| BackgroundCoronary heart disease(CHD)is a major health problem in the world.With the development of social economy and the acceleration of population aging,the number of cardiovascular disease patients in China is about 290 million,of which the prevalence and mortality of coronary heart disease are still on the rise.The trend of rural areas is more obvious than that of urban areas,and the male mortality rate is greater than that of female.Therefore,the study of diagnosis and treatment of coronary heart disease is the most important in clinical practice.According to the theory of traditional Chinese medicine,the etiology and pathogenesis of coronary heart disease are complex and diverse.The basic pathogenesis of coronary heart disease is "deficiency and excess",and the syndrome of blood stasis is one of the main syndrome elements."blood stasis" can be reflected before intervention and in 1-12 weeks of intervention.Academician Chen Keji once proposed that"in the occurrence and development of coronary heart disease,blood stasis runs through all the time." Therefore,"blood stasis" plays an important role in the occurrence and development of coronary heart disease.The method of activating blood circulation and removing blood stasis can play an important role in the treatment of coronary heart disease,to some extent,it can improve the symptoms of angina pectoris in patients with coronary heart disease and prevent the risk of restenosis after intervention.The Huoxue Huayu formula is a traditional Chinese medicine preparation which is made up by Wang Jie on the basis of the method of Huoxue Huayu.The small sample size experiment shows that the Huoxue Huayu formula has a good clinical effect.Therefore,this study used randomized parallel control test to explore the clinical effectiveness and safety of Huoxue Huayu formula,and through real-time quantitative polymerase chain reaction(qRT-PCR)detection method to explore the changes of miRNA expression and its mechanism in the intervention of Huoxue Huayu formula on coronary heart disease.ObjectiveTo explore the efficacy and safety of the Huoxue Huayu formula in the intervention of coronary heart disease and angina pectoris.And to explore the changes of miRNA expression and its mechanism in the treatment of coronary heart disease by Huoxue Huayu formula.Method1.60 patients with stable angina pectoris of coronary heart disease with heart blood stasis syndrome were selected for randomized double-blind placebo-controlled trial.The patients were divided into the experimental group and the control group,and sealed with envelopes.Both groups(the experimental group and the placebo control group)were given conventional western medicine treatment,including antiplatelet treatment,statins,etc.,and given symptomatic treatment according to the complications.In the experimental group,one capsule of Huoxue Huayu formula was added on the basis of routine western medicine treatment,three times a day;in the control group,one capsule of Huoxue Huayu formula was added on the basis of routine western medicine treatment,three times a day.The course of treatment was 4 weeks.No other proprietary Chinese medicine or traditional Chinese medicine decoction should be used in the trial period for all patients.Before and after the treatment,the patients' angina attack,ECG,the rate of nitroglycerin reduction,the curative effect of TCM syndrome,the score of TCM symptom and the safety index were observed.SPSS 20.0 was used for data statistics and analysis.2.A total of 27 patients with stable angina pectoris of coronary heart disease and blood stasis syndrome were selected.The random number was generated by procplan program statement of SAS software.The patients were divided into two groups according to the order of treatment:the experimental group and the control group.The total RNA was extracted from the peripheral venous blood before the intervention in the morning.Both groups(the experimental group and the placebo control group)were given conventional western medicine treatment,including antiplatelet treatment,statins,etc.,and given symptomatic treatment according to the complications.In the experimental group,one capsule of Huoxue Huayu formula was added on the basis of routine western medicine treatment,three times a day;in the control group,one capsule of Huoxue Huayu formula was added on the basis of routine western medicine treatment,three times a day.The course of treatment was 4 weeks.The total RNA was extracted from the peripheral venous blood of the patients after the intervention.The changes of mir-199a-5p,mir-146b-5p,mir-499a-5p and mir-133a-3p before and after the intervention of Huoxue Huayu formula were detected by fluorescence quantitative PCR.Result1.There was no significant difference in baseline between the two groups before and after treatment;the total effective rate of angina pectoris in the experimental group was 70%,and that in the control group was 36.6%,with significant difference(P<0.05);the total effective rate of ECG in the experimental group was 34.6%,and that in the control group was 20%,with significant difference(P<0.05);the total effective rate of TCM syndromes in the experimental group was 83.3%,and that in the control group was 36.6%There was a significant difference(P<0.05)between the two groups(10%).At the same time,it could also improve the total score of TCM syndromes and the score of single TCM symptoms(such as chest pain,chest distress,palpitation)of the patients,and there was a significant difference between the two groups(P<0.05).Before and after treatment,there was no significant difference in the stopping rate of nitroglycerin between the two groups(P>0.05);the safety index showed no significant difference between the two groups(P>0.05).The basic vital signs of the patients were normal.No adverse events occurred during the test.2.By observing the changes of the contents of mir-199a-5p,mir-146b-5p,mir-499a-5p,mir-133a-3p in the peripheral venous blood before and after the intervention of Huoxue Huayu formula,we found that:? The expression of mir-199a-5p in the experimental group was significantly different from that in the control group(P<0.05),but there was no significant difference in the expression of mir-146b-5p,mir-499a-5p and mir-133a-3p(P>0.05).? The expression of mir-499a-5p in the experimental group was significantly lower than that before treatment(P<0.05);there was no significant difference in the expression of mir-199a-5p,mir-146b-5p and mir-133a-3p(P>0.05).? The expression of mir-199a-5p,mir-146b-5p,mir-499a-5p and mir-133a-3p in the control group before and after treatment had no significant difference(P>0.05).ConclusionThe Huoxue Huayu formula can improve the incidence of angina pectoris in patients with coronary heart disease,improve the overall efficiency of electrocardiogram and TCM syndrome treatment,and relieve clinical symptoms such as chest tightness,chest pain,and palpitations.This shows that the Huoxue Huayu group prescription has good clinical efficacy in the treatment of coronary heart disease and stable angina pectoris and blood stasis syndrome,without obvious toxic and side effects.MiR-199a-5p,miR-146b-5p,miR-499a-5p,miR-133a-3p can all express coronary heart disease blood stasis syndrome.The Huoxue Huayu formula may achieve the purpose of treating coronary heart disease by down-regulating the expression of miR-499a-5p.Down-regulating miR-499a-5p could reduce the inflammatory response,reduce ventricular remodeling,and reduce the degree of coronary arteriosclerosis in patients with coronary heart disease,thereby improving the clinical symptoms of patients with coronary heart disease. |
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