平肝潜阳法对高血压病患者血管衰老及miRNAs-HSP27表达的影响  

Effects of Pinggan Qianyang method on vascular aging and expression of miRNAs-HSP27 in hypertension patients

作　　者：姚佳梅[1,2] 张翠 杨玉书 杨海燕[1,2] 张丹 陈琼[2] 王东生[3] 邱新建[3] 钟广伟[1,2] YAO Jia-mei;ZHANG Cui;YANG Yu-shu;YANG Hai-yan;ZHANG Dan;CHEN Qiong;WANG Dong-sheng;QIU Xin-jian;ZHONG Guang-wei(International Medical Center,Xiangya Hospital,Central South University,Changsha 410008,China;National Center of Clinical Medicine for The Elderly,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Integrated TCM&Western Medicine,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院国际医疗部,长沙410008 [2]中南大学湘雅医院国家老年疾病临床医学研究中心,长沙410008 [3]中南大学湘雅医院中西医结合科,长沙410008

出　　处：《中华中医药杂志》2021年第11期6866-6873,共8页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81673858,No.81704062);湖南省自然科学基金项目(No.2020JJ8017,No.2021JJ31118);国家老年疾病临床医学研究中心(湘雅)建设项目(No.2017-07-1007)。

摘　　要：目的:观察平肝潜阳法延缓早、中期原发性高血压患者血管衰老(VA)的作用,并探讨其作用机制。方法:采用分层随机设计的方法将85例符合纳入标准的患者分为治疗组(43例)和对照组(42例),治疗12周。观察2组治疗前后中医临床症状改善、24h动态血压(ABMP)、VA、降压疗效,同时检测治疗前后外周血氧化应激指标,RT-qPCR和ELISA检测外周血miRNAs及热休克蛋白27(HSP27)的表达水平。结果:平肝潜阳法方药治疗后,中医临床症状总有效率为88.37%,降压的总有效率为90.70%,能够显著降低收缩压和舒张压,减少收缩压和舒张压的血压变异性,纠正血压昼夜节律障碍;同时改善颈动脉血管重构指标(PA、S、IMT、IMT/ID)及VA指标(baPWV和ABI),对血清氧化应激指标MDA和ROS均明显下降,而SOD明显升高;能够升高血清HSP27基因表达和蛋白含量,调控血清miRNA-20a和miRNA-145表达下降,miRNA-98和miRNA-30表达上升。相关性分析显示HSP27与baPWV呈负相关,与ABI呈正相关。本研究结果也证实HSP27与miRNA-20a和miRNA-145呈负相关,与miRNA-98和miRNA-30呈正相关。结论:平肝潜阳法对高血压病患者具有较好的降压作用和临床疗效,能够延缓VA,其作用机制可能与减轻氧化应激损伤及调控miRNAs-HSP27信号通路相关。Objective: To observe the effect of Pinggan Qianyang method on vascular aging(VA) in early and middle stage of essential hypertension, and to explore its mechanism of delaying vascular aging in essential hypertension. Methods: A total of 85 patients who conformed to the inclusion criteria were divided into treatment group(43 cases) and control group(42 cases) by stratified random design, and treated for 12 weeks. The improvement of TCM clinical symptoms, 24-hour ambulatory blood pressure(ABMP), VA and antihypertensive effect were observed before and after treatment in the two groups. The clinical effect of Pinggan Qianyang method on VA of hypertension was evaluated. The oxidative stress indexes of peripheral blood before and after treatment were detected. The expression levels of miRNAs and heat shock protein 27(HSP27) in peripheral blood were detected by RT-qPCR and ELISA. Results: After the treatment of Pinggan Qianyang method, the total effective rate of clinical symptoms of traditional Chinese medicine was 88.37%, and the total effective rate of reducing blood pressure was 90.70%. It could significantly reduce systolic and diastolic blood pressure, reduce the blood pressure variability of systolic and diastolic blood pressure, correct the circadian rhythm disorder of blood pressure, and improve the indexes of carotid vascular remodeling(PA, S, IMT, IMT/ID) and VA(baPWV and ABI), which had a significant effect on blood pressure MDA and ROS in peripheral blood decreased significantly, while SOD increased significantly;HSP27 gene expression and protein content in peripheral blood increased, miRNA-20a and miRNA-145 expression decreased, miRNA-98 and miRNA-30 expression increased. Correlation analysis showed that HSP27 was negatively correlated with baPWV and positively correlated with ABI. The results also confirmed that HSP27 was negatively correlated with miRNA-20a and miRNA-145, and positively correlated with miRNA-98 and miRNA-30. Conclusion: Pinggan Qianyang method has a good antihypertensive effect and clin

关 键 词：平肝潜阳法 高血压病 血管衰老 MIRNAS 热休克蛋白27 氧化应激 

分 类 号：R259[医药卫生—中西医结合]