| ObjectiveCoronary heart disease(CHD)is a chronic ischemic heart disease caused by coronary atherosclerosis(As),in which unstable angina pectoris is characterized by easy plaque rupture,rapid disease progression,and high mortality.Unstable angina pectoris is closely related to inflammatory response.The change level of related inflammatory factors before and after treatment in such patients can be used as part of evaluating the therapeutic effect of drugs.As an important part of the inflammatory response,the NF-?B signaling pathway has indicative changes.Xuesaitong soft capsule has the effects of activating blood circulation,removing blood stasis and activating blood vessels.In order to explore the relationship between the effect of Xuesaitong soft capsule and NF-?B in the treatment of patients with coronary heart disease and blood stasis syndrome,a clinical and experimental study was designed.By observing the changes in the expression of NFKBIA mRNA,CARD11 mRNA and miR-155 and SIRT1 mRNA on the signaling pathway NF-?B,and the changes in the expression of IL-6,TNF-?,NF-?B and other proteins downstream of the pathway,to explore the clinical efficacy of Xuesaitong soft capsules(panax notoginseng saponins)and the effect on the expression level of miR-155/NF-?B inflammatory signaling pathway.Method1.A clinical research of Xuesaitong soft capsules in the treatment of unstable angina patients with blood stasis syndromeSixty-four patients with unstable angina pectoris and blood stasis syndrome who were diagnosed by coronary angiography and met the criteria of admission and discharge were recruited from January 2019 to November 2019,and randomly divided into the experimental group and the control group using sealed envelopes according to the order of presentation The patients in the two groups were given conventional western medicine treatment such as antiplatelet therapy and lipid-lowering therapy,and were given symptomatic treatment according to the complications.The experimental group 32 was additionally treated with Xuesaitong soft capsules on the basis of conventional western medicine treatment;the control group 32 was additionally treated with Xuesaitong capsule simulant on the basis of conventional western medicine treatment.The treatment cycle was 1 month.The observation indexes were recorded before and after treatment:blood stasis symptoms changes,Seattle scale,blood stasis syndrome score scale,blood lipid changes,high-sensitivity C-reactive protein,three routine of blood,urine,stool,and liver and kidney function.The observation indicators were statistically processed,and the data were analyzed with SPSS 21 software and plotted with Graph Pad Prism 8.0.2.2.An experiment of the Xuesaitong soft capsules's effects of on miR-155 and NF-?B Signaling PathwayA total of 35 patients with unstable angina pectoris and blood stasis syndrome diagnosed by coronary angiography were randomly divided into experimental group and control group by sealed envelope according to the order of visit.The patients in the two groups were given conventional western medicine treatment such as antiplatelet therapy and hypolipidemic therapy,and symptomatic treatment was given according to the complications.The experimental group additionally took Xuesaitong soft capsules on the basis of conventional western medicine treatment;the control group additionally took Xuesaitong capsule simulant on the basis of conventional western medicine treatment.After 1 month of treatment,peripheral venous blood was drawn to extract total RNA in the morning under fasting conditions,once before and once after treatment.Selection of NF-?B signaling pathway-related Indicators such as NFKBIA,CARD11,SIRT1,and miR-155,as well as changes in the expression of proteins such as IL-6,TNF-?,and NF-?B downstream of the pathway were used as outcome measures.Validation with real-time polymerase chain reaction the changes of NF-?B Related molecules on signaling pathways NFKBIA mRNA,CARD11 mRNA,SIRT1 mRNA and miR-155 before and after treatment.Detection of peripheral blood plasma by ELISA Changes in the expression of proteins such as IL-6,TNF-?,and NF-?B.Data were analyzed with SPSS 21 software and plotted with GraphPad Prism 8.0.2 softwareResults1.A clinical research of Xuesaitong soft capsules in the treatment of unstable angina patients with blood stasis syndromeFinally,this study finally included 64 patients,32 patients in each group.The baseline of general conditions was stable and comparable.After drug intervention,the total effective rate of improving the symptoms of coronary heart disease with blood stasis syndrome was 87.5%in the experimental group and 81.5%in the control group.Statistical analysis of Seattle Scale changes:The degree of physical activity limitation,stable state of angina pectoris and frequency of angina pectoris attack in the two groups were improved compared with before.Except that there was no significant difference in the degree of physical activity limitation before and after treatment in the control group(P>0.05),there was significant difference before and after treatment in other groups(P<0.05).Statistical analysis of the improvement of blood stasis syndrome:the score of the test group was lower than that of the control group,suggesting that:combined treatment and western medicine alone can reduce the TCM syndrome score,but the effect of combined treatment in reducing the score is better.Analysis of inflammatory indicators:There was no significant difference in the changes before and after treatment in each group(P>0.05).Statistical analysis of blood lipid changes showed that there was no significant difference in changes before and after treatment(P>0.05).There was no significant difference in liver and kidney function,hematuria and routine indicators before and after treatment between the two groups(P>0.05).The basic vital signs(heart rate,respiration,body temperature,blood pressure)were not abnormal,indicating that the drug had good safety2.An experiment of the Xuesaitong soft capsules's effects of on miR-155 and NF-?B Signaling PathwayMiR-155 Expression changes:the expression levels of miR-155 in experimental group up-regulated 2.05 times;the expression levels Of miR-155 in control group up-regulated 1.57 times,the experimental group and the control group have the same change trend,the experimental group change more.There was no significant difference between the two groups before the experiment(P>0.05),The confidence interval is 95%,indicates that the baseline is stable and the two groups are comparable,so the effect of drug intervention can be thought to have a promoting effect on the expression of miR-155.NFKBIA mRNA of expression changes:the expression levels of NFKBIA mRNA in experimental group up-regulated 1.65 times;the expression levels Of NFKBIA mRNA in control group down-regulated to the original 0.86 fold,the experimental group and the control group have the different change trend,the experimental group change more.There was no significant difference between the two groups before the experiment(P>0.05),The confidence interval is 95%,indicates that the baseline is stable and the two groups are comparable.Therefore,it can explain the effect of pharmacological intervention on NFKBIA mRNA of expression has a promoting effect.SIRT1 mRNA of expression changes:the expression levels of SIRT1 mRNA in experimental group up-regulated 1.51 times;the expression levels of SIRT1 mRNA in control group down-regulated to the original 0.9 fold,the experimental group and the control group have the different change trend.There was no significant difference between the two groups before the experiment(P>0.05),the confidence interval is 95%,indicates that the baseline is stable and the two groups are comparable.Therefore,it can explain the effect of pharmacological intervention on the expression of SIRT1 mRNA has a promoting effect.CARD11 mRNA of expression changes:the expression levels of CARD11 mRNA in experimental group down-regulated to the original 0.78fold;the expression levels of CARD 11 mRNA in control group up-regulated 1.1 times.The experimental group and the control group have the different change trend,There was no significant difference between the two groups before the experiment(P>0.05),the confidence interval is 95%,indicates that the baseline is stable and the two groups are comparable.Therefore,the effect of drug intervention has an inhibitory effect on the expression of CARD11 mRNA.NF-?B,TNF-?,IL-6 and other protein analysis results:There were differences between the two groups before and after(P<0.05),and the concentration changes showed a downward trend.From the trend of mean level change of TNF-?,the experimental group had slightly better efficacy.ConclusionXuesaitong soft capsule has a good clinical therapeutic effect on unstable angina pectoris with blood stasis syndrome.It can effectively improve blood stasis symptoms,as well as the degree of physical activity limitation of patients,Angina stable state,frequency of angina pectoris attack.It can effectively improve the blood stasis syndrome score of patients with unstable angina pectoris of coronary heart disease with blood stasis syndrome;it has a certain tendency to anti-inflammatory effect;it has a tendency to improve blood lipid levels.And it has good safety.ELISA demonstrated that the inflammatory indicators including TNF-?,IL-6 and NF-?B showed a downward trend after treatment in the two groups,indicating that the drug intervention had a anti-inflammatory role.Although the difference was not statistically significant,from the mean level,the experimental group had a slightly better effect.Among the changes in gene expression levels detected by PCR amplification,the expression levels of NFKBIA mRNA,SIRT1 mRNA,MiR-155 were up-regulated,the expression levels of CARD 11 mRNA were down-regulated.Therefore,it is speculated that the immunosuppression and anti-inflammatory effect of Xuesaitong soft capsules,a blood-activating drug,may be related to up-regulating the expression of miR-155 and down-regulating the expression of its target gene CARD 11 mRNA,up-regulating the expression of its target gene SIRT1 mRNA,to intervene the downstream NF-?B Signaling pathway,which also confirms that miR-155 may be a target of panax notoginseng saponins in the treatment of patients with unstable angina patients with blood stasis syndrome. |
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