| Objective: Chronic heart failure(CHF)is a serious stage of heart disease due to various causes.The study on normal rat cardiac fibroblast phosphatidylinositol 3-kinase / protein kinase B/ glycogen synthase kinase-3 beta(PI3K-AKT-GSK beta 3)signal pathway by observing Fu Xin Mixture.To analyse Fu Xin Mixture in the treatment of heart failure,while the BNP level and the quality of life of patients score and TCM syndrome score were evaluated to investigate the clinical curative effect of Fu Xin Mixture's,provide a new direction for scientific research.Methods: This study is divided into two parts: animal/cell experiment and clinical research.1.Animal and cell experiments: 50 healthy adult male Wistar rats were randomly divided into normal saline group(blank group),low dose group of Fu Xin Mixture,middle dose group of Fu Xin Mixture,high dose group of Fu Xin Mixture and western medicine group,respectively,who is given the corresponding drugs once a day for 2 weeks.After the last administration we collecte rats abdominal aorta blood,then separate,inactivate,filtrate bacteria and make drug-containing serum.Then we culture primary cardiac fibroblasts according to differential adherence method,detecte different concentrations of medicated serum using MTT colorimetric method to observe effect of increasing the value of cardiac fibroblasts,select the appropriate concentration of serum intervene cardiac fibroblasts,finally detecte the expression of PI3 K,P-AKT,AKT,P-GSK-3? and GSK-3? by Western-blot.2.Clinical efficacy observation: 40 patients according with the inclusion criteria were randomly divided into experimental group and the control group,The control group was treated with valsartan and conventional western medicine,the experimental group adds with Fu Xin Mixture on the basis of the control group.After 6 weeks treatment,observe the level of BNP ? TCM syndrome integral the cardiac function classification(NHYA grade)and the changes of quality of life score index of heart failure in Minnesota in two groups before and after treatment.Results:1.The results of animal and cell experiments:(1)MTT results:After culturing 48 h in the above conditions of medium,the proliferation of cardiac fibroblasts in the middle dose group?the 10% western medicine group and the western medicine group(15%)was higher than that in the normal group which has significant difference(P<0.05).(2)The expression of PI3K: compared with the blank group,the relative expression of PI3 K were lower in Chinese medicine group and Western medicine group which has significant difference(P<0.01);compared with the traditional Chinese medicine group,the expression of PI3 K in western medicine group was reduced which has significant difference(P<0.01)(3)The expression of P-AKT and AKT: compared with the blank group,the relative expression of P-AKT were lower in Chinese medicine group and Western medicine group which has significant difference(P<0.01);compared with the traditional Chinese medicine group,the P-AKT expression in western medicine group was significantly decreased which has significant difference(P <0.05).There was no significant difference in AKT in each group(P>0.05).(4)The expression of P-GSK-3? and GSK-3?: compared with the blank group,the relative expression of P-GSK-3? were lower in Chinese medicine group which has significant difference(P<0.01),but the expression of P-GSK-3? in the western medicine group has no change which was no statistical significance(P>0.05);compared with the western medicine group,the P-GSK-3? expression in the traditional Chinese medicine group was significantly decreased which has significant difference(P <0.01);compared with the blank group,the relative expression of GSK-3? were has no change in Chinese medicine group and Western medicine group which was no statistical significance(P>0.05).2.Clinical efficacy observation:(1)TCM syndrome integral: two groups of TCM syndrome integral after treatment were significantly decreased which has significant difference(P<0.01);comparison between groups after treatment,TCM syndrome integral in the experimental group was lower than the control group(P< 0.05).(2)The level of BNP:two groups of the level of BNP after treatment were significantly decreased which has significant difference(P <0.01);comparison between groups after treatment,the level of BNP in the experimental group was lower than the control group(P< 0.05).(3)The improvement rate of cardiac function:After treatment,the total effective rate was 85% in experimental group and 65% in the control group which was no significant difference between the two groups(P> 0.05).(4)Minnesota quality of life score: After treatment,the Minnesota quality of life score in two groups were significantly lower than that before treatment(P <0.01);and the Minnesota quality of life score in experimental group was better than the control group(P <0.05).Conclusion: 1.Fu Xin Mixture can reduce the expression of PI3 K and P-AKT,but its effect is inferior to valsartan.2.Fu Xin Mixture can reduce the expression of P-GSK-3?,and its effect is better than valsartan.3.Fu Xin Mixture may play an important role in the treatment of chronic heart failure by regulating the PI3K-AKT-GSK-3? pathway in rat cardiac fibroblasts.4.Fu Xin Mixture and western medicine can significantly reduce the TCM syndrome integral,and its efficacy is better than western medicine group.5.Fu Xin Mixture and western medicine can significantly reduce the level of BNP,and its effect is better than western medicine group.6.Fu Xin Mixture and western medicine can significantly improve the quality of life of patients(Minnesota quality of life score),and its efficacy is better than western medicine group. |
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