参芪口服液联合西医常规方案治疗稳定型心绞痛的疗效及对TLR4/NF-κB信号通路的影响

Efficacy of Shenqi Oral Liquid Combined with Conventional Western Medicine Regimen in the Treatment of Stable Angina Pectoris and Its Effects on TLR4/NF-κB Signaling Pathway

目的:探讨参芪口服液联合西医常规方案治疗稳定型心绞痛(SAP)的疗效及对Toll样受体4(TLR4)/核因子κB(NF-κB)信号通路的影响。方法:选取2020年2月至2021年6月济宁医学院附属医院邹城院区心内科收治的SAP患者108例,根据临床病例随机表分为联合组(n=54)、对照组(n=54)。对照组患者采用西医常规方案治疗,联合组患者在西医常规方案治疗的基础上加用参芪口服液。比较两组患者的心电图疗效、不良反应,治疗前、治疗4周后的心绞痛症状(心绞痛发作频率、持续时间)、血液流变学指标[血浆黏度(PV)、纤维蛋白原(FIB)和红细胞聚集指数(RCAI)]水平、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平及外周血单核细胞TLR4、NF-κB mRNA相对表达量。结果:联合组患者的总有效率高于对照组[92.59%(50/54)vs. 75.93%(41/54)],差异有统计学意义(P<0.05)。治疗4周后,两组患者心绞痛发作频率均减少,持续时间均缩短;联合组患者发作频率少于对照组,持续时间短于对照组,差异均有统计学意义(P<0.05)。治疗4周后,两组患者的PV、FIB和RCAI水平,以及外周血单核细胞TLR4、NF-κB mRNA相对表达量降低,且联合组患者低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,两组患者的CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均升高,且联合组患者高于对照组;两组患者CD8^(+)水平降低,且联合组患者低于对照组,差异均有统计学意义(P<0.05)。联合组、对照组患者的不良反应发生率比较[7.41%(4/54)vs. 5.56%(3/54)],差异无统计学意义(P>0.05)。结论:参芪口服液联合西医常规方案治疗SAP的效果显著,可有效改善患者心绞痛症状及血液流变学,抑制TLR4/NF-κB信号通路激活,调节免疫功能,安全性高。

OBJECTIVE: To probe into the efficacy of Shenqi oral liquid combined with conventional western medicine regimen in the treatment of stable angina pectoris(SAP) and its effects on Toll-like receptor 4(TLR4)/monocyte nuclear factor-κB(NF-κB) signaling pathway. METHODS: A total of 108 patients with SAP admitted into Department of Cardiology, Zoucheng Hospital, Affiliated Hospital of Jining Medical College from Feb. 2020 to Jun. 2021 were extracted to be divided into the combination group(n=54) and control group(n=54) according to the randomized table of clinical cases. The control group was treated with conventional western medicine, while the combination group received Shenqi oral liquid on the basis of conventional western medicine. The efficacy of electrocardiogram, adverse drug reactions, the symptoms of angina pectoris(frequency and duration of angina pectoris), blood rheology indicators [plasma viscosity(PV), fibrinogen(FIB), erythrocyte aggregation index(RCAI)], T lymphocyte subsets(CD3^(+), CD4^(+), CD4^(+)/CD8^(+)), the relative expression of TLR4 and NF-κB mRNA in peripheral blood mononuclear cells before treatment and after treatment of 4 weeks were compared between two groups. RESULTS: The total effective rate of combination group was higher than that of control group [92.59%(50/54) vs. 75.93%(41/54)], the difference was statistically significant(P<0.05). After treatment of 4 weeks, the frequency and duration of angina pectoris decreased in both groups. The frequency in the combination group was less than that in the control group, and the duration was shorter than that in the control group, with statistically significant difference(P<0.05). After treatment of 4 weeks, the relative expressions of PV, FIB and RCAI, TLR4 and NF-κB mRNA in peripheral blood mononuclear cells decreased in both groups, and the combination group was lower than in the control group, the differences were statistically significant(P<0.05). After treatment of 4 weeks, the levels of CD3^(+), CD4^(+)and CD4^(+)/CD8^(+)increased in both groups, and the combination group was higher than the control group;the level of CD8^(+)decreased in two groups, and the combination group was lower than the control group, the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse drug reactions between the combination group and control group [7.41%(4/54) vs. 5.56%(3/54), P>0.05]. CONCLUSIONS: The efficacy of Shenqi oral liquid combined with conventional western medicine regimen in the treatment of SAP is significant, which can effectively improve the symptoms and hemorheology of patients with angina pectoris, inhibit the activation of TLR4/NF-κB signaling pathway, regulate the immune function with higher safety.