血塞通对冠心病不稳定型心绞痛血瘀证患者microRNA的干预作用  

Invention Effect of Xuesaitong for Coronary Heart Disease Unstable Angina with Blood Stasis and Relevant microRNA

作　　者：王阶[1] 滕菲[2] 刘咏梅[1] 陈光[1,3] 

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]首都医科大学附属北京中医医院,北京100010 [3]北京中医药大学,北京100029

出　　处：《中国实验方剂学杂志》2017年第19期11-16,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81473561;81673847)

摘　　要：目的:观察血塞通(XST)治疗及干预冠心病不稳定型心绞痛血瘀证临床疗效及患者外周血hsa-miR-199a-5p,hsa-miR-146b-5p,KIR3DS1,HLA-DPB1,TP53SESN2,NCR1,PRF1表达的影响,阐述XST治疗冠心病血瘀证可能的分子机制。方法:选取心绞痛分级Ⅰ~Ⅲ级的冠心病不稳定型心绞痛血瘀证患者80例,随机分为对照组和治疗组,各40例。对照组给予常规西药治疗+安慰剂,治疗组在常规西药治疗基础上加用血塞通软胶囊,治疗4周。观察治疗前后患者缺血总负荷、西雅图心绞痛质量评分,血流动力学和血脂指标变化,评估XST治疗冠心病血瘀证的临床疗效。实时荧光定量聚合酶链反应(Realtime polymerase chain reaction,Real-time PCR)检测外周血hsa-miR-199a-5p,hsa-miR-146b-5p,KIR3DS1,HLA-DPB1,TP53,SESN2,NCR1,PRF1等基因表达变化。结果:治疗后与对照组比较,治疗组缺血总负荷降低(P<0.05);治疗后与对照组比较,治疗组全血黏度、血浆黏度和红细胞刚性指数下降(P<0.05);治疗后与对照组比较,治疗组甘油三酯(TG),总胆固醇(TC),低密度脂蛋白-胆固醇(LDL-C)降低(P<0.05);治疗后与对照组比较,治疗组KIR3DS1,TP53,SESN2,PRF1上调,hsa-miR-199a-5p,hsa-miR-146b-5p下调(P<0.05)结论:XST可有效改善冠心病不稳定型心绞痛血瘀证患者症状,其机制可能与调控hsa-miR-199a-5p,hsa-miR-146b-5p相关。Objective： To observe the clinical efficacy of xuesaitong （XST） for coronary heart disease unstable angina with blood stasis, and investigate its effects on expression levels of hsa-miR-199a-5p, hsa-miR- 146b-Sp, KIR3DS1, HLA-DPB1, TP53SESN2, NCR1, and PRF1 in peripheral blood and to elucidate the molecular mechanism of XST for the coronary heart disease with blood stasis. Method： The 80 patients with coronary heart disease unstable angina grade Ⅰ-Ⅲ with blood stasis were enrolled and randomly divided into treatment group and control group （40 cases in each group）. The patients in control group received routine western medicine and placebo, while the patients in treatment group also received XST capsules on the basis of routine western medicine therapy. The treatment duration was 4 weeks for both groups. The levels of total ischemic burden, seattle quality score for angina pectoris, haemo-dynamics and blood lipid were observed before and after treatment to evaluate the clinical of XST capsules for coronary heart disease unstable angina with blood stasis. Besides, hsamiR-199a-5p, hsa-miR-146b-5p, KIR3DS1, HLA-DPB1, TP53, SESN2, NCR1, and PRF1 were validated by Real-time PCR. Result： As compared with control group, total ischemic burden, whole blood viscosity, plasma viscosity, red blood cell rigidity index, cholesterol （TC）, triglyceride （TG）, and low density lipoprotein cholesterol （LDL-C） were decreased in treatment group （P 〈 0.05） after treatment; KIR3DS1, TP53, SESN2, PRF1 genes were up-regulated significantly while hsa-miR-199a-5p, hsa-miR-146b-5p levels were down-regulated in treatment group （P 〈 0.05）. Conclusion ： XST could ease the symptoms of patients with coronary heart disease unstable angina with blood stasis and the underlying mechanism might be associated with hsamiR-199a-5p and hsa- miR-146b-5p.

关 键 词：冠心病 不稳定型心绞痛 血瘀证 微小RNA 

分 类 号：R287[医药卫生—中药学] R759[医药卫生—中医学]