Study Of The XieFeiLiShui On The Treatment Of Chronic Heart Failure Patients And Its Influence On The Endoplasmic Reticulum Stress

Clinical researchObjective:To observe the clinical effects in the treatment of heart fai lure patients and the effects on myocardial cell endoplasmic reticulum stress-related apoptosis factors by XinShuaiErHao which eliminating Pathogens from the Lung and Diuresis. Methods:Research object is CHF inpatients in Beijing Hospital of Traditional Chinese Medicine and Pinggu district hospital of traditional Chinese medicine between2011.4to2012.12. They were divided randomly into two groups, the control group (35cases) and the treatment group (35cases).Firstly, CHF patients were clsssified by differente symptoms and signs, based on routine therapy the treatment group combined with Chinese medicine which was formed under the guidance of eliminating Pathogens from the Lung and Diuresis. LVEF, LVED were detected by echocardiographic before and after2two weeks therapy, and test the level of apoptosis-related factors sFas/Apo-1, sFasL and NT-proBNP level content in serum. Result:After treatment, the symptoms and physical signs of the treatment group were lower than the control group, the difference was statistically significant (P<0.05); after treatment, the NT-proBNP decreased, LVEF increased, LVED decreased in the two groups, while the NT-proBNP and LVEF increased of the treatment group decreased significantly compared with the control group (P<0.05); after treatment the serum sFas/Apo-1, sFasL content of the two groups were significantly decreased than before treatment (P<0.01); the sFas/Apo-1and sFasL levels were significantly lower in the treatment group than that in the control group (P<0.05). Conclusion:XieFeiLiShui can effectively improve the clinical symptoms of patients with heart failure, reduced the level of brain natriuretic peptide in patients, enhanced the value of the LVEF, reduced LVED, improve the cardiac function of CHF patients. And also can down-regulate the apoptosis related factor sFas and sFasL levels of myocardial cells so as to inhibite myocardial apoptosis.Basic researchObjective:To observe the effects of XinShuaiErHao which eliminating Pathogens from the Lung and Diuresis cell apoptosis on the hypertrophy of myocardial of mice in vitro model. Methods:Cultured primary neonatal rat myocardial cells, established hypertrophic myocardial model by AngⅡ, Experiment were divided into7groups:control group, model group,5%blank serum group,5%XinShuaiErHao group,10%blank serum group,10%XinShuaiErHao group, and captopril group. Use morphological and immunocytochemical methods to identify of myocardial cells. Calculated myocardial cell area by image processing software. Compared cell viability among the groups of myocardial by typan-blue exclusion assays. Compared myocytes early apoptosis rate by Hoeehst33342staining method. Us ing Western blot to detected protein expression of Grp78, caspase-12, JNK and CHOP. Result:Identification of myocardial cells showed myocytes positive rate≥95%, ensured the veracity and reliability of this experiment.①Comparing with the control group, the cell area of model group increases markedly(P<0.05), the survival rate of myocardial cells reduced (P<0.05). Early apoptosis rate of myocardial cells increased significant ly (P<0.01). Grp78、caspase-12、JNK and CHOP proteins were over-expressed.②5%XinShuaiErHao group can not prevent hypertrophy of Myocardial cell compared with5%black serum group, though survival rate of5%XinShuaiErHao group is higher than that of5%control group (P<0.05), and early apoptosis rate and the of5%XinShuaiErHao group decline (P<0.01).③Comparing with the10%black serum group,10%XinShuaiErHao group has the effect of inhibiting the hypertrophy (P<0.05). Although the survival rate of myocardial cells has improved, No significant difference were found between two groups.10%XinShuaiErHao group’s early apoptosis rate (P<0.01) were lower than10%black serum group. Besides that, the expression level of Grp78、caspase-12、CHOPwere down-regulated (P<0.01), JNK protein level decreased (P<0.05) compared with10%black serum group.④Between10%XinShuaiErHao group and5%XinShuaiErHao group,10%XinShuaiErHao group can preventing cardiac myocyte hypertrophy (P<0.05), the survival rate of10%XinShuaiErHao group is higher than that of5%XinShuaiErHao group, but the difference was not statistically significant (P>0.05), the early apoptosis rate of myocardial cells was lower markedly (P<0.01), and release rate of LDH declined (P<0.05). Conclusion:①Cardiac myocytes which intervention by XinShuaiErHao can improve the hypertrophic cells survival and reduce the rate of early apoptotic.②Comparing with the5%XinShuaiErHao group,10%XinShuaiErHao group can preventing cardiac myocyte hypertrophy, reducing the rate of early apoptotic and elease rate of LDH, prompting that there may be the best dose for XinShuaiErHao in clinic, if reducing the density of the medicine, efficacy could be worse.③XinShuaiErHao can down-regulated the level of Endoplasmic reticulum stress associated protein: Grp78、caspase-12、JNK and CHOP, which suggest that XinShuaiErHao can protect cardiac myocyte maybe through alleviate Endoplasmic reticulum stress.