Clinical Observation And Network Pharmacological Exploration Of Fuxinmai Formula In Treating Stable Angina Pectoris (Yang Qi Deficiency Type)

Objective:To observe the effects of Fuxinmai Formula on the TCM evidence score,electrocardiogram,Seattle Angina Scale(SAQ),nitroglycerin discontinuation rate,and TCM evidence efficacy in patients with stable angina pectoris(Yang Qi deficiency type),and to investigate the molecular mechanism with the help of network pharmacology.Methods:1.A total of 56 patients with stable angina pectoris(Yang Qi deficiency type)who met the inclusion and exclusion criteria were collected from the outpatients of the cardiovascular department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine.The control group(28 patients)was given isosorbide mononitrate extended-release tablets,aspirin enteric soluble tablets,atorvastatin calcium tablets,and metoprolol succinate extended-release tablets,and the test group(28 patients)was given Fuxinmai Formula soup on top of the treatment in the control group,and both groups were treated continuously for 6 weeks,and the TCM evidence score,electrocardiogram,Seattle angina pectoris,and nitroglycerin withdrawal rate were recorded before and after treatment.The changes of indexes such as TCM syndrome score,electrocardiogram,Seattle angina scale,nitroglycerin withdrawal rate and TCM syndrome efficacy were recorded before and after treatment.SPSS25.0 statistical software was applied for statistical analysis and data processing.2.The active ingredients and corresponding targets of Fuxinmai Formula were obtained from TCMSP database,and the related targets of stable angina pectoris were obtained from Gene Cards,OMIM,Drug Bank,Dis Ge NET and TTD databases,and Venn diagrams were drawn with the help of Venny platform to obtain drug-disease common targets,and drug-ingredient-target visualization network was constructed with the help of Cytoscape software.-We then used Cytoscape to find the key core targets,and finally imported the key core targets into Metascape and combined with the microbiology platform to build the enrichment analysis results and visualize them.Results:1.comparison of general data: there was no statistical difference between the two groups in terms of gender,age,and angina pectoris grading(P > 0.05),which was comparable.2.Comparison of TCM syndrome points: after treatment,the total TCM syndrome points,major TCM syndrome points(chest pain,chest tightness)and most minor TCM syndrome points(shortness of breath,palpitations,fatigue and weakness,fear of cold,soreness and weakness of the waist and knees)were significantly improved in the two groups,with statistical differences(P < 0.05);however,the TCM syndrome points of spontaneous sweating or night sweating and sleeplessness were not significantly improved,with no statistical differences(P > 0.05).3.Comparison of SAQ: Compared with the two groups within the two groups,all indicators of SAQ were significantly different between the two groups after treatment than before treatment(P < 0.05).Compared between the two groups,there was no significant difference in SAQ scores between the test group and the control group before treatment(P> 0.05),and there was a significant difference in SAQ scores between the test group and the control group after treatment(P< 0.05).4.Comparison of nitrate discontinuation rate: the total nitrate discontinuation rate was 85% in the test group and 64% in the control group after treatment,and there was a statistical difference between the two groups(P < 0.05).5.Comparison of electrocardiographic efficacy: the total effective number of electrocardiograms in the test group was 79%,and the total effective number of electrocardiograms in the control group was 57% after treatment,and there was a statistical difference between the two groups(P <0.05).6.Comparison of the efficacy of TCM symptoms: after treatment,the total effective number of TCM symptoms in the test group was 93%,and the total effective number of TCM symptoms in the control group was 83%,and there was a statistical difference between the two groups(P < 0.05).7.The network pharmacology results showed that the herbal components that played important roles were quercetin,kaempferol,dousterol,β-sitosterol,and xanthophylls,etc.The targets with the highest disease relevance were AKT1,IL6,TNF,TP53,and VEGFA,etc.KEGG enrichment analysis showed that Fuxinmai Formula may be a pathway through cancer,human cytomegalovirus infection,HIF-1 signaling pathway,fluid shear stress and atherosclerosis,thyroid hormone signaling pathway,central carbon metabolism in cancer,VEGF signaling pathway,neurodegenerative-multiple disease pathway,and other multiple pathways for the treatment of stable angina pectoris.Conclusion:1.Fuxinmai Formula combined with western medicine can better improve various indexes such as TCM evidence score,ECG,SAQ,nitroglycerin stop-reduction rate,and TCM evidence efficacy in patients with stable angina pectoris(Yang Qi deficiency type),and the effect was generally better than that of the western medicine alone group.In the whole treatment process,the combination of Fuxinmai Formula with western medicine did not show any obvious adverse reactions,and the safety is good,which is worth promoting.2.Through the network pharmacology,it can be found that Fuxinmai Formula has the characteristics of multi-component,multi-target and multi-pathway in the treatment of stable angina pectoris,and it has certain practical significance for its further in-depth study.