Abstract

Coronary heart disease (CHD) remains the leading cause of morbidity and mortality worldwide. Traditional Chinese medicine (TCM) is one of the effective complementary and alternative therapies used to improve the prognosis of CHD patients. Xuefu Zhuyu (XFZY) decoction, a classical traditional Chinese medication for regulating Qi and promoting blood circulation, has a clinical benefit in CHD; however, the underlying mechanism is not clear. Recently, it was found that the metabolites involved in amino acid metabolism and the tricarboxylic acid cycle were altered in CHD patients with Qi and Yin deficiency syndrome. To understand the material foundation of Qi, it is of great significance to study the differential metabolites involved in Qi during treatment of CHD with Qi-regulating and blood-promoting herbs. In this study, we investigated the metabolic profiles of serum in CHD patients by nontargeted metabolomics analysis to detect differential metabolites between the XFZY decoction group and placebo group. Ten CHD patients were enrolled and treated with placebo granules or XFZY decoction granules in a random and double-blind manner. Serum samples of all patients were evaluated by untargeted high-performance liquid chromatography with tandem mass spectrometry-based metabolomics. In total, 513 metabolites were detected in the serum of CHD patients, and six of these metabolites participating in seven metabolic pathways were significantly different between CHD patients treated with XFZY decoction and the placebo group. Among the six differential metabolites, FA (20:2)-H and tetracarboxylic acid (24:0), involved in fatty acid metabolism; cis-aconitic acid, which participates in the tricarboxylic acid cycle; 2-deoxy-D-glucose, involved in glucose metabolism; and N-acetylglycine, involved in amino acid metabolism, were decreased, whereas spermine, which participates in amino acid metabolism, was increased as compared with the placebo group. Our findings, combined with the perspective of biological functions, indicate that 2-deoxy-D-glucose and spermine might constitute the partial material foundation of Qi in CHD patients treated with XFZY decoction.

Highlights

  • Coronary heart disease (CHD) remains the major cause of morbidity and mortality worldwide, responsible for about one in every seven deaths (Lozano et al, 2012)

  • Ten CHD patients were randomly and double blindly divided into two groups: five patients were treated with placebo granules for 12 weeks, and five patients were treated with Xuefu Zhuyu (XFZY) decoction granules for 12 weeks

  • With the statistical analysis by Student’s t test, the levels of HGB and Glu were increased, whereas activated partial thrombin time (APTT) was decreased in the XFZY decoction group as compared with those in the placebo group (P < 0.05)

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Summary

Introduction

Coronary heart disease (CHD) remains the major cause of morbidity and mortality worldwide, responsible for about one in every seven deaths (Lozano et al, 2012). Effective complementary and alternative therapy is necessary to improve functional status and quality of life in CHD patients. As an effective complementary and alternative therapy, TCM has improved the prognosis of CHD patients. One of the critical treatments of CHD in TCM is to regulate Qi and promote blood circulation (Xu and Chen, 2007). Xuefu Zhuyu (XFZY) decoction, which originated from the ancient Chinese document “Yilin Gaicuo” in the late Qing Dynasty, has effects on regulating Qi and promoting blood circulation, which is the basic prescription for the treatment of CHD (Meng et al, 2018). Previous studies confirmed that XFZY decoction reduced the incidence of cardiovascular events and improved the prognosis of patients with CHD; the underlying mechanism is still unclear

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