血塞通软胶囊干预冠心病血瘀证患者lncR CTB114C7.4-miR3656-BCL2A1调控网络的临床研究

Clinical Study of Xuesaitong Soft Capsule Treatment for Coronary Heart Disease and Blood Stasis Syndrome Based on lncR CTB114C7.4-miR3656-BCL2A1 Regulatory Network

目的研究血塞通软胶囊(XST)干预冠心病不稳定型心绞痛血瘀证患者的临床疗效以及对lncR CTB114C7.4-miR3656-BCL2A1网络的调控作用,以揭示其潜在作用靶点及分子机制。方法招募冠心病不稳定型心绞痛血瘀证患者80例,随机分为试验组和对照组各40例。试验组给予西医基础治疗+XST,对照组给予西医基础治疗+XST模拟剂,疗程为4周。观察两组治疗前后的疗效指标和安全指标,并利用qRT-PCR检测外周血有核细胞中lncR CTB114C7.4-miR3656-BCL2A1表达变化情况。结果①XST能明显减少心绞痛发作次数,降低硝酸甘油使用量和血瘀证积分,将患者的平均减分率从6.63%提高到34.44%,与对照组相比均有统计学意义(P <0.001)。同时,XST还能改善胸痛、胸闷和唇龈暗红的症状体征,与对照组相比有统计学差异(P <0.001、P=0.002、P=0.018)。②XST治疗后比治疗前的血糖(P=0.019)、LDL(P=0.014)、AST(P=0.006)和ALT(P=0.005)含量降低;血常规、肾功能及凝血功能等指标变化无统计学差异。③与对照组相比,XST能上调lncR CTB-114C7.4(P=0.046)和BCL2A1(P=0.049)表达,并下调miR-3656表达(P <0.001)。结论 XST治疗冠心病不稳定型血瘀证有效、安全,并能进一步上调患者外周血有核细胞中lnc RCTB-114C7.4和BCL2A1表达,并下调miR-3656表达水平,从而发挥调节lncR CTB114C7.4↑-miR3656↓-BCL2A1↑网络的作用。

Objective To explore the clinical efficacy of Xuesaitong soft capsules(XST) in the treatment of patients with unstable angina pectoris(UA) and blood stasis syndrome(BSS) and detect the underlying regulatory effect of XST on lncR CTB114 C7.4-miR3656-BCL2 A1 network, in order to reveal potential treatment targets and molecular mechanism.Methods A total of 80 patients with UA and BSS were included and randomly divided into the test group and control group with 40 cases in each group. In the 4 weeks of treatment, the test group was given western medication + XST, the control group was given western medication + XST placebo. The efficacy and safety indicators were observed, and the expression of lncR CTB114 C7.4-miR3656-BCL2 A1 in peripheral blood mononuclear cells(PBMCs) was detected by qRT-PCR in the two groups before and after treatment. Results ①XST could significantly reduce the frequency of angina attack, the usage of nitroglycerin and the score of BSS scale, and increase the average reduction rate from 6.63%to 34.44%, which were statistically different from those of the control group(P < 0.001). In addition, it could improve chest pain, chest tightness and dark red lips, which were statistically different from that of the control group(P < 0.001,P = 0.002, P = 0.018). ②The levels of blood glucose(P = 0.019), LDL(P = 0.014), AST(P = 0.006), and ALT(P =0.005) decreased after XST treatment;while there were no statistically differences in complete blood count, renal function and coagulation function. ③Compared with the control group, XST could up-regulate the expressions of lncR CTB-114 C7.4(P = 0.046), BCL2 A1(P = 0.049), and down-regulate miR-3656 expression(P < 0.001). Conclusion XST was effective and safe in the treatment of UA patients with BSS. Furthermore, it up-regulated the expressions of lncR CTB-114 C7.4 and BCL2 A1, and down-regulated miR-3656 expression in PBMCs, exerting a regulatory effect on lncR CTB114 C7.4↑-miR3656↓-BCL2 A1↑network.