Clinical Observation And Network Pharmacological Study Of Huoxuexhuexindan In Treating Stable Angina Pectoris Of Qi Deficiency And Blood Stasis Type

Objective:To explore the clinical efficacy and safety of "Huoxue Jiuxin Dan" in the treatment of stable angina pectoris(qi deficiency and blood stasis type)through a certain period of clinical observation.The principle and mechanism of the treatment of stable angina pectoris(qi deficiency and blood stasis)with the method of network pharmacological research were analyzed,providing certain guidance for the later clinical application and research.Methods:In this study,a total of 80 patients with stable angina pectoris(Qi deficiency blood type)of coronary heart disease hospitalized in Yantai Hospital of Traditional Chinese Medicine were collected and divided into observation group and control group according to random number table method,with 40 cases in each group.The control group was treated according to the standard Western medicine treatment,and the observation group was treated with self-prepared "Huoxue Xuexxindan" on the basis of Western medicine treatment in the control group,for a total of 4 weeks.After 4 weeks,the relevant safety indicators(vital signs,three routines,liver and kidney function,adverse reactions)and efficacy indicators(TCM syndrome score,electrocardiogram efficacy,nitroglycerin stopping rate,SAQ score)were analyzed and evaluated.Then,the chemical constituents of various traditional Chinese medicines were screened by TCMSP database,and the target of each effective ingredient was predicted.Secondly,Genecards and OMIM databases were used to screen targets of stable angina pectoris disease.Then,drug--component--target--disease network diagram and protein interaction network diagram(PPI network diagram)were constructed using Cytoscape3.7.2 and STRING databases respectively.Finally,GO function and KEGG pathway enrichment were analyzed in the DAVID data platform.Results:1.A total of 80 cases were included,and a total of 80 cases were statistically analyzed after treatment,without shedding medical records.The two groups were comparable in demographic characteristics(age,sex),course of disease and main scores of TCM syndromes(P>0.05).In terms of safety,all vital signs of patients were stable before and after treatment,and there were no significant changes in blood,urine,stool routine,liver and kidney function and other safety indicators,and no adverse reactions occurred during the test.2.Efficacy of TCM syndromes:Compared with before treatment,the total volume of TCM syndromes in observation group and control group after treatment was lower than before treatment,and the observation group was better,with statistical significance(P<0.05)3.Electrocardiogram:After treatment,the effective rate of the observation group(90%)was higher than that of the control group(72.5%),and the difference was statistically significant(P<0.05).4.Nitroglycerin stopping rate:After 4 weeks of treatment,the effective rate of nitroglycerin stopping rate in the observation group(87.5%)was higher than that in the control group(65%),the difference was statistically significant(P<0.05).5.SAQ:The SAQ score of the two groups was improved compared with that before treatment,the difference was statistically significant(P<0.05).Compared with the control group,SAQ in observation group improved better(P<0.05).6.In the network pharmacological research,89 effective Chinese medicine chemical components of "Huoxue Jiuxin Dan" were collected,quercetin,luteolin,kaempferol,β-sitosterol play an important role in the treatment of diseases.There were 1879 Drugaction targets and 3635 disease targets.A total of 201 intersection targets of drugs and diseases were obtained.Among them,protein kinase 1(AKT1),tumor suppressor P53(TP53),tumor necrosis factor(TNF),interleukin-6(IL-6),vascular endothelial growth factor(VEGFA),mitogen activated protein kinase 3(MAPK3)and other genes are key targets for the treatment of stable angina pectoris.GO functional enrichment analysis showed 925 biological processes.KEGG pathway enrichment analysis showed that there were 180 pathways,among which,PI3K-Akt signaling pathway(phosphatidylinositol 3-kinase/protein kinase B signaling pathway),TNF signaling pathway,and Interleukin-17 signaling pathway(IL-17 signaling pathway),fluid shear stress and atherosclerosis are the intervention pathways of "Huoxuexhuxin-saving Dan" in the treatment of stable angina pectoris.Conclusion:1.Huoxuexhuexxindan can effectively relieve the degree of chest pain,chest tightness and attack frequency of patients with stable angina pectoris of coronary heart disease(qi deficiency and blood stasis type),and improve the relevant efficacy scores.2.Huoxue Jiexin Dan can reduce the frequency and dosage of nitroglycerin in patients with coronary heart disease stable angina pectoris(qi stagnation and blood stasis type),and can significantly improve the quality of life of patients.3."Huoxue Lifesaving Dan" has the advantage of "multi-component,multi-target and multi-pathway",which makes up for the limitation of single target in traditional disease treatment and is worthy of clinical application.