Correlation Study And Cell Experiment On The Intervention Of Sheng Mai In Myocardial Injury Caused By PM2.5

The paper consists of three parts:theoretical review,clinical research and experimental study.Theory research mainly from the Chinese medicine cognizance of "smog" and its etiology and pathogenesis of disease and PM2.5 epidemiology of cardiovascular system diseases and the impact of PM2.5 mechanism of myocardial cell damage,PM2.5 of arrhythmia,heart failure,acute coronary syndrome and other heart disease research progress of impact has carried on the detailed discussion,and on the Sheng Mai characteristics and treatment of cardiovascular diseases of modern pharmacology effect were summarized.Clinical study objectives:(1)exploring the relationship between atmospheric PM2.5 concentration and the incidence and development of cardiovascular diseases in ICU patients;(2)systematically evaluating the efficacy and safety of Sheng Mai in the treatment of cardiovascular diseases.Methods:(1)202 patients cases data statistics of ICU in Traditional Chinese Medical hospital of Jiangsu province between January 2017 and December 2018 were included in this study.According to the air quality index corresponding to the PM2.5 concentration level in the month of admission,the patients were divided into the low-concentration group and the high-concentration group,including 114 cases in the low-concentration group and 88 cases in the high-concentration group,to analyze the influence of PM2.5 effect on cardiovascular disease and mortality of patients with cardiovascular disease;(2)Searching domestic and foreign published literature on Sheng Mai in the treatment of cardiovascular diseases on PubMed?Web of Science?MEDLINE?CNKI?CBM?VIP?Wan Fang,and using Revman5.3 software for meta-analysis.Results:(1)there were 44 patients with cardiovascular disease in the low-concentration group,accounting for 38.6%of the patients in this group,and 47 patients with cardiovascular disease in the high-concentration group,accounting for 53.4%of the patients in this group.The proportion of patients with cardiovascular disease in the high-concentration group was higher than that in the low-concentration group,and the difference between the two groups was statistically significant(P<0.05).(2)the mortality rate of cardiovascular patients in the low-concentration group was 22.7%,and that in the high-concentration group was 46.8%.The mortality rate of cardiovascular patients in the high-concentration group was higher than that in the low-concentration group,and the difference between the two groups was statistically significant(P<0.05).(3)a total of 943 patients from 12 literatures were included in the Meta-analysis,and the results showed that the overall clinical efficacy of Sheng Mai group patients[RR=1.25,95%CI(1.15,1.36),P<0.00001],LVEF[MD=6.935 95%CI(6.09,7.78),P<0.00001],SV[MD=8.78,95%CI(6.47,11.09),P<0.00001],CO[MD=0.79,95%CI(0.52,1.06),P<0.00001),CI[MD=0.60,95%CI(0.44,0.76),P<0.00001]is superior to the improvement of the control group.In addition,cardiovascular diseases can be improved by increasing the rate of coronary artery reflow and FS,increasing the walking distance of 6min,reducing the level of BNP and controlling the HR etc.Among the cases included in the study,only 4 patients reported adverse reactions after the use of Sheng Mai.Conclusion:PM2.5 can have an adverse effect on the development of cardiovascular disease patients and increase the mortality rate of cardiovascular disease patients.Sheng Mai has its advantages in the clinical treatment of cardiovascular diseases in many aspects.It can improve the efficacy of cardiovascular diseases by combining with conventional medicine,and its safety is relatively reliable.Experimental study objective:to investigate the effects of PM2.5,Sheng Mai and its formula including Ren Shen,Mai Dong and Wu Weizi on the activity of H9C2 cardiomyocytes,so as to provide cytological basis for clinical guidance.Methods:(1)H9C2 cardiomyocytes were cultured in a fresh and complete culture medium,5%C02,and 37? incubator.The cells were poisoned with different concentrations of PM2.5 suspensions.The control group was added with the same amount of culture medium without PM2.5.After 12h,the cell surface morphology was observed by electron microscope,and the cell viability was calculated by cck-8 method.(2)Use completely culture in 96-well plate cultivation H9C2 cardiac muscle cells within 24h,the cells with growth of 80-90%of the pore bottom area were selected,and the suspensions of shengmai with different concentrations were added to protect them.Set the control group to add the same amount of medication-free medium,OD values of all Wells were detected by cck-8 method and the cell viability was calculated after 24h.The cell viability of Ren Shen,Mai Dong and Wu Weizi was calculated by the same method.Results:(1)PM2.5 can destroy the normal morphology of H9C2 cardiomyocytes,and PM2.5 can inhibit the activity of H9C2 cardiomyocytes,and there is a significant negative correlation between PM2.5 concentration and cell activity(r=-0.896,N=17,P<0.001).(2)Sheng Mai and characteristics of each single drug in the certain concentration range can enhance the vitality of H9C2 cardiac muscle cells,when its action in a certain concentration after reaching the maximum,with the increase of drug concentration will weaken the role in enhance the cell vitality,even inhibit the cell vitality,the effects of different drug concentrations on cell viability in each group were statistically significant(P<0.05).Conclusion:PM2.5 can inhibit the activity of cardiomyocytes in good growth condition,and the inhibitory effect can be gradually increased with the increase of PM2.5 concentration,and the single drug in Sheng Mai and its prescription at the appropriate concentration can enhance the cell activity.