Clinical And Network Pharmacological Study Of Shenqi Qiangxin Capsule In The Treatment Of Stable Angina Pectoris (Qi And Yin Deficiency,Heart-Pulse Stasis Syndrome)

Objective:By observing and studying the clinical efficacy of Shenqi Qiangxin capsule in the treatment of stable angina pectoris(qi and Yin deficiency,heart-pulse stasis group syndrome),and then using network pharmacological methods to analyze the mechanism of action of Shenqi Qiangxin capsule in the treatment of SAP,so as to open up certain ideas for clinical application and further research and development.Methods:1.A total of 70 patients diagnosed as SAP by Western medicine from December 1,2021 to December 1,2022 in Heart Disease Department 1,Shijiazhuang Hospital of Traditional Chinese Medicine were collected and divided into two groups according to random number table with 35 patients in the experimental group and 35 patients in the control group.The control group received conventional treatment with Western medicine,and the experimental group received combined treatment with Shenqi Qiangxin Capsule on the basis of Western medicine in the control group.The observation period was 8 weeks,and the clinical efficacy of Shenqi Qiangxin capsule was analyzed.2.Then,the active ingredients and stable angina targets of Shenqi Qiangxin capsules were collected through online database using network pharmacology method.Network construction using cytoscape;Finally,Metascape was used to analyze the core target by GO and KEGG,and the mechanism of action was obtained.Results:1.Observation group and control group were comparable in gender,age,course of disease,smoking,drinking,hypertension,diabetes,hyperlipidemia(P>0.05),and no obvious adverse reactions occurred during treatment.2.Intra-group comparison showed that the individual scores and total scores of TCM syndroms in the two groups were improved after treatment compared with those before treatment(P<0.05),and the difference was statistically significant.After treatment,the individual scores and total scores of TCM syndromes in the observation group decreased more significantly(P<0.05),and the difference was statistically significant.The total effective rate of TCM syndrome score was 90.91% in the observation group and 71.88% in the control group(P<0.05),and the difference was statistically significant.3.In intra-group comparison,the degree of physical activity restriction(PL),angina attack(AF),treatment satisfaction(TS)and disease awareness(DS)in the observation group and the control group after treatment were improved compared with before treatment,with statistical significance P<0.05,while there was no significant difference in stable state of angina(anginal stability,AS),P>0.05.After treatment,the scores of PL,AF,TS and DS in the observation group were higher(P<0.05),but there was no significant difference in AF dimension(P > 0.05).4.After treatment,the reduction rate of nitroglycerin in the treatment group was 87%,which was better than61% in the control group,and the difference was statistically significant(P< 0.05).5.After treatment,the total effective rate of the treatment group was 93.94%,which was better than that of the control group(75.00%),and the difference was statistically significant(P < 0.05).In the network pharmacological study,Shenqi Qiangxin capsule had118 active ingredients,465 targets,1761 targets for stable angina pecina,and 240 targets for their intersection.The main components of Shenqi Qiangxin capsule for the treatment of stable angina pectoris are quercetin,stigmasterol,luteolin,β-sitosterol,naringin,kaempferol,etc.The core targets are 36 RPS3 A,HNRNPH1,DDX3 X,SRSF3,ANXA2,etc.GO enrichment analysis: Biological process(BP),cell component(CC)and molecular function(MF)were selected as the top 20.It involves REDOX,antioxidant,transcriptional regulation,positive regulation of cell migration,hormone regulation,extracellular stimulation,circulatory regulation,ion transport and other biological processes and molecular functions.A total of222 KEGG pathways were enriched,and the first 20 pathways were also selected.The signaling pathways enriched by KEGG included PI3K-Akt signaling pathway,cell aging signaling pathway,sphingolipid signaling pathway,AMPK signaling pathway,etc.Conclusions:1.The clinical observation showed that Shenqi Qiangxin capsule combined with conventional Western medicine was effective in the treatment of stable angina pectoris,superior to the simple western medicine group in improving TCM syndrome score,Seattle angina pectoris scale,electrocardiogram and nitroglycerin stopping rate,and could improve the overall efficacy,which was worth promoting clinically.2.In the aspect of network pharmacology,Shenqi Qiangxin Capsule is used to treat stable angina pectoris by multi-component,multi-target and multi-pathway.The process involves a variety of biological processes and molecular functions,which may involve PI3K-Akt signaling pathway,cell aging pathway,sphingolipid signaling pathway,AMPK signaling pathway,NF-κ B signaling pathway,etc.,and plays a role in myocardial cell metabolism,angiogenesis,myocardial fibrosis and protection,lipid metabolism,and vascular endothelial function.