益气消癥法方药治疗冠心病的疗效及其对ERK12信号转导通路、Omentin-1的影响
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摘要
目的:探究益气消癥法方药治疗冠心病的疗效及其对ERK12信号转导通路、Omentin-1的影响。方法:选取2017年3月至2018年3月郑州大学附属郑州中心医院收治的冠心病患者90例作为研究对象,按照随机数表法随机分为对照组和观察组,每组45例,对照组使用氯吡格雷治疗,观察组在对照组基础上联合益气消癥法方药治疗。比较2组患者的临床疗效。检测并比较2组患者治疗前后血清hs-CRP、TNF-α、和Omentin-1水平。并通过qRT-PCR反应检测MEK和ERK mRNA的表达水平。结果:观察组的有效率显著高于对照组(P <0. 05)。治疗后2组心功能指标均得到显著改善(P <0. 05);治疗后观察组的LVEF显著高于对照组,LVEDD显著低于对照组(均P <0. 05)。治疗后2组炎性反应因子均显著降低,治疗后观察组hs-CRP、TNF-α显著低于对照组(P <0. 05)。治疗前2组MEK和ERK水平差异无统计学意义(P>0. 05),治疗后均显著降低(P <0. 05),治疗后观察组MEK和ERK水平均显著低于对照组(P <0. 05)。术前2组Omentin-1水平差异无统计学意义(P> 0. 05),术后均显著升高(均P <0. 05),术后观察组血清Omentin-1显著高于对照组(P <0. 05)。结论:益气消癥法方药对冠心病具有更好的临床疗效,并可上调血清Omentin-1水平,提高预后;进一步的研究显示气消癥法方药可抑制MEK/ERK通路水平,降低炎性反应因子水平,可能是取得更好疗效的作用机制。
Objective: To explore the therapeutic effects of Yiqi Xiaozheng method in the treatment of coronary heart disease and its effects on ERK12 signal transduction pathway and Omentin-1. Methods: A total of 90 patients with coronary heart disease treated in the Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2017 to March 2018 were selected as the study object. They were randomly divided into the control group and the observation group according to the random number table method,with 45 cases in each group. The control group was treated with clopidogrel,and the observation group was prescribed medicine of Yiqi Xiaozheng method,on the basis of the treatment of the control group. The clinical effects of the 2 groups of patients were compared. Serum hs-CRP,TNF-α,and Omentin-1 levels were detected before and after the treatment of both groups. The expression levels of MEK and ERK mRNA were detected by qRT-PCR reaction. Results: The effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). After the treatment,the cardiac function indexes of both groups were significantly improved( P < 0. 05). The LVEF of the observation group was significantly higher than that of the control group after treatment,and the LVEDD was significantly lower than that of the control group( P < 0. 05). The inflammatory factors of the 2 groups were significantly decreased after treatment. The levels of hs-CRP and TNF-α in the observation group were significantly lower than those in the control group( P < 0. 05). There was no statistical significance of the difference in MEK and ERK levels between the 2 groups before treatment( P > 0. 05). After treatment,the levels of MEK and ERK in the observation group were significantly lower than those of the control group( P < 0. 05). There was no significant difference in the levels of Omentin-1 between the 2 groups before treatment( P > 0. 05),while the level in both groups was significantly increased after the treatment( P < 0. 05). The serum Omentin-1 level of the observation group after the treatment was significantly higher than that of the control group( P < 0. 05). Conclusion: Yiqi Xiaozheng method has better clinical efficacy for coronary heart disease,and can up-regulate serum Omentin-1 level and improve prognosis. Further studies have shown that prescriptions of Yiqi Xiaozheng method can further inhibit the level of MEK/ERK pathways,and reduce the level of inflammatory factors,which may be related to better efficacy.
Objective: To explore the therapeutic effects of Yiqi Xiaozheng method in the treatment of coronary heart disease and its effects on ERK12 signal transduction pathway and Omentin-1. Methods: A total of 90 patients with coronary heart disease treated in the Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2017 to March 2018 were selected as the study object. They were randomly divided into the control group and the observation group according to the random number table method,with 45 cases in each group. The control group was treated with clopidogrel,and the observation group was prescribed medicine of Yiqi Xiaozheng method,on the basis of the treatment of the control group. The clinical effects of the 2 groups of patients were compared. Serum hs-CRP,TNF-α,and Omentin-1 levels were detected before and after the treatment of both groups. The expression levels of MEK and ERK mRNA were detected by qRT-PCR reaction. Results: The effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). After the treatment,the cardiac function indexes of both groups were significantly improved( P < 0. 05). The LVEF of the observation group was significantly higher than that of the control group after treatment,and the LVEDD was significantly lower than that of the control group( P < 0. 05). The inflammatory factors of the 2 groups were significantly decreased after treatment. The levels of hs-CRP and TNF-α in the observation group were significantly lower than those in the control group( P < 0. 05). There was no statistical significance of the difference in MEK and ERK levels between the 2 groups before treatment( P > 0. 05). After treatment,the levels of MEK and ERK in the observation group were significantly lower than those of the control group( P < 0. 05). There was no significant difference in the levels of Omentin-1 between the 2 groups before treatment( P > 0. 05),while the level in both groups was significantly increased after the treatment( P < 0. 05). The serum Omentin-1 level of the observation group after the treatment was significantly higher than that of the control group( P < 0. 05). Conclusion: Yiqi Xiaozheng method has better clinical efficacy for coronary heart disease,and can up-regulate serum Omentin-1 level and improve prognosis. Further studies have shown that prescriptions of Yiqi Xiaozheng method can further inhibit the level of MEK/ERK pathways,and reduce the level of inflammatory factors,which may be related to better efficacy.
引文
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[11]陈志强,方敬,王月华,等.益气养阴消癥通络中药治疗早期糖尿病肾病的临床观察[J].中国中西医结合肾病杂志,2015,16(11):962-964.
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[17]Wang A,Zhang H,Liang Z,et al.U0126 attenuates ischemia/reperfusion-induced apoptosis and autophagy in myocardium through MEK/ERK/EGR-1 pathway[J].European Journal of Pharmacology,2016,16(788):280-285.
[18]Lv L,Yao Y,Zhao G,et al.Rutin inhibits coronary heart disease through ERK1/2 and Akt signaling in a porcine model[J].Experimental&Therapeutic Medicine,2018,15(1):506-508.
[19]章丽霞,王宇,张丽华,等.转化生长因子β1和细胞外信号调节激酶1/2在冠心病猝死早期心肌缺血中的表达及意义[J].川北医学院学报,2016,31(6):813-815.
[20]王菁,徐美林,畅昶,等.ERK1/2信号转导通路参与冠心病致心肌炎症的机制[J].天津医药,2016,44(8):938-942.
[21]刘丽丽,李爽,李海东,等.益气消癥法中药含药血清干预ERmRNA及VEGFR mRNA表达抑制EA.hy926增殖的研究[J].天津中医药,2014,31(1):36-41.
[22]Parthasarathy G,Philipp M T.The MEK/ERK pathway is the primary conduit for Borrelia burgdorferi-induced inflammation and P53-mediated apoptosis in oligodendrocytes[J].Apoptosis An International Journal on Programmed Cell Death,2014,19(1):76-79.
[23]Zhang X,Mao H,Chen J Y,et al.Increased expression of microR-NA-221 inhibits PAK1 in endothelial progenitor cells and impairs its function via c-Raf/MEK/ERK pathway[J].Biochemical&Biophysical Research Communications,2013,431(3):404-408.
[2]黄伟,张碧华,高素强.脉血康胶囊治疗冠心病心绞痛临床疗效观察[J].中国医药,2013,8(8):1051-1052.
[3]李爽,刘丽丽,夏天,等.益气消癥法方含药血清干预EA.hy926细胞MAPK信号转导通路ERK1/2表达的研究[J].药物评价研究,2016,39(5):766-770.
[4]李缙婷,王琦,吴海斌,等.益气消癥通络方治疗慢性阻塞性肺疾病稳定期疗效观察[J].中华中医药杂志,2018,33(6):2699-2701.
[5]Lv L,Yao Y,Zhao G,et al.Rutin inhibits coronary heart disease through ERK1/2 and Akt signaling in a porcine model[J].Experimental&Therapeutic Medicine,2018,15(1):506-509.
[6]Wang X H,Dou L Z,Gu C,et al.Plasma levels of omentin-1 and visfatin in senile patients with coronary heart disease and heart failure[J].Asian Pacific Journal of Tropical Medicine,2014,7(1):55-62.
[7]沈迎,张奇,沈卫峰.美国和欧洲稳定性冠心病诊治指南解读[J].中华心血管病杂志,2014,42(1):70-72.
[8]王波,王临池,赵翼洪,等.2009-2013年苏州20岁及以上居民冠心病发病率变化趋势及类型分析[J].中国全科医学,2015,18(24):2952-2956.
[9]Liu T,Yin T,Li Y,et al.CYP2C19 polymorphisms and coronary heart disease risk factors synergistically impact clopidogrel response variety after percutaneous coronary intervention[J].Coronary Artery Disease,2014,25(5):593-597.
[10]白晓旭,王琦,吴海斌,等.益气消癥方对慢性阻塞性肺疾病稳定期患者肺功能和血流变的影响[J].中华中医药杂志,2015,15(12):4257-4260.
[11]陈志强,方敬,王月华,等.益气养阴消癥通络中药治疗早期糖尿病肾病的临床观察[J].中国中西医结合肾病杂志,2015,16(11):962-964.
[12]Ramadan R,Dhawan S S,Syed H,et al.Effects of clopidogrel therapy on oxidative stress,inflammation,vascular function,and progenitor cells in stable coronary artery disease[J].Journal of Cardiovascular Pharmacology,2014,63(4):369-372.
[13]Du Y,Ji Q,Cai L,et al.Association between omentin-1 expression in human epicardial adipose tissue and coronary atherosclerosis[J].Cardiovascular Diabetology,2016,15(1):90-92.
[14]Klein C,Ninni S,Coisne A,et al.Omentin-1,epicardial fat and coronary artery disease[J].Atherosclerosis,2016,16(255):224-225.
[15]Nazar S,Zehra S,Azhar A.Association of single Nucleotide Missence Polymorphism Val109Asp of Omentin-1 gene and coronary artery disease in Pakistani population:Multicenter study[J].Pakistan Journal of Medical Sciences,2017,33(5):1128-1133.
[16]王小清,窦灵芝,王秀华.老年冠心病患者血浆网膜素1及内脂素水平分析[J].中国动脉硬化杂志,2014,22(6):579-586.
[17]Wang A,Zhang H,Liang Z,et al.U0126 attenuates ischemia/reperfusion-induced apoptosis and autophagy in myocardium through MEK/ERK/EGR-1 pathway[J].European Journal of Pharmacology,2016,16(788):280-285.
[18]Lv L,Yao Y,Zhao G,et al.Rutin inhibits coronary heart disease through ERK1/2 and Akt signaling in a porcine model[J].Experimental&Therapeutic Medicine,2018,15(1):506-508.
[19]章丽霞,王宇,张丽华,等.转化生长因子β1和细胞外信号调节激酶1/2在冠心病猝死早期心肌缺血中的表达及意义[J].川北医学院学报,2016,31(6):813-815.
[20]王菁,徐美林,畅昶,等.ERK1/2信号转导通路参与冠心病致心肌炎症的机制[J].天津医药,2016,44(8):938-942.
[21]刘丽丽,李爽,李海东,等.益气消癥法中药含药血清干预ERmRNA及VEGFR mRNA表达抑制EA.hy926增殖的研究[J].天津中医药,2014,31(1):36-41.
[22]Parthasarathy G,Philipp M T.The MEK/ERK pathway is the primary conduit for Borrelia burgdorferi-induced inflammation and P53-mediated apoptosis in oligodendrocytes[J].Apoptosis An International Journal on Programmed Cell Death,2014,19(1):76-79.
[23]Zhang X,Mao H,Chen J Y,et al.Increased expression of microR-NA-221 inhibits PAK1 in endothelial progenitor cells and impairs its function via c-Raf/MEK/ERK pathway[J].Biochemical&Biophysical Research Communications,2013,431(3):404-408.