| PurposeThrough a period of clinical observation,to explore the effectiveness and safety of "No.1 prescription for coronary heart disease" in the treatment of stable angina pectoris(Qi deficiency and blood stasis).And using the method of modern network pharmacology to analyze the mechanism of "No.1 prescription of coronary heart disease" in the treatment of stable angina pectoris(type of Qi deficiency and blood stasis),to provide a certain direction for further research in the later.MethodsA total of 92 patients with stable angina pectoris of qi stagnation and blood stasis type(from December 2018 to December2019)in the outpatient and inpatient departments of Guanggu District of Hubei Hospital of Traditional Chinese Medicine were collected and randomly divided into observation group and control group,with 46 patients in each group.The control group was treated according to the traditional standard treatment plan of western medicine,while the observation group was given "No.1 prescription for coronary heart disease" in addition to the basic treatment of the control group.After 4 weeks,the relevant safety indicators(vital signs,three routine procedures,liver and kidney function,adverse reactions)and curative indicators(TCM syndrome single item/total score,electrocardiogram efficacy,nitroglycerin stop rate,SAQ score)were analyzed and evaluated.The TCMSP database was used to screen the chemical components in "CHD No.1 Recipe",and the effective components of each TCM were predicted by the UNIPROT database.Stable angina pectoris disease targets were screened by Genecards,OMIM,TTD and DRUGBANK database.Then,the "drug-component-target-disease" network graph and PPI network graph were drawn by using Cytoscape3.7.2 and String database respectively.Finally,GO function and KEGG pathway were enriched and analyzed on the David data platform.ResultsThe observation group and the control group were comparable in demographic characteristics(age,sex),disease course,risk factors(smoking,alcohol consumption,hypertension,diabetes,hyperlipidemia),and the baseline level of the main scores of TCM syndromes(P > 0.05).After 4 weeks of treatment,(1)there was no significant difference in liver and kidney function and other safety indexes between the two groups compared with before treatment,and no adverse reactions occurred;(2)There was statistically significant difference in single TCM syndrome scores between the two groups(P < 0.05).Among them,there were statistically significant differences in the improvement of chest pain,chest tightness,palpitation,shortness of breath,spontaneous sweating and night sweating in the observation group(P < 0.05),while there were no statistically significant differences in the improvement of fatigue,chills,pain and weakness in waist and knee,and insomnia in the observation group(P > 0.05).The improvement of TCM syndrome total score in the two groups was better than that before treatment,with statistical significance(P < 0.05),and the observation group was better than the control group,with statistical significance(P < 0.05);(3)After treatment,the total effective rate of the observation group was higher than that of the control group in improving ECG efficacy,and the difference was statistically significant(P < 0.05).(4)The stopping rate of nitroglycerin in 2 groups was compared,the stopping rate of observation group was better than control group,the difference was statistically significant(P < 0.05);(5)SAQ scores in 2 groups were significantly improved compared with before treatment,the difference was statistically significant(P < 0.05),and the improvement degree in the observation group was better than that in the control group,the difference was statistically significant(P < 0.05).In the network pharmacological study,289 chemical components of traditional Chinese medicine in "No.1 prescription for coronary heart disease" were finally collected,kaempferol and quercetin play an important role in the treatment of the disease.274 drug action targets,1864 disease targets;A total of 125 targets were obtained for the intersection of drugs and diseases,among which20 genes including protein kinase 1(AKT1),interleukin-6(IL-6),vascular endothelial growth factor(VEGFA),tumor necrosis factor(TNF)and tumor suppressor P53(TP53)may be key targets for the treatment of stable angina pectoris.The GO functional enrichment analysis showed that there were 362 biological processes,and the biological processes of drug action were mainly concentrated in the activity of signal receptor activator,cytokine receptor binding,receptor ligand activity,etc.KEGG pathway enrichment analysis showed a total of 123 pathways,among which fluid shear force,atherosclerosis,AGE-RAGE signal of diabetes complications and other pathways were all the intervention pathways of "CHD No.1Prestige" in the treatment of stable angina pectoris.Conclusion"Coronary heart disease(CHD)1 party" treatment of stable angina(qi deficiency and blood stasis type)of the efficacy and safety,can reduce this kind of patients with angina pectoris attack number of times and the onset of chest pain severity,to reduce the total score of syndromes,reduce the usage and dosage of nitroglycerin drugs,can significantly improve the patient’s quality of life.Moreover,"No.1 prescription for coronary heart disease" has the advantages of "multi-component,multi-target and multi-pathway",breaking the limitation of traditional single target treatment of disease,and is worthy of continuous clinical application and promotion. |
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