加减养心通脉方干预对冠心病血瘀证亚型患者CTNNB1基因表达的影响及疗效观察

目的 探讨加减养心通脉方对冠心病血瘀证亚型CTNNB1基因表达及临床疗效观察。方法 选择符合冠心病血瘀证诊断标准患者23例，按胸痹血瘀证亚型诊断标准分成冠心病气虚血瘀证组7例、气滞血瘀证组8例和痰浊血瘀证组8例，进行为期1个月的加减养心通脉方的治疗，采用实时荧光定量PCR仪检测服药前后CTNNB1基因表达的变化，观察服药前后血脂血糖临床疗效的变化。结果 治疗后不同证型的患者相比治疗前CTNNB1基因表达改变不明显，差异无统计学意义（P>0.05）；治疗后相比治疗前血糖值均有所下降，气虚血瘀组治疗前后血糖值改变差异有统计学意义（P<0.05）；不同证型的患者中TC、TG在治疗后，比治疗前值均有所下降，3组治疗前后TC值改变差异有统计学意义（P<0.05）；气滞血瘀证组、气虚血瘀证组TG改变有统计学意义（P<0.05）；不同证型患者的HDL、LDLC值在治疗后相比治疗前均有所下降，但差异无统计学意义（P>0.05）。结论 加减养心通脉方对冠心病血瘀证3个亚型（气虚、气滞、痰浊）CTNNB1基因表达无明显的调控作用，以方测证，说明CTNNB1基因的表达可能不是冠心病血瘀证的发病机制之一。但该方可以明显改善冠心病血瘀证亚型血糖及脂类异常，有较好的降脂和降糖作用。

Effects of Modified Yangxin Tongmai Formula on CTNNB1 Gene Expression in Subtype of Blood Stasis Syndrome in Patients with Coronary Heart Disease and Observation on Its Clinical Efficacy

Objective To investigate the expression of Modified Yangxin Tongmai Formula on CTNNB1 gene in subtype of blood stasis syndrome in coronary heart disease (CHD) and to observe its clinical effects. Methods A total of 23 CHD cases with blood stasis syndrome met the diagnostic criteria were selected, and they were divided into a group of Qi stagnation and blood stasis syndrome of CHD (n=8), a group of phlegm-turbidity and blood stasis syndrome of CHD (n=8), and a group of Qi deficiency and blood stasis syndrome of CHD (n=7), according to the subtype diagnostic criteria of chest Bi with blood stasis syndrome. They were treated with Modified Yangxin Tongmai Formula for 1 month. Expression change of gene CTNNB1 was detected by real-time qPCR before and after taking medicine. Changes of clinical efficacy in blood lipid and blood glucose were observed before and after taking medicine. Results After the treatment, the expression changes of gene CTNNB1 before the treatment were not significant and there was no statistical significance in the patients with different syndrome types (P>0.05). However, after the treatment, the blood glucose levels were decreased compared to those before the treatment, and the change of blood glucose in the Qi deficiency and blood stasis group was statistically significant before and after the treatment (P<0.05). After the treatment, TC and TG in the patients with different syndrome types were decreased compared to those before the treatment. The changes of TC before and after the treatment in the 3 groups were statistically significant (P<0.05); The changes of TG in the group of Qi stagnation and blood stasis syndrome and the group of Qi deficiency and blood stasis syndrome were statistically significant (P<0.05). After the treatment, HDL and LDLC in the patients with different syndrome types were decreased, but there was no statistical significance (P>0.05). Conclusion There was no obvious regulation effect of Modified Yangxin Tongmai Formula on the expression of CTNNB1 gene in the 3 subtypes of blood stasis syndrome of CHD (Qi deficiency, Qi stagnation and phlegm-turbidity), which suggests that the expression of CTNNB1 gene may not be one of the pathogenesis of blood stasis syndrome of CHD, through testing syndrome by formula. But it can obviously alleviate the abnormal level of blood lipid and blood glucose in subtypes of blood stasis syndrome of CHD, and also has good effects on reducing glucose and lipid.