交泰丸治疗抑郁症心肾不交证患者的中医证候疗效及对COX2/PGE2信号通路的影响

Effects of Jiaotaiwan on traditional Chinese medicine syndromes and COX2/PGE2 signaling pathway in depression patients with heart kidney imbalance syndrome

关键词:  交泰丸  抑郁症心肾不交证  中医证候量表  COX2/PGE2信号通路

Key words:  Jiaotaiwan  depression with heart-kidney imbalance syndrome  traditional Chinese medicine syndrome scale  COX2/PGE2 signaling pathway

摘要:

[目的] 观察交泰丸治疗抑郁症心肾不交证患者的中医证候疗效及对环氧合酶2（COX2）/前列腺素E2（PGE2）信号通路的影响。[方法] 收集2021年10月-2022年10月就诊于天津4家临床医院的120例抑郁症心肾不交证患者，随机分为交泰丸组、交泰丸联合西药组和西药对照组3组，每组40例，疗程8周。观察治疗前后中医证候量表积分、中医证候量表积分有效率变化情况，采用酶联免疫吸附法（ELISA）检测COX2、PGE2、前列腺素受体3（EP3）表达水平，采用反转聚合酶链式反应（RT-PCR）法检测COX2 mRNA、EP3 mRNA表达水平。[结果] 3组患者治疗后中医证候量表积分较治疗前明显降低（P＜0.01），治疗8周后交泰丸联合西药组中医证候量表评分低于西药对照组（P＜0.05）；交泰丸联合西药组中医证候量表积分有效率明显高于西药对照组（P＜0.05）。3组患者COX2、EP3表达水平与健康人比较明显升高（P＜0.05或P＜0.01），治疗后，其表达水平明显降低（P＜0.05或P＜0.01）。3组患者EP3 mRNA表达水平与健康人比较明显升高（P＜0.01）；治疗后，其表达水平明显降低（P＜0.01）。治疗后，交泰丸联合西药组患者COX2 mRNA的表达水平较治疗前明显降低（P<0.05）。[结论] 交泰丸治疗可以缓解抑郁症心肾不交证患者抑郁状态，改善中医症状体征，并有效调节COX2/PGE2信号通路表达水平。

Abstract:

[Objective] To observe the effects of Jiaotaiwan on traditional Chinese medicine syndromes and the cyclooxygenase-2（COX2）/ prostaglandins E2（PGE2） signaling pathway in depression patients with heart kidney imbalance syndrome. [Methods] Collect 120 depression patients with heart kidney imbalance syndrome who visited 4 clinical hospitals in Tianjin from October 2021 to October 2022. They were randomly divided into 3 groups：Jiaotaiwan group，Jiaotaiwan combined with Western medicine group，and Western medicine control group，with 40 patients in each group. The course of treatment was 8 weeks. Observe the changes in the scores and effective rates of the traditional Chinese medicine syndrome scale before and after treatment. ELISA was used to detect the expression levels of COX2，PGE2，and Prostaglandin E receptor 3（EP3）. RT-PCR was used to detect the expression levels of COX2 mRNA and EP3 mRNA. [Results] After treatment，the scores of the traditional Chinese medicine syndrome scale in the 3 groups of patients were significantly reduced compared to before treatment（P<0.01）. After 8 weeks of treatment，the score of the traditional Chinese medicine syndrome scale in Jiaotaiwan combined with Western medicine group was lower than that in Western medicine control group（P<0.05）；the effective rate of the traditional Chinese medicine syndrome scale score in Jiaotaiwan combined with Western medicine group was significantly higher than that in Western medicine control group（P<0.05）. The expression levels of COX2 and EP3 in the 3 groups of patients were significantly higher than those in healthy individuals（P<0.05 or P<0.01），and after treatment，the expression levels were significantly reduced（P<0.05 or P<0.01）. The expression levels of EP3 mRNA in the 3 groups of patients were significantly higher than those in healthy individuals（P<0.01）. After treatment，the expression level of COX2 mRNA in the Jiaotaiwan combined with Western medicine group was significantly reduced compared to before treatment（P<0.05）. [Conclusion] Jiaotaiwan treatment can alleviate the depressive state of patients with heart kidney imbalance syndrome，improve traditional Chinese medicine symptoms and signs，and effectively regulate the expression level of COX2/PGE2 signaling pathway.