Study On CircRNA Mechanism Of Huoxue Huayu Recipe In The Treatment Of Stable Angina Pectoris Of Coronary Heart Disease With Heart And Blood Stasis Syndrome

Coronary heart disease?CHD?belongs to the category of "chest pain" in traditional Chinese medicine?TCM?.The combination of disease and syndrome diagnosis according to syndrome differentiation is the main method to improve the curative effect.So this study conducts clinical research using Huoxue-Huayu prescription?HXHYP?as intervention in CHD patients of blood stasis syndrome to analysing the efficacy and detect the mechanism of circRNA function,reviewing epigenetic research progress of CHD blood stasis syndrome and the methods of combination of disease and syndrome.Objective1.To investigate the clinical efficacy and safety of HXHYP on CHD patients with blood stasis syndrome,and provide research foundation in order to popularize TCM prescription in clinic and make Chinese patent drugs.2.To verify how circRNA expression changes before and after the intervention of HXHYP.MethodClinical trial used double-blind randomized placebo experiment design,collecting 60 patients,1:1 divided into two groups.The patients in the experimental group were provided with HXHYP,while in control group were provided with simulation placebo.The duration is 4 weeks with one-week run-in period.After the research,we unblind and analysis to evaluate the safety and efficacy of HXHYP.Mechanism research used five patients with significant efficacy in the experimental group and five patients without placebo effect in the control group.The above 20 blood samples were for RNA purification and extraction.Finally,the changes of RNA expression before and after intervention were analyzed and compared between the two groups.ResultsClinical trial1.About angina score,it has changed in both groups.But the experimental group was superior?P=0.042?.The result shows that HXHYP can improve angina score of CHD patients with blood stasis syndrome.2.About TCM syndrome score,the differences between two groups were statistically significant?P<0.001?.The result shows that HXHYP can improve TCM syndrome of CHD patients with blood stasis syndrome.3.About electrocardiogram?ECG?,the differences between two groups were statistically significant after intervention?P<0.01?.The result shows that HXHYP can change ECG outcome of CHD patients with blood stasis syndrome4.About treadmill exercise test?TET?,the differences of ST segment amplitude in peak motion between two groups were statistically significant after intervention?P=0.015?.The result shows that HXHYP can change TET outcomes of CHD patients with blood stasis syndrome.5.The experimental group didn't have obvious adverse reactions,without statistically significant with P>0.05.It shows that HXHYP has good safety.Mechanism Research1.The melting curves of the selected genes,circRNA₁8046 and circRNA 04345,show a single peak.Moreover,the PCR amplification specificity was good.2.Target RNAs expression quantity in both groups uses independent sample t-test.The results showed that circRNA₁8046 expressed significant difference between two groups,P<0.05,while the other selected RNA expression difference between the two groups was not significant?P>0.05?.It prompted circRNA 18046 has expression difference between the experimental group and the control groupConclusion1.HXHYP is effective and safe enough in the treatment of CHD patients with stable angina pectoris and heart blood stasis.2.Preliminarily,we believed that circRNA 18046 is a potential biomarker of CHD patients with heart blood stasis syndrome and also the target of HXHYP.But further studies are required on the target of single drug ingredients,which will be conducted cross comparison.