| Objective: It is proposed to verify the clinical efficacy of Mingjunsan on coronary heart disease(yang qi deficiency syndrome)through clinical trial,and then to confirm the intervention effects of Mingjunsan on blood fat levels,oxidation indicator MDA content and antioxidant factor SOD level in AS rats through animal experiments,and from the JAK2/STAT3 signaling pathway to explore its anti-AS mechanism,to objectively evaluate the efficacy of Mingjunsan,and to give a strong argument for its anti-AS mechanism.Methods:1.Clinical study : The enrollment of cases began in early January,2023 to the end of December,2023.The researchers collected cases with stable angina pectoris with yang-qi deficiency syndrome in the outpatient department and inpatient area of cardiology of Changchun Hospital of Traditional Chinese Medicine,and randomly divided them into two groups during the enrollment process.Both groups were treated with conventional western medicine.Among them,the treatment group was given oral administration of Mingjun San on this basis for 4 weeks of observation.The basic information of the patients was recorded in time during the collection process,and the angina pectoris symptom score,SAQ score,TCM syndrome score,nitroglycerin discontinuation rate,angina pectoris efficacy,electrocardiogram changes,and the fluctuation of physical and chemical indexes blood fat and HCY level of patients before and after treatment were analyzed.2.Experimental study : 70 SPF rats with an average weight of 200±20g,6-8 weeks of age,were divided into groups after 7 days of environmentally friendly conventional feeding,and 15 were randomly selected as blank control group;the remaining 55 rats were used as the experimental group,and the rat AS model was established by feeding high-fat diet+vitamin D3.After 9 weeks,5 rats were randomly selected from each of the two groups for HE staining and blood fat detection to ensure the successful replication of the AS model.After the model was established,the remaining rats in the experimental group were randomly assigned to the model group,the middle,high and low dose groups of Mingjun san and the western medicine group and were given gavage administration respectively.After 8 weeks of drug intervention,HE staining and blood fat detection were performed,and serum MDA and SOD levels were detected by ELISA.The protein expression levels of JAK2,STAT3 and VEGF were detected by RT-PCR and Western Blot.Results:1 Clinical study(1)Comparison of the efficacy of angina pectoris before and after treatment in the two groupsThe angina pectoris symptom scores of in both groups decreased significantly after intervention(P<0.05).Compared with the control group,the curative effect of angina pectoris in the treatment group after intervention was significantly better than that in the control group(P<0.05).(2)Comparison of nitroglycerin discontinuation rate between the two groups before and after treatmentAfter 4 weeks of treatment,there was no increase in the amount of nitroglycerin in both groups.The total reduction rate of the treatment group was 81.58%;the total stop reduction rate of the control group was 60.53%.Therefore,the effective rate of the treatment group was significantly higher than that of the control group(P<0.05).(3)Comparison of SAQ scores between the two groups before and after treatmentThe SAQ scores of the two groups increased significantly after treatment(P<0.05).Compared with the two groups,the SAQ scores of the treatment group increased more significantly(P<0.05).Therefore,it is suggested that the treatment group is better than the control group in improving the quality of life of patients.(4)Comparison of ECG changes between the two groups before and after treatmentCompared with the control group,the total effective percentage of ECG in the treatment group was more obvious after the intervention(P<0.05).(5)Comparison of the efficacy of TCM syndromes between the two groups before and after treatmentBoth Mingjun san Chinese medicine treatment and western medicine routine treatment can improve the curative effect of TCM syndromes and reduce the total score of TCM syndromes(P<0.05),and the effective degree of the treatment group is better than that of the control group(P<0.05).(6)Comparison of HCY between the two groups before and after treatmentThere was no distinction in HCY detection level between Mingjun san treatment group and conventional Western medicine treatment group after intervention(P>0.05).There was a certain change in the comparison before and after the intervention in the group(P<0.05).(7)Comparison of blood fat between the two groups before and after treatmentAfter intervention,the levels of TG,TC and LDL-C in the two groups decreased to varying degrees(P<0.05);the treatment group was better than the control group in improving the efficacy of TG and HDL-C(P<0.05).2 Experimental study(1)HE staining results of rat aorta in each groupThe aortic vascular structure of the rats in the blank control group was clear and complete,and no plaque was found.In the model group,the vascular structure was disordered and there were typical atherosclerotic plaques.Compared with the model group,the atherosclerotic plaques of the Chinese medicine group and the western medicine group was alleviated to varying degrees.(2)Blood fat of ratsCompared with the model group,the expression trend of TC,TG and LDL-C in the western medicine group and the middle and high dose groups of traditional Chinese medicine decreased significantly after intervention(P<0.05 or P<0.01),and the expression level of HDL-C also showed a significant upward trend(P<0.05 or P<0.01).(3)Serum MDA and SOD expression levels in ratsCompared with the model group,the MDA detection level of rats in the western medicine group and the each dose group of Chinese medicine decreased significantly after intervention(P<0.01),and the expression trend of SOD increased significantly after intervention(P<0.01).(4)Protein and gene expressions of JAK2,STAT3 and VEGF in aortaCompared with the blank control group,the protein and m RNA expression trends of JAK2,STAT3 and VEGF in the model group were significantly increased(P<0.01).Compared with the model group,the protein content and m RNA expression levels of JAK2,STAT3 and VEGF in each intervention group showed a significant decreasing trend(P<0.05 or P<0.01).Conclusion:1.Clinical research: Mingjun san can significantly improve the clinical symptoms of patients with stable angina pectoris of yang qi deficiency syndrome,regulate blood lipid levels,and play a certain antioxidant role by reducing the level of oxidation index HCY.2.Experimental research: Mingjun san can significantly optimize the AS of rat aorta,regulate the blood lipid and oxidation indexes of AS rats,inhibit the protein and m RNA expression of JAK2,STAT3 and VEGF,and balance the state of oxidative imbalance.Mingjun san may play an anti-AS role by inhibiting the JAK2/STAT3 signaling pathway and its downstream factor VEGF-mediated oxidative stress mechanism. |
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