| Purpose: In this study,patients with phlegm and blood stasis syndrome of coronary heart disease were studied.Based on the LC-MS metabolomics technology,taking the small molecule metabolites as the starting point,elucidating the mechanism of Huayu Qutan recipe prevent and treat patients with phlegm and blood stasis syndrome of coronary heart disease,for providing scientific basis for the Chinese medicine treat the coronary heart disease from phlegm and blood stasis.Material and method: This study included 180 inpatients and outpatients with phlegm and blood stasis syndrome of coronary heart disease in Cardiology and Chinese medicine of First Affiliated Hospital of Jinzhou Medical University and Cardiology of Yingkou City Hospital of Traditional Chinese Medicine from June 2015 to March 2016,and divided them into experimental group and control group,the experimental group was given Huayu Qutan recipe and western medicine treatment,the control group was given placebo of Huayu Qutan recipe and western medicine treatment,the course of treatment was 8 weeks.At 0-week and 8-week,the changes of blood lipid in each group were detected.LC-MS metabolomics was used to detect the serum small molecule metabolites affected by Huayu Qutan recipe.Analysis of KEGG metabolism pathways of identified differential metabolites by Systemic Bioinformatics Analysis.To further explore the the efficacy mechanism of Huayu Qutan recipe prevent and treat patients with phlegm and blood stasis syndrome of coronary heart disease.Results: 1.The effect of Huayu Qutan recipe on the lipid levels of patients with phlegm and blood stasis syndrome of coronary heart disease.The levels of TC and LDL-C in the 8-week experimental group were significantly lower than those in the 0-week(P<0.01)and significantly decreased compared with the 8-week control group(P<0.05 or P<0.01).And the level of HDL-C was significantly higher than it in the 0-week(P<0.05).There was no significant change in the level of serum lipids in the control group between 8-week and 0-week(P>0.05),it indicated that Huayu Qutan recipe might be improve the levels of TC,LDL-C and HDL-C in patients with phlegm and blood stasis syndrome of coronary heart disease.2.Effect of Huayu Qutan recipe on the profile distribution of serum metabolites in patients with phlegm and blood stasis syndrome of coronary heart disease.In this study,univariate analysis,principal component analysis and partial least squares discriminant analysis were used to observe the effect of Huayu Qutan recipe on the profile distribution of serum metabolites in patients with phlegm and blood stasis syndrome of coronary heart disease.The results showed that Huayu Qutan recipe had a significant effect on the profile distribution of serum metabolites in patients with phlegm and blood stasis syndrome of coronary heart disease.Forty potential biomarkers were regulated by Huayu Qutan recipe,mainly involved in the lipid metabolism of L-Carnitine,Beta-Guanidinopropionic acid,3-hydroxyhexanoyl carnitine,14,15-Epoxy-5,8,11-eicosatrienoic acid,6-Dehydrotestosterone glucuronide,glycerophospholipids,etc.;in the protein metabolism of Ornithine,Proline,Cysteineglutathione disulfide,etc.;in the purine metabolism of Diisopropyl Methyl Phosphonate(d IMP)and Allantoic acid;in the vitamin metabolism of Riboflavin and 6-Dehydrotestosterone glucuronide;and scattered small molecule metabolites that are involved in other metabolic pathways.3.Efficacy mechanism of Huayu Qutan recipe on prevention and treatment of patients with phlegm and blood stasis syndrome of coronary heart disease.The results of KEGG metabolic pathway analysis showed that the 40 potential biomarkers regulated by Huayu Qutan recipe had enriched on 33 metabolic pathways,mainly involved in lipid,protein and vitamins metabolic process,and metabolic pathway involved in lipid metabolism changes the most obvious.Further exploration found that the Huayu Qutan recipe significantly improved the content of serum linoleic acid metabolites,arachidonic acid metabolites,fatty acid metabolism carrier L-carnitine,fatty acid metabolism essential compounds 3-hydroxyhexanoyl carnitine,bile secretion promoter 6-Dehydrotestosterone glucuronide,glycerophospholipids and Beta-Guanidinopropionic acid,and significantly reduced the acetoacetate content.Conclusion: 1.Huayu Qutan recipe might be improve the levels of TC、LDL-C and HDL-C in patients with phlegm and blood stasis syndrome of coronary heart disease.2.Huayu Qutan recipe has a significant effect on the profile distribution of serum metabolites in patients with phlegm and blood stasis syndrome of coronary heart disease.3.Huayu Qutan recipe may play a role in prevention and treatment of patients with phlegm and blood stasis syndrome of coronary heart disease by regulating fatty acid metabolism,glycerophospholipids and β-Guanidinopropionic acid. |
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