bacteroides,and Faecalibacterium in control group were lower than those in the blank group(P<0.05);Compared with the blank group,the abundance level of Bacteroidota,Ruminococcaceae,Bacteroidaceae,Bacteroides,and Faecalibacterium in observation group was lower(P<0.05);There was no significant difference in the abundance level of Bacteroidota,Ruminococcaceae,Bacteroidaceae,Bacteroides,and Faecalibacterium in control group compared with observation group(P>0.05),suggesting that the two groups are comparable.3.The effect of Modified Gualou Xiebai Banxia Decoction on the gut microbiota of patients with SAP phlegm-turbid internal obstruction syndrome:After treatment,compared with control group,the number of OTU in observation group increased,and there was a difference in the increase of the Sobs index,Chao1 index,and ACE index in the α diversity analysis(P<0.05).At the level of Phylum,Family,and Genus,the abundance of Lachnospiraceae in control group was higher than that in the blank group(P<0.05),and the abundance level of Bacteroidota,Bacteroidaceae,and Bacteroides were higher Slightly decrease(P<0.05);Compared with the blank group,the abundance level of Lachnospiraceae in observation group was higher(P<0.05),and the abundance of Bacteroidota,Bacteroidaceae,Bacteroides was lower(P<0.05);Compared with control group,the abundance level of Bacteroidota,Lachnospiraceae,Bacteroidaceae in observation group was higher(P<0.05).Conclusions:1.Modified Gualou Xiebai Banxia Decoction can effectively improve the clinical efficacy of SAP phlegm-turbid internal obstruction syndrome,further relieve symptoms of angina pectoris,improve TCM syndromes,regulate blood lipid levels,and have good safety.This shows that Modified Gualou Xiebai Banxia Decoction can be used to treat SAP patients with phlegm-turbid internal obstruction syndrome,and its curative effect is definite.2.The abundances level of Bacteroidota,Ruminococcaceae,Bacteroidaceae,Bacteroides,and Faecalibacterium in patients with SAP phlegm internal resistance syndrome are significantly lower than those of the normal population,suggesting that patients with SAP phlegm-turbid internal obstruction syndrome are in the gut microbiota imbalance state.3.Modified Gualou Xiebai Banxia Decoction can effectively improve the imbalance of gut microbiota in patients with SAP phlegm-turbid internal obstruction syndrome,and regulating the imbalance of gut microbiota may be one of its mechanisms of preventing and treating coronary artery disease. |
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