| Purpose:To observe the clinical effects of chronic cardiac failure treatment by Ginseng shrinkage heart drink through clinical trials.To investigate the intervention effect and mechanism of rat myocardial remodeling procedure in Ginseng shrinkage heart drink treatment.Process:Though clinical observation,we choose 63 patients,dated from Feb 2013 to May 2015,to form a randomized controlled trial to test the safety index and the therapeutic effect assessment index.In animal experiment,we put 120 Wistar rats into sham operation group(Sham),myocardial hypertrophy group,low Ginseng shrinkage heart drink dose group,middle Ginseng shrinkage heart drink dose group,high Ginseng shrinkage heart drink dose group and positive drug group randomly.To establish experimental model of ventricular remodeling of rats.To determine hemodynamic index,visceral organ index of ventriculus sinister,thickness of left ventricular anterior wall and ventricular septum,Protein content of Left ventricular,Collagen content of myocardium and Collagen volume fraction of myocardial matrix.To detect the biochemical activity of Caspase by Bradfor method.To measure content of Ang ?,ALD,ET and ANP by radioimmunoassay.To detect the expression of protein of Caspase-3,Caspase-9,PARP,Bcl-2,Bax,p-38MAPK,p-P38MAPK,JNK,p-JNK,AKT and p-AKT in cardiac muscle tissues.Result:1.The level of SBP,DBP,MAP,LVSP and ±dp/dtmax in the myocardial hypertrophy group rats is low and the HR and LVEDP is high compared with the sham operation group rats,and the differences mark a statistical significance(P<0.01)· The level of SBP,DBP,MAP,LVSP and ±dp/dtmax in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats is high while the HR and LVEDP is low compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.05 or P<0.01).The effect matches Captopril.And although the level of SBP.DBP,MAP,LVSP and ±dp/dtmax in the low Ginseng shrinkage heart drink dose group has a slightly increasing trend and the level of HR and LVEDP has a decreasing trend,it does not have a statistical significance(P>0.05).2.The absolute weight of ventriculus sinister and the visceral organ index of ventriculus sinister in the myocardial hypertrophy group rats increases compared with the sham operation group rats,and the differences mark a statistical significance(P<0.001).While the body weight decreases but it does not have a statistical significance(P>0.05).The visceral organ index of ventriculus sinister in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats decreases compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.01).The effect matches Captopril.And although the absolute weight of ventriculus sinister and the visceral organ index of ventriculus sinister in the low Ginseng shrinkage heart drink dose group slight decreases,it does not have a statistical significance(P>0.05).3.The thickness of left ventricular anterior wall and ventricular septum in the myocardial hypertrophy group rats increases apparently compared with the sham operation group rats,and the differences mark a statistical significance(P<0.01).The thickness of left ventricular anterior wall and ventricular septum in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats decreases compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.05).The effect matches Captopril.And although the thickness of left ventricular anterior wall and ventricular septum in the low Ginseng shrinkage heart drink dose group slight decreases,it does not have a statistical significance(P>0.05).4.The collagen content of myocardium in the myocardial hypertrophy group rats increases apparently compared with the sham operation group rats,and the differences mark a statistical significance(P<0.01).And the protein content of Left ventricular increases but it does not have a statistical significance(P>0.05).The collagen content of myocardium in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats decreases compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.05).The effect matches Captopril.And although the collagen content of myocardium and the protein content of Left ventricular in the low Ginseng shrinkage heart drink dose group slight decreases,it does not have a statistical significance(P>0.05).5.The collagen volume fraction of myocardial matrix in the myocardial hypertrophy group rats increases apparently compared with the sham operation group rats,and the differences mark a statistical significance(P<0.01).The collagen volume fraction of myocardial matrix in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats decreases compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.05).The effect matches Captopril.And although the collagen volume fraction of myocardial matrix in the low Ginseng shrinkage heart drink dose group slight decreases,it does not have a statistical significance(P>0.05).6.The content of serum MDA in the myocardial hypertrophy group rats.increases and the biochemical activity of SOD?GSH-Px decreases compared with the sham operation group rats,and the differences mark a statistical significance(P<0,01 or P<0.001),The content of serum MDA in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats decreases and the biochemical activity of SOD?GSH-Px increases compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.05).The rat plasma and the content of Ang ??ALD in the cardiac muscle tissues in the myocardial hypertrophy group rats increases compared with the sham operation group rats,and the differences mark a statistical significance(P<0.01).The rat plasma and the content of Ang ??ALD in cardiac muscle tissues in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats decreases compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.05).The rat plasma endothelin(ET)and atrial natriuretic peptide(ANP)in the myocardial hypertrophy group rats increases compared with the sham operation group rats,and the differences mark a statistical significance(P<0.01).The rat plasma endothelin(ET),atrial natriuretic peptide(ANP)and Ca2+ in cardiac muscle tissues in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats decreases compared with the myocardial hypertrophy group rats,and the differences mark a statistical significance(P<0.05).7.The biochemical activity of Caspase-3,Caspase-9 in cardiac muscle tissues in the myocardial hypertrophy group rats rises apparently compared with the sham operation group rats(P<0.01).The biochemical activity of Caspase-3,Caspase-9 in cardiac muscle tissues in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats reduces apparently compared with the myocardial hypertrophy group rats(P<0.05).The expression of protein Caspase-3,Caspase-9 in cardiac muscle tissues in the myocardial hypertrophy group rats rises apparently and the Caspase-3 substrate PARP degradation increases compared with the sham operation group rats.The expression of protein Caspase-3,Caspase-9 in cardiac muscle tissues in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats reduces apparently and the Caspase-3 substrate PARP degradation decreases compared with the myocardial hypertrophy group rats.There is no obvious dose effect relationship between the two dose groups.The expression of protein Bax in cardiac muscle tissues in the myocardial hypertrophy group rats rises while protein Bcl-2 reduces compared with the sham operation group rats.The expression of protein Bax in cardiac muscle tissues in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats reduces apparently while protein Bcl-2 rises compared with the myocardial hypertrophy group rats.There is no obvious dose effect relationship between the two dose groups.The phosphorylation level of P38MAPK and JNK in cardiac muscle tissues in the myocardial hypertrophy group rats increases compared with the sham operation group rats.The phosphorylation level of P38MAPK and JNK in cardiac muscle tissues in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats reduces decreases compared with the myocardial hypertrophy group rats.The phosphorylation level of AKT in cardiac muscle tissues in the myocardial hypertrophy group rats decreases compared with the sham operation group rats.The phosphorylation level of AKT in cardiac muscle tissues in the middle Ginseng shrinkage heart drink dose group and high Ginseng shrinkage heart drink dose group rats increases compared with the myocardial hypertrophy group rats.Conclusion:The Ginseng shrinkage heart drink can significantly improve security index and curative effect index of heart failure patients.It can improve hemodynamic parameters,reduce Heart coefficient,reduce the thickness of left ventricular anterior wall and ventricular septum,lower protein content of Left ventricular and Collagen content of myocardium and Collagen volume fraction of myocardial matrix of myocardial hypertrophy rats,enhance antioxidant capacity of myocardium.It can also restrict myocardial hypertrophy rat renin angiotensin aldosterone activity,reduce Vasoconstrictors level and biochemical activity of Caspase-3 and Caspase-9,lower the expression of protein Caspase-3,Caspase-9,PARP,Bcl-2 and Bax of myocardial hypertrophy rats.It can also restrict signal transduction pathway of P38MAPK,JNK and PI3K/AKT of myocardial hypertrophy rats. |
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