Clinical Study And Network Pharmacological Analysis Of Guizhi Renshen Decoction In The Treatment Of Sinus Bradycardia

Objective: To observe the clinical efficacy and safety indicators of of Guizhi Renshen Decoction in treating sinus bradycardia of xinyang depression,qi deficiency and blood stasis.To explore its mechanism of action based on the network pharmacology.To provide the theoretical foundation and research basis for the clinical effect,application and popularization of Guizhi Renshen Decoction of xinyang depression and qi deficiency and blood stasis type sinus bradycardia.Methods:1.A total of 60 patients who met the inclusion criteria were randomly divided into the control group and the treatment group,with 30 cases in each group.They were treated with Xinbao Pill and Guizhi Renshen Decoction respectively for 4 weeks.The changes of resting heart rate,average heart rate,maximum heart rate and minimum heart rate of 24-hour dynamic electrocardiogram,and the TCM syndrome scores were compared between the two groups before and after treatment.The various statistical methods were used to evaluate the clinical efficacy and safety.2.Firstly,obtaining the main chemical composition of Guizhi Renshen Decoction through the database of TCMSP and acquiring ideal targets through HERB database.Secondly,screening the disease targets of sinus bradycardia through Gene Cards database and drawing the Venn diagram to get the common targets.Thirdly,the String database was used for protein interaction analysis,building a PPI network.Finally,the Metascape platform was adopted to analyze the protein interaction and its involved GO function and KEGG pathway.Cytoscape 3.9.1 software was used to construct the network of ingredients-targets-passways and screen the core composition,main targets and passways.Results:1.Clinical research:(1)There was no statistical difference in the general data between the two groups,and they were comparable(P>0.05).(2)Resting heart rate: The treatment group was more obvious than that of the control group in improving resting heart rate after treatment and 4weeks after the end of treatment.The difference was statistically significant(P<0.05).(3)24-hour dynamic ECG: Compared the 24-hour dynamic electrocardiogram changes of the two groups before and after treatment,the treatment group was significantly better than the control group in the improvement of average heart rate,minimum heart rate and maximum heart rate.The effective rate of the treatment group was 83.33% and that of the control group was 56.67%,with statistical significance(P<0.05).(4)TCM syndrome score: The treatment group could effectively reduce TCM syndrome score,and was significantly better than the control group in improving the single TCM syndrome such as palpitation,chest tightness,chest pain,shortness of breath,fatigue,chills.The difference was statistically significant(P<0.05).In terms of dizziness,lackluster complexion,dark lip and nails and other TCM individual syndromes,the curative effect of the two groups was similar(P>0.05).(5)Safety evaluation: Both groups of patients successfully completed the study without adverse reactions or drug side effects.2.Network Pharmacology Research: A total of 160 compounds and 310 targets from Guizhi Renshen Decoction were screened out,and 570 targets related to sinus bradycardia were obtained.Based the 57 intersecting target genes,the main active ingredients were quercetin,protoopioid,kaempferol,etc.,and the core targets were ESR1,AR,NOS2,CALM3,SCN5 A,etc.20 biological processes,13 cellular components,and 14 molecular functions were obtained by GO functional enrichment analysis.The KEGG pathways associated with sinus bradycardia included fluid shear stress and atherosclerosis,lipid and atherosclerosis,cytokine-cytokine receptor interaction and IL-17 signaling pathway,etc.Conclusion:1.Guizhi Renshen Decoction has obvious curative effect in the treatment of sinus bradycardia,which can effectively improve TCM syndrome and increase heart rate with good safety.2.The core active ingredients of Guizhi Renshen Decoction for sinus bradycardia are quercetin,protoopioid,kaempferol,etc.The ideal targets are ESR1,AR,NOS2,CALM3,SCN5 A,etc.The Guizhi Renshen Decoction plays a therapeutic role in sinus bradycardia by reducing inflammation and avoiding myocardial damage.