Effectiveness and Safety of Acupoint Application of Guan Xin Su He Pill (冠心苏合丸) for Patients with Chronic Stable Angina Pectoris: A Multi-Center, Randomized Controlled Trial

Objective To assess the clinical effectiveness of acupoint application(AP)of Guan Xin Su He Pill(冠心苏合丸,GXSHP)for patients with chronic stable angina pectoris(CSAP).Methods This study was carried out in 3 local hospitals in Chengdu,China.After baseline evaluation,eligible patients were randomly assigned to the placebo application for acupoints(PAA)group or the herbal application for acupoints(HAA)group.Patients in the HAA group underwent AP with herbal powder,which was mainly GXSHP,and patients in the PAA group underwent AP with sham drugs.For each treatment session,unilateral acupoints including Neiguan(PC 6),Danzhong(RN 17),Xinshu(BL 15)and Jueyinshu(BL 14),were stimulated for both groups.AP was performed 3 times a week with a 2-day interval for 4 weeks.The primary outcome was the frequency of angina pectoris attacks per week,while the secondary outcomes included angina pain intensity measured by the Visual Analogue Scale(VAS),dose of rescue oral drugs(nitroglycerin),scores on the Seattle Angina Questionnaire(SAQ),Self-Rating Anxiety Scale scores(SAS)and Self-Rating Depression Scale scores(SDS).Clinical outcomes were measured at week 0,4 and 8.The safety of AP of GXSHP treatment for CSAP were assessed.Results A total of 121 patients were enrolled.Baseline characteristics were comparable across the 2 groups.After treatment,the angina attack numbers in the HAA group were significantly reduced from 11.00 to 4.81(P<0.05).While,for PAA group,the angina frequency was not significantly improved(baseline 10.55;post-treatment 11.05).The HAA group had significantly fewer angina attacks than the PAA group(P<0.05).Pain intensity measured by VAS in HAA group was significantly reduced from 4.06 to 3.02(P<0.05).While,for PAA group,the VAS was significantly increased(baseline 3.62;post-treatment 3.96;P<0.05).Clinical outcomes showed better improvement after treatment in the HAA group than in the PAA group in terms of oral administration of rescue drugs,SAS,SDS and SAQ scores(P<0.05).The adverse events were also reported.Conclusion AP of GXSHP is a safe and effective treatment for CSAP patients(Registration No.NCT02029118).

Assessment of Acute Episodes in Chronic Stable Angina: A Clinical-Laboratory Approach to the Use of the Coronary Vasodilator Propatyl Nitrate

Background/Objectives: Propatyl nitrate is a coronary vasodilator with immediate and prolonged action, indicated in the treatment and prevention of acute angina pectoris episodes. Methods: This was an open, self-paired comparative study performed at UNIFESO Medical School evaluating the clinical and laboratory results of treatment with propatyl nitrate in patients with chronic stable angina pectoris. Subjects received 10 mg of propatyl nitrate, at the dose of three sublingual tablets per day, to be taken at 8:00 A.M., 2:00 P.M., and 8:00 P.M. Subjects returned to the study center after 15 days of treatment for Visit 2 assessments, and at the end of the 30-day treatment period (Visit 3). Results: A total of 200 subjects were included in the study. There was a statistically significant reduction in blood pressure (p < 0.0001) and heart rate (p = 0.0001), but no change in respiratory rate (p = 0.23). Laboratory results did not vary throughout the treatment period. There was no significant change from pretreatment in the SAQ Physical Limitation scale (p = 0.7415). The Angina Stability, Angina Frequency, and Treatment Satisfaction, and Quality of Life scales showed a significant improvement from pretreatment (p < 0.0001). Adverse events were observed among 41 subjects at Visit 2 and 35 subjects at Visit 3. Conclusions: Propatyl nitrate was safe and effective in treating chronic stable angina pectoris over the course of the 30-day treatment period. Treatment with propatyl nitrate increased angina stability and reduced angina frequency while increasing treatment satisfaction and quality of life in the patient population evaluated.