| Objective: To observe the clinical efficacy and safety of Panax notoginseng fufangteng in the treatment of patients with chronic heart failure(yang deficiency and blood stasis type),and to explore its mechanism by using network pharmacology.Methods: 60 CHF patients were randomly divided into control group and treatment group,30 cases in each group.Before treatment and after 6 months of treatment were observed.The observation indexes were pro-BNP,CRP,TNF-α,IL-17,CDFI,cardiac function classification,6MWT,TCM syndrome score,and MLHFQ,Finally,the statistical results were analyzed.Objective to screen the active components and related targets of Panax notoginseng fufangteng pair by traditional Chinese medicine systems pharmacy database and analysis platform(tcmsp).The active components were input into universal protein(Uni Prot)database and Swiss target was used The target data of Panax notoginseng fufangteng pair were obtained by adding target information,deleting and duplicating in prediction database.Genecards database was used to obtain disease targets.Using R software to install Bioconductor software package to analyze the related pathways and diseases of Panax notoginseng fufangteng pair,and to predict its mechanism of action in coronary heart disease induced CHF.Results: there was no significant difference in the general baseline data between the control group and the treatment group(P>0.05).Before treatment,there was no significant difference in Pro BNP,CRP,TNF-α,IL-17,cardiac color Doppler ultrasound index,6MWT,TCM syndrome score,MLHFQ score and NYHA cardiac function between the two groups(P > 0.05))After treatment,pro-BNP,CRP,TNF-α,IL-17,cardiac ultrasound index,6MWT,TCM syndrome score,MLHFQ score,NYHA cardiac function of the two groups were significantly improved,and the treatment group was significantly better than the control group(P < 0.05),no obvious adverse reactions such as liver and kidney function injury,no acute heart failure,malignant arrhythmia,cardiogenic sudden cardiac arrest were found in the two groups before and after treatment Major adverse cardiovascular events(MACE)such as death occurred.According to the screening conditions,there were 16 active components,345 drug targets,2000 disease targets,148 drug disease common targets,and98 KEGG pathways(P< 0.05).It was found that the drug pair could play a role through IL-17 pathway,AGE-RAGE pathway,TNF pathway,EGRF pathway,PI3K-Akt pathway and other pathways,and the expression of these target proteins was significantly different Subfunctions involve cytokine binding,Endopeptidase activity,Cytokine activity,inflammation related enzyme activation,receptor ligand activity and other aspects,and are related to biological processes such as extracellular stimulation response and nutritional molecular level.Conclusion:(1)through clinical observation,Panax notoginseng fufangteng can significantly reduce the TCM syndrome score of patients with chronic heart failure(yang deficiency and blood stasis type),improve the cardiac function classification,and improve the clinical symptoms;(2)Panax notoginseng fufangteng can effectively reduce CRP,IL-17 and TNF-α in patients with chronic heart failure(yang deficiency and blood stasis type),which may be due to the inhibition of inflammatory response of the body by Panax notoginseng fufangteng,so as to effectively improve the prognosis of patients.(3)Panax notoginseng fufangteng drug pair can pass through IL-17 pathway,AGE-RAGE pathway,TNF pathway,ERF pathway,PI3K-Akt pathway,HIF-1 pathway Through the pathway of IL-6,AKT1,VEGFA,CASP3,EGF,EGFR,MMP9,MAPK1,ACE and other targets,the effect of traditional Chinese medicine can be exerted.It is suggested that Panax notoginseng fufangteng can inhibit inflammatory reaction,improve cardiac function,enhance myocardial contraction,inhibit ventricular remodeling and other effects in the treatment of chronic heart failure through multi-component,multi-target and multi-channel. |
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