Professor Jiang Lihong’s Medication Rule Of Supplementing Qi And Activating Blood In The Treatment Of Patients After PCI And The Mechanism Of Qidan Fumai Prescription Against Myocardial Ischemia-reperfusion Injury

Objective:Study 1: Based on data mining technology,we summarized the medication rules of Professor Jiang Lihong in the treatment of patients with Qi-deficiency and blood-stasis syndrome after PCI,and provided references for clinical treatment.Study 2: Through systematic evaluation and re-evaluation,the influence of TCM for supplementing qi and promoting blood circulation on the effectiveness and safety of patients after PCI was discussed,so as to provide evidence-based evidence for clinical treatment.Study 3: Related active ingredients and targets of "Qidan Fumai Fang" in the treatment of myocardial ischemia-reperfusion injury were analyzed through network pharmacology.Study 4: To verify the protective effect of "Qidan Fumai Fang" on myocardial ischemia-reperfusion injury in rats and its related mechanism.Methods:Study 1: Medical records of Professor Jiang’s outpatient and hospitalization in Jilin Provincial Hospital of Traditional Chinese Medicine after PCI(syndrome of Qi deficiency and blood stasis)from January 2021 to December 2023 were collected,and frequency analysis,association rules and cluster analysis integrated with the cloud platform of ancient and modern medical records were used for data mining.Study 2: Systematic review and meta-analysis of TCM for supplementing qi and promoting blood circulation in the treatment of patients after PCI were conducted through database retrieval,basic information and outcome indicators were extracted for the included studies,and the quality of reports,methodological quality and evidence level were evaluated.Study 3: Relevant databases were retrieved to collect the chemical components of Qidan Fumai formula and construct target prediction,obtain MIRI target information,map drug targets and disease targets to each other,construct drug-composition-disease-target network diagram,and reveal the possible mechanism of "Qidan Fumai Fang " in treating MIRI through protein interaction network,GO enrichment and KEGG pathway analysis.Study 4: 90 rats were randomly divided into sham operation group,model group,Qidan Fumai prescription low,medium and high dose groups,and 3-MA group.After 28 days of administration,the model was created,the left anterior descending branch was threaded in the sham operation group,and the other groups were ligation for 30 min and reperfusion for 120 min.Heart rate changes were recorded;After sampling,HE,TTC,TUNEL,Elisa and Western Blot were performed.Results:Study 1: A total of 317 prescriptions and 167 flavors of drugs were screened out,including 30 flavors of high-frequency drugs(frequency > 42 times),mainly with the effects of removing blood stasis,tonifying,calming and soothing the liver;The drug properties are mainly flat,warm and slightly cold drugs.The main medicinal tastes are sweet,bitter and xin.The main drugs are liver,spleen,heart and lung.Three prescription groups were obtained by clustering analysis of high-frequency drugs.One protocol was "Qidan Fumai prescription".7 pairs of commonly used drug combinations were obtained by rule analysis.Study 2: 19 literatures were included.Through analysis,the incidence of adverse cardiovascular events and TCM syndrome efficacy of traditional Chinese medicine combined with conventional Western medicine for supplementing qi and promoting blood circulation after PCI were superior to conventional Western medicine.The average score of PRISMA’s overall report quality was 21.63;R-AMSTAR overall methodological quality score,the total score of a single study was 14-35 points,the overall average score was 27.7points,high,medium and low quality grades were 11,7 and 1,respectively.There were 24 intermediate,84 low and 52 very low grades of evidence,respectively.Study 3: 192 active ingredients and 1753 targets related to myocardial ischemiareperfusion injury of Qidan Fumai Fang obtained,and 255 intersection targets of Qidan Fumai Fang and myocardial ischemia-reperfusion injury were obtained.After PPI network analysis,10 main core targets were obtained.GO enrichment obtained 680 biological functions,71 cellular components and 115 molecular functions.KEGG pathway enrichment analysis showed that the main pathways of "Qidan Fumai Fang " in the treatment of myocardial ischemia-reperfusion injury included lipid and atherosclerosis,TNF signaling pathway,apoptosis,HIF-1 signaling pathway,IL-17 signaling pathway,PI3K-Akt signaling pathway,etc.Study 4: 1.The heart rate of the drug group after reperfusion was higher than that of the model group;2.HE,TTC and TUNEL results: Compared with the model group,the myocardial infarction size in the drug group decreased and the apoptosis rate decreased;3.Elisa results: Compared with blank group,the concentrations of CK-MB,TNF-α,IL-1β and ROS in model group were significantly increased,while the SOD concentration was significantly decreased.Compared with the model group,the levels of CK-MB,TNF-α,IL-1β and ROS in drug group were decreased,while the level of SOD was increased.4.Western Blot results: Compared with the model group,the expressions of HIF-1α,BNIP3,Bax and caspase3 proteins in the drug group decreased,while the expressions of Bcl-2proteins increased.Conclusion:Study 1: Professor Jiang Lihong believed that the treatment of Qi deficiency and blood stasis after PCI should be based on "supplementing Qi and promoting blood circulation,removing blood stasis and channeling pulse".It emphasizes the therapeutic idea of "harmonization of liver and spleen,the same treatment of heart and liver".Study 2: The Chinese medicine with the effect of supplementing qi and promoting blood circulation has positive effect and good safety in patients after PCI,reduces the incidence of adverse cardiovascular events and improves heart function.However,the overall quality of systematic evaluation is not high,and the level of evidence is low.Study 3: The treatment of MIRI by "Qidan Fumai Fang" is mainly involved in gene regulation,apoptosis regulation,inflammatory response,signal transduction and other processes,and is closely related to lipid and atherosclerosis,TNF signaling pathway,HIF-1signaling pathway,IL-17 signaling pathway,PI3K-Akt signaling pathway and other signaling pathways.Study 4: "Qidan Fumai Fang" can regulate autophagy,inhibit apoptosis,reduce inflammation and oxidative damage,and its mechanism may be related to the inhibition of HIF-1α/BNIP3 signaling pathway.