ABSTRACT
Objective:To observe the effect of Yangxin Tongmaifang （YXTM） on endogenous metabolites in the myocardial tissue of rats with coronary heart disease due to blood stasis based on the metabolomics approach， and to explore its mechanism in the treatment of heart blood stasis syndrome. Method:A rat model of chronic myocardial ischemia due to heart blood stasis was established via the high-fat diet combined with intragastric administration of vitamin D<sub>3</sub> and subcutaneous injection of isoproterenol （ISO）， followed by the intervention with YXTM. The metabolites in the myocardial tissues of rats in the normal group （<italic>n</italic>=8）， model group （<italic>n</italic>=8）， and YXTM group （<italic>n</italic>=8） were detected by ultra-high performance liquid chromatography coupled to high resolution mass spectrometry. The high-throughput metabolomics data were then subjected to multivariate statistical analysis using SIMCA 14.1， and the related metabolic pathways were analyzed with MetaboAnalyst. Result:The myocardial sample points of rats in the three groups were located in different areas of the elliptical confidence interval. The normal group and the model group were completely separated. There existed some crossovers and overlaps between the YXTM group and the normal group. The heart blood stasis syndrome model was proved successfully replicated from the perspective of metabolic profiling， and YXTM had the potential to promote the body to return to a normal state. After the intervention with YXTM， six differential metabolites changed significantly. Such metabolic pathways as valine， leucine， and isoleucine biosynthesis， pantothenate and coenzyme A （CoA） biosynthesis， valine， leucine， and isoleucine degradation， biosynthesis of aminoacyl-transfer RNA synthetases， and purine metabolism were involved. Conclusion:The therapeutic effect of YXTM on heart blood stasis syndrome in rats is related to the improved levels of myocardial endogenous metabolites， and its mechanism involves phospholipid metabolism， amino acid metabolism， energy metabolism， inflammatory response， and platelet activation and aggregation.
ABSTRACT
OBJECTIVE@#To explore the clinical efficacy of acupuncture combined with granule for nerve-root type cervical spondylosis and its effects on serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and hemorheological indexes.@*METHODS@#A total of 114 patients with nerve-root type cervical spondylosis were randomly divided into an observation group and a control group, 57 cases in each group. The patients in both groups were treated with traction. The patients in the control group were treated with oral administration of granule, 4 g each time, 3 times a day, while based on the treatment of control group, the patients in the observation group were treated with acupuncture at Dazhui (GV 14), Tianzhu (BL 10), Houxi (SI 3), cervical Jiaji (EX-B 2), Quchi (LI 11), Hegu (LI 4) and Waiguan (TE 5), once a day. Both groups were treated for 4 weeks. The simplified McGill pain questionnaire (MPQ), neck disability index (NDI), numbness score, levels of IL-6, TNF-α, IL-1β in serum and hemorheological indexes were observed before and after treatment, and the clinical efficacy was compared between the two groups.@*RESULTS@#The total effective rate was 91.2% (52/57) in the observation group, which was higher than 71.9% (41/57) in the control group (<0.05). Compared before treatment, the scores of MPQ, NDI and numbness in the two groups were reduced after treatment (<0.05). After treatment, the scores of MPQ, NDI and numbness in the observation group were lower than those in the control group (<0.05). After treatment, the serum levels of IL-6, TNF-α and IL-1β in the two groups were reduced (<0.05), and those in the observation group were lower than the control group (<0.05). After treatment, the plasma viscosity, fibrinogen, low shear rate of whole blood viscosity and high shear rate of whole blood viscosity in the two groups were lower than before treatment (<0.05), and those in the observation group were lower than the control group (<0.05).@*CONCLUSION@#Acupuncture combined with granule have significant clinical efficacy for nerve-root type cervical spondylosis, which could reduce the serum levels of IL-6, TNF-α and IL-1β and improve hemorheology.