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ObjectiveTo investigate the clinical efficacy and safety of Qihuang Jianpi Zishen granules in the treatment of cardiac involvement in systemic lupus erythematosus （SLE）. MethodA total of 62 SLE patients with cardiac involvement treated in the Department of Rheumatology and Immunology， the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2021 to December 2022 were randomized into control and observation groups （n=31）. The control group was treated with methylprednisolone tablets and hydroxychloroquine sulfate tablets， and the observation group with Qihuang Jianpi Zishen granules on the basis of the therapy in the control group. After 12 weeks of treatment， the two groups were compared in terms of the therapeutic effect， cardiac function indicators ［left atrial end-diastolic diameter （LADd）， left ventricular end-diastolic diameter （LVDd）， left ventricular posterior wall thickness （LVPWTd）， peak blood flow velocity in early diastolic period （peak E）， peak blood flow velocity in late diastolic period （peak A）， E/A ratio， stroke volume （SV）， left ventricular ejection fraction （LVEF）， left ventricular short axis shortening rate （LVFS）， and B-type natriuretic peptide （BNP）］， vascular damage indicators ［nitric oxide （NO）， endothelin-1 （ET-1）， vascular endothelial growth factor （VEGF）， and homocysteine （Hcy）］， inflammation indicators ［erythrocyte sedimentation rate （ESR） and hypersensitive C-reactive protein （Hs-CRP）］， anti-double-stranded DNA （dsDNA） antibodies， disease activity index （SLEDAI） score， mitigation of symptoms and signs， and occurrence of adverse reactions. ResultThe total response rate in the observation group was 87.09%， which was higher than that （67.74%） in the control group （P<0.01）， and the incidence of adverse reactions had no significant difference between the two groups. After treatment， the control group showed lowered LVDd， LVPWTd， BNP， ET-1， VEGF， and Hcy （P<0.05） and increased E peak， E/A ratio， SV， LVEF， and LVFS （P<0.05）. In the observation group， LADd， LVDd， LVPWTd， peak A， BNP， NO， ET-1， VEGF， and Hcy decreased （P<0.05）， while peak E， E/A ratio， SV， LVEF and LVFS increased （P<0.05） after treatment. The treatment in both groups decreased the scores of palpitation， chest tightness， dyspnea， and edema （P<0.05）， reduced ESR， Hs-CRP， ds-DNA， and SLEDAI （P<0.05）. After treatment， the observation group had lower LADd， LVDd， LVPWTd， peak A， BNP， and scores of palpation， chest tightness， dyspnea， and edema （P<0.05） and higher peak E， E/A ratio， SV， LVEF， and LVFS （P<0.05） than the control group. In addition， the observation group had lower NO， ET-1， VEGF， Hcy， ESR， Hs-CRP， ds-DNA， and SLEDAI than the control group （P<0.05）. ConclusionQihuang Jianpi Zishen granules combined with hydroxychloroquine sulfate and methylprednisolone can improve multiple indicators and mitigate the symptoms and signs of SLE patients with cardiac involvement， demonstrating a clinical application value.
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OBJECTIVE： To study the improvement effects of fibrinolytic enzyme from Sipunculus nudus （SNFE） on hemorheology disorder and vascular endothelium injury in naked acute blood stasis model rats. METHODS： SD rats were randomly divided into control group， model group， aspirin group （100 mg/kg） and SNFE high-dose and low-dose groups （2 500， 5 000 U/kg）， with 10 rats in each group. They were given relevant medicine intragastrically once a day， for consecutive 7 d. One hour after the 6th day of administration， except for control group， other groups were given adrenaline hydrochloride 0.8 mg/kg subcutaneously， and then the acute blood stasis model was induced by ice-water bath. Blood was collected from abdominal aorta 2 h after the next day. Blood rheological parameters such as whole blood viscosity （high， medium and low shear rate）， plasma viscosity， hematocrit， erythrocyte aggregation index and erythrocyte deformability index were measured by automatic rheometer. The contents of NO and ET-1 in plasma and their ratio were determined by ELISA， and the damaged degree of vascular endothelium were observed by HE staining. RESULTS： Compared with control group， whole blood viscosity of high， medium and low-shear rate， plasma viscosity， erythrocyte aggregation index and ET-1 content were increased significantly in model group， while erythrocyte deformability index， NO content and NO/ET-1 ratio were decreased significantly， with statistical significance （P＜0.05 or P＜0.01）. Compared with model group， whole blood viscosity of high， medium and low-shear rate， plasma viscosity， hematocrit， erythrocyte aggregation index and ET-1 content were decreased significantly in SNFE high-dose groups. Erythrocyte deformability index， NO content and NO/ET-1 ratio were increased significantly， with statistical significance （P＜0.05 or P＜0.01）. In SNFE low-dose group， erythrocyte deformability index and NO/ET-1 ratio were increased significantly， while ET-1 content was decreased significantly， with statistical significance （P＜0.05 or P＜0.01）. Vascular endothelial staining showed that compared with control group， the structure of aorta layers in model group was loose and disordered， the endothelial defect was incomplete， the vacuoles increased， and the endothelial damage was obvious. The endothelium of rats in each administration group was damaged to varying degrees， but the degree of injury was lighter than in model group. CONCLUSIONS： SNFE can improve hemorheological abnormalities and vascular endothelial injury in rats with acute blood stasis.
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OBJECTIVE:To study the anti-coagulation effect and mechanism of fibrinolytic enzyme SNFE in sipuculus nudus, and provide reference for further development of SNFE. METHODS:40 mice were randomly divided into blank control group(nor-mal saline),Xueshuantong group(positive control,15 mg/kg)and SNFE low-dose,high-dose group(15,30 mg/kg),10 in each group. After intravenous injection in tail,tail bleeding time (BT) and clotting time (CT) were respectively determined to investi-gate the anti-coagulation effect of SNFE. After taking blood in abdominal aorta of rats,test was divided into blank control group, positive control group and SNFE low-mass concentration,medium-mass concentration,high-mass concentration groups (0.25, 0.50,1.00 mg/mL). Prothrombin time(PT),re-calcium time(PRT)(using orokinase as positive drug,100000 U/mL),and max-mum platelet aggregation rate (PAG) in 5 min under adenosine diphosphate (ADP) inducer (using asprin as positive drug,0.50 mg/mL) were respectively determined,and anti-coagulation effect mechanism of SNFE was analyzed. RESULTS:Compared with blank control group,BT,CT of mice in each group were prolonged,with statistical significance in Xueshuantong group and SNFE high-dose group (P<0.05 or P<0.01). Plasma PT of rats in positive control group,SNFE medium-dose,high-dose groups and PRT in each administration group were significantly prolonged(P<0.05 or P<0.01);and PAG in administration group was signifi-cantly reduced(P<0.01). CONCLUSIONS:The fibrinolytic enzyme SNFE in sipuculus nudus can play its anti-coagulant effect by inhibiting the activity of coagulation factors in internal and external sources and ADP-induced platelet aggregation.
ABSTRACT
OBJECTIVE:To study the anti-coagulation effect and mechanism of fibrinolytic enzyme SNFE in sipuculus nudus, and provide reference for further development of SNFE. METHODS:40 mice were randomly divided into blank control group(nor-mal saline),Xueshuantong group(positive control,15 mg/kg)and SNFE low-dose,high-dose group(15,30 mg/kg),10 in each group. After intravenous injection in tail,tail bleeding time (BT) and clotting time (CT) were respectively determined to investi-gate the anti-coagulation effect of SNFE. After taking blood in abdominal aorta of rats,test was divided into blank control group, positive control group and SNFE low-mass concentration,medium-mass concentration,high-mass concentration groups (0.25, 0.50,1.00 mg/mL). Prothrombin time(PT),re-calcium time(PRT)(using orokinase as positive drug,100000 U/mL),and max-mum platelet aggregation rate (PAG) in 5 min under adenosine diphosphate (ADP) inducer (using asprin as positive drug,0.50 mg/mL) were respectively determined,and anti-coagulation effect mechanism of SNFE was analyzed. RESULTS:Compared with blank control group,BT,CT of mice in each group were prolonged,with statistical significance in Xueshuantong group and SNFE high-dose group (P<0.05 or P<0.01). Plasma PT of rats in positive control group,SNFE medium-dose,high-dose groups and PRT in each administration group were significantly prolonged(P<0.05 or P<0.01);and PAG in administration group was signifi-cantly reduced(P<0.01). CONCLUSIONS:The fibrinolytic enzyme SNFE in sipuculus nudus can play its anti-coagulant effect by inhibiting the activity of coagulation factors in internal and external sources and ADP-induced platelet aggregation.