Non-pharmacotogicat treatment is an important means to control hypertension, with many advantages such as tow cost, tess medication, stable btood pressure, tess compHcations, and improved prognosis. This article revie...Non-pharmacotogicat treatment is an important means to control hypertension, with many advantages such as tow cost, tess medication, stable btood pressure, tess compHcations, and improved prognosis. This article reviews the research progress of non-drug treatment of hypertension in Chinese medicine in the past five years, and evaluates traditional Chinese medicine such as TCM Qigong, Wuhuo opera, Ba Duanjin and Taijiquan, and Chinese medicine acupuncture, moxibustion, massage, apptication, acupoint embedding and other traditional Chinese medicine. The effect of external treatment in hypertension control provides guidance for non-drug therapy to control hypertension.展开更多
Background:To evaluate the clinical efficacy of oral administration of Chinese medicines with warming Yang effects and Western medicine in the treatment of heart failure caused by dilated cardiomyopathy.Methods:Seven ...Background:To evaluate the clinical efficacy of oral administration of Chinese medicines with warming Yang effects and Western medicine in the treatment of heart failure caused by dilated cardiomyopathy.Methods:Seven databases including Chinese National Knowledge Infrastructure,Weipu database,Wanfang database,China Biomedical Literature Service System,Cochrane library,PubMed,and Embase were searched.The search date was from established to October 2019.Randomized clinical trials of dilated cardiomyopathy patients with heart failure under the combination treatment of Chinese medicines with warming Yang effects and Western medicine were included.We then assessed the methodological quality of included literatures,extracted valid data and conducted systematically evaluation according to the Cochrane systematic review method.Outcome index included clinical efficacy,left ventricular ejection fraction,and brain natriuretic peptide.Results:Meta-analysis results showed that the clinical effective rate was higher in the combination group than that in the control group(RR=1.24,95%CI(1.14,1.34),P<0.01).In addition,the combination group could improve left ventricular ejection fraction compared with the control group(Std.MD=0.85,95%CI(0.69,1.01),P<0.01).However,the meta-analysis of brain natriuretic peptide levels showed that the included literatures have higher heterogeneity and the meta-analysis results were unstable.So the results of brain natriuretic peptide were abandoned.Conclusion:Oral administration of Chinese medicines with warming Yang effects combined with Western medicine is better than Western medicine alone in improving clinical effect and left ventricular ejection fraction,but it is not clear whether brain natriuretic peptide can be improved.Because the quality of the included studies is not high and inconsistent outcome index,more standardized and rigorous randomized double-blind controlled trials are needed to validate and guide clinical use.展开更多
It's a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in thedfferentiated populations with complex diseases,as stable coronary heart disease...It's a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in thedfferentiated populations with complex diseases,as stable coronary heart disease.Here,in an adaptive,31-center,randomized,double-blind trial invoving 920 patients with moderate symptomatic stable angina treated by 14-day Danhong injection(DHI),a kind of polyphamacological drug with high quality control,or placebo(0.9%saline),with 76-day following-up,we firstly confrmed that DHl couldincrease the proportion of patients with clinically significant changes on angina-frequency assessed by Seattle Angina Questionnaire(ASAQ-AF220)(12.78%at Day 30,95%confidence interval[C]5.86-19.71%,P=0.0003,13.82%at Day 6C0,95%CI 6.82-20.82%,P=0.0001and 8.95%at Day 90,95%CI 2.06-15.85%,P=0.01).We also found that there were no significant differences in new-onset major vascularevents(P=0.8502)and serious adverse events(P=0.9105)between DHl and placebo.After performing the RNA sequencing in 62 selectedpatients,we developed a systemic modular approach tp identfy differentilly expressed modules(DEMs)of DHI with the Z_(summay)valueless than 0 compared with the control group,calculated by weighted gene co-expression network analysis(WGCNA),and sketched out thebasic framework on a modular map with 25 functional modules targeted by DII.Furthermore,the effective therapeutic module(ETM),defined as the highest corelation value with the phenotype alteration(SAQ-AF,the change in SAQ-AF at Day 30 from baseline)calculatedby WGCNA,was identifed in the population with the best effect(ASAQ-AF240),which is related to anticoagulation and regulation ofcholesterol metabolism.We assessed the modular flexbility of this ETM using the global topological D value based on Euclidean distance,which is corelated with phenotype alteration(r^(2):0.8204,P=0.019)by linear regression.Our study identified the ant-angina therapeuticmodule in the effective population treated by the multi-target drug.Modular methods facilitate the discovery of network pharmacologicalmechanisms and the advancement of precision medicine.(ClinicalTrials.gov identifier:NCTO1681316).展开更多
文摘Non-pharmacotogicat treatment is an important means to control hypertension, with many advantages such as tow cost, tess medication, stable btood pressure, tess compHcations, and improved prognosis. This article reviews the research progress of non-drug treatment of hypertension in Chinese medicine in the past five years, and evaluates traditional Chinese medicine such as TCM Qigong, Wuhuo opera, Ba Duanjin and Taijiquan, and Chinese medicine acupuncture, moxibustion, massage, apptication, acupoint embedding and other traditional Chinese medicine. The effect of external treatment in hypertension control provides guidance for non-drug therapy to control hypertension.
文摘Background:To evaluate the clinical efficacy of oral administration of Chinese medicines with warming Yang effects and Western medicine in the treatment of heart failure caused by dilated cardiomyopathy.Methods:Seven databases including Chinese National Knowledge Infrastructure,Weipu database,Wanfang database,China Biomedical Literature Service System,Cochrane library,PubMed,and Embase were searched.The search date was from established to October 2019.Randomized clinical trials of dilated cardiomyopathy patients with heart failure under the combination treatment of Chinese medicines with warming Yang effects and Western medicine were included.We then assessed the methodological quality of included literatures,extracted valid data and conducted systematically evaluation according to the Cochrane systematic review method.Outcome index included clinical efficacy,left ventricular ejection fraction,and brain natriuretic peptide.Results:Meta-analysis results showed that the clinical effective rate was higher in the combination group than that in the control group(RR=1.24,95%CI(1.14,1.34),P<0.01).In addition,the combination group could improve left ventricular ejection fraction compared with the control group(Std.MD=0.85,95%CI(0.69,1.01),P<0.01).However,the meta-analysis of brain natriuretic peptide levels showed that the included literatures have higher heterogeneity and the meta-analysis results were unstable.So the results of brain natriuretic peptide were abandoned.Conclusion:Oral administration of Chinese medicines with warming Yang effects combined with Western medicine is better than Western medicine alone in improving clinical effect and left ventricular ejection fraction,but it is not clear whether brain natriuretic peptide can be improved.Because the quality of the included studies is not high and inconsistent outcome index,more standardized and rigorous randomized double-blind controlled trials are needed to validate and guide clinical use.
基金funded by China National Science and Technology Major Project for"Significant New Drugs Development"(2011ZX09304-07)National Natural Science Foundation of China(81673833)China Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ0908029).
文摘It's a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in thedfferentiated populations with complex diseases,as stable coronary heart disease.Here,in an adaptive,31-center,randomized,double-blind trial invoving 920 patients with moderate symptomatic stable angina treated by 14-day Danhong injection(DHI),a kind of polyphamacological drug with high quality control,or placebo(0.9%saline),with 76-day following-up,we firstly confrmed that DHl couldincrease the proportion of patients with clinically significant changes on angina-frequency assessed by Seattle Angina Questionnaire(ASAQ-AF220)(12.78%at Day 30,95%confidence interval[C]5.86-19.71%,P=0.0003,13.82%at Day 6C0,95%CI 6.82-20.82%,P=0.0001and 8.95%at Day 90,95%CI 2.06-15.85%,P=0.01).We also found that there were no significant differences in new-onset major vascularevents(P=0.8502)and serious adverse events(P=0.9105)between DHl and placebo.After performing the RNA sequencing in 62 selectedpatients,we developed a systemic modular approach tp identfy differentilly expressed modules(DEMs)of DHI with the Z_(summay)valueless than 0 compared with the control group,calculated by weighted gene co-expression network analysis(WGCNA),and sketched out thebasic framework on a modular map with 25 functional modules targeted by DII.Furthermore,the effective therapeutic module(ETM),defined as the highest corelation value with the phenotype alteration(SAQ-AF,the change in SAQ-AF at Day 30 from baseline)calculatedby WGCNA,was identifed in the population with the best effect(ASAQ-AF240),which is related to anticoagulation and regulation ofcholesterol metabolism.We assessed the modular flexbility of this ETM using the global topological D value based on Euclidean distance,which is corelated with phenotype alteration(r^(2):0.8204,P=0.019)by linear regression.Our study identified the ant-angina therapeuticmodule in the effective population treated by the multi-target drug.Modular methods facilitate the discovery of network pharmacologicalmechanisms and the advancement of precision medicine.(ClinicalTrials.gov identifier:NCTO1681316).