| ObjectiveThe clinical research part of this subject mainly discusses the effect of Bushen Yixin Tablet on the antihypertensive effect and TCM syndrome score of male patients with hypertension grade 1-2(syndrome differentiation belongs to kidney qi deficiency)and erectile dysfunction(ED).After treatment,the blood pressure change index,erectile function score,TCM syndrome score,renin activity,angiotensin I level,aldosterone,NO,ET1 and other relevant laboratory indexes of patients with hypertension were compared before and after treatment,so as to observe and analyze the antihypertensive effect of Bushen Yixin Tablet,And further analyze the clinical effect and material basis of Bushen Yixin Tablet in improving hypertension related ED,so as to provide clinical reference for better clinical application of Bushen Yixin Tablet in reducing blood pressure and improving patients' quality of life.In the animal experiment research part,spontaneously hypertensive rats(SHR)were used as the model of hypertension related erectile dysfunction,and WKY rats were used as the blank control group;After intervention with Bushen Yixin Tablet and valsartan,the blood pressure of caudal artery and erectile function in each group were measured.After taking samples,the levels of ACE2,Ang(1-7),NOS,NO and plasma Ang(1-7),NOS and NO in abdominal aorta and penile cavernous tissue were detected by immunohistochemistry,fluorescence quantitative PCR,ELISA and colorimetry;By studying the effect of Bushen Yixin Tablet on the changes of relevant indexes of SHR after intervention,we can preliminarily clarify the mechanism of Bushen Yixin Tablet in reducing blood pressure and improving hypertension related ED through ACE2-Ang(1-7)-Mas-NO pathway,so as to provide clinical experimental reference for better clinical application of Bushen Yixin Tablet in reducing blood pressure and improving patients' quality of life.MethodsThe first part,clinical research: This study collected the symptoms,signs and auxiliary laboratory examination indexes of inpatients and outpatients in the Department of Cardiology of our hospital due to hypertension from December 2019 to July 2020,and carried out statistical analysis after summary.A total of 60 male patients with hypertension grade 1-2were randomly divided into 30 patients in each group.The control group was treated with basic regimen(amlodipine,5mg,once a day);In the combined Chinese and Western medicine group,Bushen Yixin tablets(5 tablets,3 times / day)were added on the basis of the basic regimen(amlodipine,5mg,once a day);Every 4 weeks was a small course of treatment.The two groups were treated for a total of 12 weeks.Blood pressure,24 h ambulatory blood pressure,TCM syndrome score scale and IIEF-5 score scale were monitored before and after treatment to evaluate the erectile dysfunction of patients in each group,the determination of four items of hypertension [including plasma renin activity(PRA),angiotensin I(A I)level and aldosterone(ALD)],and NO,ET1 were measured,statistically analyzed and compared,and the curative effect of the two groups was evaluated.The second part,animal experiment research: Spontaneously hypertensive rats(SHR)was selected as the model of hypertension related erectile dysfunction,and divided into model control group,combined Chinese and Western medicine group(Bushen Yixin Tablet +valsartan)and Western medicine group(valsartan).WKY rats were used as the blank control group;Each group was given normal saline(blank control group and model control group),combined Chinese and Western Medicine(Bushen Yixin Tablet + valsartan)and Western medicine valsartan.After 4 weeks of treatment,the caudal artery blood pressure of rats in each group was measured by caudal artery manometer;After subcutaneous injection of apomorphine(APO)into the neck,the times of penile erection were recorded to detect the erectile function of rats in each group.The expression of ACE2 in corpus cavernosum and abdominal aorta was observed by immunohistochemistry,and the expression of ACE2 m RNA in corpus cavernosum was detected by fluorescence quantitative PCR;The value of ACE2 in penile cavernous tissue was detected by ELISA,and Ang(1-7)in plasma and penile cavernous tissue was detected by ELISA;The contents of NOS and NO in plasma,corpus cavernosum and abdominal aorta were detected by BCA protein quantitative colorimetry;The relevant data were statistically analyzed and compared,and the efficacy of intervention drugs in each group was evaluated.ResultsPart ? Clinical Research:1.After treatment,the antihypertensive effect and the total effective rate of 24 h ambulatory blood pressure control in the combined Chinese and Western medicine group were higher than those in the control group(P < 0.05).2.After the treatment of the two groups,the score of TCM Syndrome Scale in the combined Chinese and Western medicine group decreased more than that in the previous group,and the difference between the combined Chinese and Western medicine group and the control group was also more significant(P < 0.05).In terms of the curative effect of single symptoms,the symptoms of the two groups were improved in varying degrees after treatment(P < 0.05);Compared with the control group,the combined Chinese and Western medicine group had more advantages in improving premature ejaculation,insomnia and tongue pulse score(P < 0.05).3.After treatment,the systolic blood pressure smoothing index(SISBP)and diastolic blood pressure smoothing index(SIDBP)in the combined Chinese and Western medicine group were significantly higher than those in the control group(P < 0.05).4.The recovery of erectile dysfunction after treatment in the two groups: IIEF-5 erectile function score in the combined Chinese and Western medicine group was significantly higher than that in the control group(P < 0.05).5.After treatment,there was significant difference in the level of aldosterone between the two groups,and the level of ALD in Bushen Yixin Tablet treatment group was lower(P <0.05).6.After treatment,there were significant differences in the levels of serum NO and ET1 between the two groups,NO increased significantly and ET1 decreased significantly(P <0.05);Comparing the difference between the two groups before and after treatment,the increase of serum NO and the decrease of serum ET1 in the combined Chinese and Western medicine group were more obvious than those in the control group(P < 0.05).Part ? Animal experiment research:1.The blood pressure of SHR in the combined Chinese and Western medicine group(Bushen Yixin Tablet + valsartan)and valsartan group decreased significantly after the intervention,which was significantly different from that before the intervention(P < 0.05).2.The times of penile erection in the combination group of Chinese and Western medicine and valsartan group increased significantly after intervention,which was significantly different from that in the model group(P < 0.05).3.The expression of ACE2 in rat corpus cavernosum was further confirmed by immunohistochemistry and fluorescence quantitative PCR.4.The expression of ACE2 in corpus cavernosum and abdominal aorta in the combination of Chinese and Western medicine group and valsartan intervention group was significantly higher than that in model group(P < 0.05);There was no significant difference between the two groups(P > 0.05).5.The combination of Chinese and Western medicine group and valsartan intervention could increase the content of Ang(1-7)in corpus cavernosum and plasma(P < 0.05);There was no significant difference between the two groups(P > 0.05).6.After intervention,the NOS value of penile cavernous body in the combination of Chinese and Western medicine group and valsartan group increased significantly.Compared with the model group,there was significant difference between the two groups(P < 0.05);There was no significant difference between the two groups(P > 0.05).7.After intervention,the NO values of abdominal aorta and penile cavernous body in the combination of Chinese and Western medicine group and valsartan group were significantly higher than those in the model group(P < 0.05);There was also significant difference between the combination group and valsartan group,and the increase of NO in the combination group was more significant(P < 0.05).ConclusionBushen Yixin Tablet Combined Chinese and Western medicine group can effectively and steadily reduce blood pressure in the treatment of hypertension grade 1-2 with deficiency of kidney qi;Bushen Yixin Tablet can significantly improve the TCM syndrome score of combined Chinese and Western medicine group;Bushen Yixin Tablet can significantly improve the IIEF-5 score of combined Chinese and Western medicine group and improve the penile erectile function of patients with hypertension complicated with ED;Bushen Yixin Tablet can reduce the level of ALD in patients with hypertension and regulate the function of renin angiotensin aldosterone system;The increase of serum NO and the decrease of serum ET1 in combined Chinese and Western medicine group of Bushen Yixin Tablet are more obvious,which can improve the endothelial function of patients.Bushen Yixin Tablet Combined Chinese and Western medicine group can reduce the systolic blood pressure of hypertensive SHR and improve the erectile function of SHR.ACE2 was expressed in the corpus cavernosum of the penis of rats.Bushen Yixin Tablet increased the expression of ACE2 in corpus cavernosum and abdominal aorta of SHR;Bushen Yixin Tablet can increase the content of Ang(1-7)in corpus cavernosum and plasma of SHR;Bushen Yixin Tablet can increase the NOS value of corpus cavernosum in SHR;After the intervention of Bushen Yixin Tablet,the NO values of penile cavernous body and abdominal aorta in SHR were significantly increased.Compared with valsartan group,the NO value in the combination group of Chinese and Western medicine was more significantly increased.All these provide experimental reference for revealing that Bushen Yixin Tablet can improve the erectile function of hypertension related ED patients. |
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