Clinical Observation And Network Pharmacology Exploration Of Qiangxin Mixture In The Treatment Of Heart Failure

Objective:To observe the clinical efficacy and safety of qiangxin mixture in the treatment of heart failure(HF).Methods:We would select 20 patients with HF and syndrome of deficiency of qi and Yang and mutual obstruction of blood stasisblood who were admitted to the Department of Card:iology of Jiangsu Provincial Hospital of TCM from June 2017 to February 2018,according to the proportion of 1:1 were randomly divided into treatment group(QiangXinHeJi+western medicine standardized treatment)and control group(western medicine standardized treatment),10 cases in each group.After enrollment,cardiac function grade,6MWT,TCM syndrome scale,MLHFQ,b-type natriuretic peptide(BNP),cardiac color doppler ultrasound and other indicators of the two groups were recorded.In this study,a 7-day observation period was used to evaluate cardiac function grading,6MWT,TCM syndrome scale,and MLHFQ indicators after 7 days of treatment.The incidence of adverse events and MACE were observed,and the clinical efficacy and safety of QiangXinHeJi in the treatment of heart failure were observed.The TCMSP database and TCMID database were used to query the active ingredients and targets of 8 traditional Chinese medicines in QiangXinHeJi,Uniprot database was used to unify the target name,and the target data of QiangXinHeJi was obtained without human and repeated targets.DAVID database was used for pathway analysis and disease analysis to predict the mechanism of QiangXinHeJi in the treatment of heart failure.Results:There was no significant difference in general baseline data between the control group and the treatment group(P>0.05).(1)Efficacy of NYHA cardiac function:NYHA cardiac function in both groups was improved compared with that before treatment.The significant efficiency,effective rate and total effective rate in the treatment group were 50%,50%and 100%respectively.The effective rate of the control group was 0%,50%and 100%.The significant efficiency of the treatment group was significantly higher than that of the control group.(2)6 minutes walking distance:the treatment group before and after treatment 6 MWT distance were 279.0±167.2,9 85.0±256.1 mm,the control group before and after treatment 6 MWT distance were 350.0±184.9,764.0±265.1 mm,two groups of 6 MWT distance before treatment there was no significant difference(P>0.05),the two groups after treatment 6 MWT distance are improved obviously earlier,and the treatment group improved more significantly(P<0.05),the comparison between the two groups had no significant difference(P>0.05).(3)The doctor of traditional Chinese medicine symptom integral effect:the treatment group before and after treatment of TCM symptom score were 29.1±4.8,7.9±2.3 mm,the control group before and after treatment of TCM symptom score were 26.7±4.1,11.3±3.4 mm,two groups of TCM symptom score before treatment there was no significant difference(P>0.05),the two groups after treatment of TCM symptom score were significantly lower earlier,the treatment group decreased more significantly(P<0.05),the comparison between the two groups have significant difference(P<0.05).(4)MLHFQ points:the treatment group before and after treatment respectively MLHFQ integral was 74.4±10.5,36.6±8.0 mm,the control group before and after treatment respectively MLHFQ integral was 81.2±4.8,56.1±6.2 mm,the two groups before treatment MLHFQ integral there was no significant difference(P>0.05),the two groups after treatment MLHFQ points from the previous significant decline,and the treatment group decreased more significantly(P<0.05),the comparison between the two groups have significant difference(P<0.05).(5)Neither treatment group nor control group had significant adverse reactions such as liver and kidney function injury,nor did acute heart failure,malignant arrhythmia,sudden cardiac death and other major cardiovascular adverse events(MACE)occur.Using TCMSP database and TCMID screening QiangXinHeJi formula of every flavor compounds,drug contains light with 65 kinds of chemical composition,main astragalus membranaceus has 87 kinds of chemical composition,dangshen has 134 kinds of chemical composition,salvia miltiorrhiza has 202 kinds of chemical composition,dwarf lilyturf has 55 kinds of chemical composition,semen lepidii has 67 kinds of chemical composition,semen plantaginis has 70 kinds of chemical composition,jade bamboo has 62 kinds of chemical composition.After the repeated active components were removed,the Uniprot database was used to find the corresponding targets,and 178 target proteins were obtained.Using the database of DAVID,we searched the target-disease relationship of QiangXinHeJi,and concluded 5 related diseases,including Congestive heart failure and beta-blocker response,Alzheimer disease,Congestive heart failure,tankiness,and so on.And 52 pathways are affected by Hypertension.The "KEGG," pathway was analyzed and 52 pathways were obtained,and the top 31 pathways were selected for analysis.VEGF signaling pathway is involved in angiogenesis.Calcium signaling pathway and sodium reabsorption were the pathways related to arrhythmia.Vascular smooth muscle contraction,Nitrogen metabolism and other pathways were involved in diastolic Vascular contraction.Depression-related pathways include Neuroactive ligand-receptor interaction and long-term depression,etc.The tumor-related Pathways are Glioma,Pathways in cancer and Melanoma.The B cell receptor signaling pathway and T cell receptor signaling pathway are the signaling pathways related to immune regulation.Conclusions:QiangXinHeJi combined with the standardized treatment of western medicine can effectively improve the heart function of patients with heart failure,improve the 6-minute walking distance of patients with heart failure,reduce the TCM syndrome score of patients with heart failure,improve the quality of life of patients with heart failure,and the curative effect is more obvious than the standardized treatment of western medicine.No significant adverse events and major cardiovascular adverse events(MACE)occurred.Network pharmacology study found that QiangXinHeJi can treat heart failure by acting on angiogenesis,anti-arrhythmia,diastolic vascular smooth muscle,immune regulation and other aspects.