The Protective Effect of Compound Danshen Dripping Pills on Oxidative Stress after Retinal Ischemia/Reperfusion Injury in Rats

Objective: To investigate the effect of Compound Danshen Dripping Pills (CDDP) on oxidative stress after ischemia/reperfusion (I/R) injury in the rat retina. Methods: Adult male SD rats were randomly divided into 3 groups: sham (group A), I/R (group B), and I/R plus CDDP (group C). Retinal ischemia/reperfusion injury (RIRI) was introduced by increasing the intraocular pressure (IOP) to 110 mmHg for 60 min via cannulation into the anterior chamber. Right after the insult, CDDP was administered intragastrically (450 mg/kg/d) for 7 days. The levels of malondialdehyde (MDA), the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) in the retinal tissues were determined on d1 and d7 after the ischemic insult. Results: Following ischemia, the MDA levels in group B and group C were significantly higher than those in group A (p < 0.01). CDDP significantly lowered MDA levels in group C when compared with group B (p < 0.01). The activities of SOD, GSH-Px and CAT were higher in group A than in group B and group C (p < 0.01). CDDP could increase the activities of SOD, GSH-Px and CAT remarkably in group C when compared with group B (p < 0.01). Conclusion: CDDP can protect the retina from I/R injury through reducing oxidative stress, and thus may be a promising method for the treatment of ischemic retinal disorders.

Clinical Intervention Effect of Compound Danshen Dripping Pills on Aspirin Resistant Patients with Coronary Heart Disease

[Objectives]To study the clinical intervention effect of Compound Danshen Dripping Pills on aspirin-resistant patients with coronary heart disease(CHD).[Methods]240 patients with coronary heart disease who took Aspirin were selected to measure thrombocytopenia by sonoclot.They were randomly divided into four groups:group A(n=60),Compound Danshen Dripping Pills and aspirin.group B(n=60),aspirin;group C(n=60),high dose aspirin;group D(n=60),Compound Danshen Dripping Pills.CR and PF were determined by sonoclot after one month.The incidence of angina pectoris,acute myocardial infarction,sudden cardiac death and hemorrhage were observed.[Results]After treatment,the CR and PF levels of group A and C were significantly lower than those before treatment,and there was no significant difference between group B and D and before treatment.After treatment,the levels of CR and PF in group A and C were significantly lower than those in group B and D,and there was a significant difference.Angina pectoris and myocardial infarction events in group D were significantly higher than the other four groups;hemorrhage events in group C were significantly higher than the other three groups.[Conclusions]Compound Danshen Dripping Pills combined with aspirin can be used as an economical,effective,and more dependent alternative to inhibit platelet activity in aspirin resistance,and can further reduce the occurrence of acute coronary events.

Effects of compound danshen dripping pills on the levels of serum inflammatory factors, brain natriuretic peptide and blood lipid in CABG postoperative patients

Objective:To explore the effects of compound danshen dripping pills on the levels of serum inflammatory factors,brain natriuretic peptide(BNP)and blood lipid in CABG postoperative patients.Methods:156 cases of patients who were given CABG from January 2015 to January 2018 in Baogang Hospital were chosen and randomly divided into the observation group(n=78)and the control group(n=78).Both groups were given conventional drugs,simultaneously,the observation group was given compound danshen dripping pills.The treatment lasted 3 months.The clinical efficacy was compared between two groups of patients,and the levels of serum inflammatory factors,plasma BNP and blood lipid before and after treatment in two groups of patients were detected in order to make a comparison in the incidence of adverse cardiac events between two groups of patients.Results:After treatment,the total effective rate of treatment in the observation group was significantly higher than that in the control group;in the two groups,the levels of serum interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein and plasma BNP after treatment were obviously lower than those before treatment,and these indicators in the observation group were lower than those in the control group(p<.05);the levels of TG,TC and LDL-C in two groups were obviously lower(p<.05)with the level of HDL-C significantly higher(all p<.05),and the descending or ascending range of each indicator in the observation group was obviously larger than that in the control group(p<.05);in the follow-up visit,the incidence of adverse cardiac events in the observation group of patients was significantly lower than that in the control group of patients(p<.05).Conclusions:Compound danshen dripping pills can effectively reduce the levels of serum inflammatory factors and BNP,regulate blood lipid metabolism and reduce the incidence of adverse cardiac events in CABG postoperative patients.

Research survey and review of the effect of Compound Danshen Dripping Pills on the uric acid metabolism of patients with coronary heart disease

A growing number of studies have reported that serum uric acid（SUA） is associated with coronary heart disease（CHD）, which has been increasingly recognized and valued by the medical community. This paper surveys the epidemiological studies of hyperuricemia and CHD and summarizes the clinical study discussing the association between hyperuricemia and coronary heart disease with a prospect of exploring the possible mechanisms of compound Danshen dripping pills in reducing SUA in patients with coronary heart disease.

Compound Danshen Dripping Pills combined with isosorbide mononitrate for angina pectoris: A systematic review and a Meta-analysis

Objective: To evaluate the efficacy of Compound Danshen Dripping Pills(CDDP) combined with isosorbide mononitrate(ISMN) versus ISMN alone for treating angina pectoris in patients.Methods: The Pub Med, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials(RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography(ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.Results: Our study included 7 245 patients with angina(59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio(OR) = 4.824, 95% confidence interval(CI) = 3.636–6.401, P = 0.000], the efficacy of angina symptom(OR = 4.347, 95% CI = 3.635–5.198,P = 0.000), the efficacy of ECG(OR = 3.364, 95% CI = 2.767–4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride(TG) [mean difference(MD) =-35.176, 95% CI =-37.439 to-32.912, P = 0.000], total cholesterol(TC)(MD =-24.296, 95% CI =-26.429 to-22.163, P = 0.000), the duration of angina attack(MD =-1.991, 95% CI =-2.349 to-1.633, P = 0.000), and the frequency of angina attack [standardized MD(SMD) =-2.840, 95% CI =-3.416 to-2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone(OR = 0.513, 95% CI = 0.421–0.626, P = 0.000).Conclusion: CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore,this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.

Effects of Compound Danshen Dripping Pills on Ventricular Remodeling and Cardiac Function after Acute Anterior Wall ST-Segment Elevation Myocardial Infarction(CODE-AAMI):Protocol for a Randomized Placebo-Controlled Trial

Background:Ventricular remodeling after acute anterior wall ST-segment elevation myocardial infarction(AAMI)is an important factor in occurrence of heart failure which additionally results in poor prognosis.Therefore,the treatment of ventricular remodeling needs to be further optimized.Compound Danshen Dripping Pills(CDDP),a traditional Chinese medicine,exerts a protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and attenuates ventricular remodeling after myocardial infarction.Objective:This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after AAMI on a larger scale.Methods:This study is a multi-center,randomized,doubleblind,placebo-controlled,parallel-group clinical trial.The total of 268 patients with AAMI after primary percutaneous coronary intervention(pPCI)will be randomly assigned 1:1 to the CDDP group(n=134)and control group(n=134)with a follow-up of 48 weeks.Both groups will be treated with standard therapy of ST-segment elevation myocardial infarction(STEMI),with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets 3 times daily after pPCI,and the control group treated with a placebo simultaneously.The primary endpoint is 48-week echocardiographic outcomes including left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume index(LVEDVI),and left ventricular end-systolic volume index(LVESVI).The secondary endpoint includes the change in N terminal pro-B-type natriuretic peptide(NT-proBNP)level,arrhythmias,and cardiovascular events(death,cardiac arrest,or cardiopulmonary resuscitation,rehospitalization due to heart failure or angina pectoris,deterioration of cardiac function,and stroke).Investigators and patients are both blinded to the allocated treatment.Discussion:This prospective study will investigate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function in patients undergoing pPCI for a first AAMI.Patients in the CDDP group will be compared with those in the control group.If certified to be effective,CDDP treatment in AAMI will probably be advised on a larger scale.(Trial registration No.NCT05000411)

Systematic review and Meta-analysis of 26 randomized controlled clinical trials of Compound Danshen Dripping Pill for non-proliferating diabetic retinopathy

Objective:Diabetic retinopathy(DR) is the retinal consequence of chronic progressive diabetic microvascular leakage and occlusion.Non-proliferating diabetic retinopathy(NPDR) is the early stage of DR.It eventually occurs to some degree in all patients with diabetes mellitus.In recent years,many clinical trials have shown that Compound Danshen Dripping Pill(CDDP) may be associated with the improvement of NPDR symptoms.The aim of this study was to quantitatively summarize the association between CDDP and the therapeutic effects of NPDR.Methods:It was conducted that a systematic literature search of Pub Med,Web of Science,CNKI,VIP and Wanfang Data updated in June 2020 with the following search terms:"diabetic retinopathy° or"retinopathy° or "DR° or "NPDR°,in combination with "Compound Danshen Dripping Pill° or "Salvia miltiorrhiza° or "Danshen°.Risk ratio(RR) and weighted mean difference(WMD) with their 95% confidence interval(CI) was calculated between treatment and control groups.The sensitivity analyses were undertaken by removing each individual study when high heterogeneity appeared.Subgroup analysis,Metaregression,and publication bias analysis were also conducted.The strength of evidence was evaluated with the Grading of Recommendation,Assessment,Development,and Evaluation(GRADE) method.Results:Twenty-six RCTs involving 2047 subjects were included to conduct a Meta-analysis after screening the studies,extracting the data,and assessing the study quality.The Stata15.0 software was utilized for processing.Meta-analysis indicated that curative effects of treatment group with CDDP was significantly better than control [RR = 0.54,95% CI(0.40,0.73);moderate-quality evidence].In addition,the results showed that CDDP was significantly associated with improving retinal hemorrhages[WMD =-0.62,95% CI(-0.78,-0.46);low-quality evidence],the vision [WMD = 0.14,and 95% CI(0.09,0.19),low-quality evidence],fundus fluorescence angiography [RR = 0.37 and 95% CI(0.23,0.60);low-quality evidence],reduction of retinal microaneurysm [WMD =-3.74 and 95% CI(-4.38,-3.11);moderate-quality evidence],hemangioma volume [WMD =-3.15,95%CI(-3.45,-2.85);moderate-quality evidence],macular thickness [WMD =-5.52,95%CI =(-64.27,-48.78);low-quality evidence],mean defect [WMD =-1.65 and 95% CI(-1.95,-1.34);very low-quality evidence],fasting blooding glucose [WMD =-0.95,95% CI(-1.19,-0.70);low-quality evidence),hemoglobin A1c[WMD =-0.62,95% CI(-0.93,-0.30);low-quality evidence],high sensitive C reaction protein[WMD =-5.66,95% CI(-8.01,-3.31);low-quality evidence].Sensitivity,subgroup,and Metaregression analyses were also assessed.Conclusion:The study demonstrated that CDDP has beneficial clinical effects for treating NPDR and improve the vision.Moreover,it indicated that oral CDDP in NPDR patients led to significant regulation of serum level of fasting blooding glucose,hemoglobin A1c and high sensitive C reaction protein,which was associated with the pathogenesis of NPDR.However,high-quality and large randomized clinical trials will be needed to prove the consequence in future.

Compound Danshen Dripping Pill inhibits hypercholesterolemia/atherosclerosis-induced heart failure in ApoE and LDLR dual deficient mice via multiple mechanisms

Heart failure is the leading cause of death worldwide.Compound Danshen Dripping Pill(CDDP)or CDDP combined with simvastatin has been widely used to treat patients with myocardial infarction and other cardiovascular diseases in China.However,the effect of CDDP on hypercholesterolemia/atherosclerosis-induced heart failure is unknown.We constructed a new model of heart failure induced by hypercholesterolemia/atherosclerosis in apolipoprotein E(ApoE)and LDL receptor(LDLR)dual deficient(ApoE^(–/–)LDLR^(–/–))mice and investigated the effect of CDDP or CDDP plus a low dose of simvastatin on the heart failure.CDDP or CDDP plus a low dose of simvastatin inhibited heart injury by multiple actions including anti-myocardial dysfunction and anti-fibrosis.Mechanistically,both Wnt and lysine-specific demethylase 4A(KDM4A)pathways were significantly activated in mice with heart injury.Conversely,CDDP or CDDP plus a low dose of simvastatin inhibited Wnt pathway by markedly up-regulating expression of Wnt inhibitors.While the anti-inflammation and anti-oxidative stress by CDDP were achieved by inhibiting KDM4A expression and activity.In addition,CDDP attenuated simvastatin-induced myolysis in skeletal muscle.Taken together,our study suggests that CDDP or CDDP plus a low dose of simvastatin can be an effective therapy to reduce hypercholesterolemia/atherosclerosis-induced heart failure.

基于网络药理学探讨速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的机制

目的采用网络药理学和分子对接技术探索速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的分子调控机制。方法中药系统药理学数据库与分析平台(TCMSP)、中医药百科全书平台(ETCM)、中药分子机制研究的生物信息学分析工具(BATMA-TCM)、本草组鉴平台(HERB)数据库结合成分检测文献筛选速效救心丸联合复方丹参注射液的成分和靶点,同时GeneCards、DisGeNET和OMIM数据库获取不稳定型心绞痛的靶点。用于进行基因本体和京都基因与基因组百科全书富集分析。结果本研究筛选出川芎嗪、丹参酮ⅡA、丹酚酸B等33种主要活性成分,得到前列腺素内过氧化物合成酶2、白细胞介素6(IL-6)等32个速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的靶点。分子对接结果证明,本研究获得的活性成分与其对应的不稳定型心绞痛靶点间均有较高的亲和力。结论速效救心丸联合复方丹参注射液通过川芎嗪、丹参酮ⅡA、丹酚酸B等活性成分靶向IL-6、白细胞介素1β(IL-1β)、肿瘤坏死因子(TNF)等关键靶点发挥治疗不稳定型心绞痛的功效。

复方麝香黄芪滴丸成型工艺优选及挥发性成分含量测定

目的优选复方麝香黄芪滴丸成型工艺,并完善该复方的质量标准。方法通过单因素实验筛选复方麝香黄芪滴丸的基质种类、基质和药液比例、滴距的最佳考察范围;以外观性状、丸重差异、溶散时限等作为评价指标,采用星点设计-效应面法优选复方麝香黄芪滴丸最佳成型工艺条件;以3批复方麝香黄芪滴丸为检测样品,采用气相色谱法测定龙脑、麝香酮和藁本内酯含量;色谱柱为HP-5石英毛细管柱,进样口温度260℃,程序升温,检测器温度300℃,分流比10:1,载气为氮气,流速为1.0 mL·min^(-1)。结果复方麝香黄芪滴丸的最佳成型工艺条件为基质:基质=0.99、药物:基质=0.55、滴距=6.00,综合评分为0.8452;龙脑、麝香酮和藁本内酯与相邻成分色谱峰均达到基线分离;3种成分的线性范围依次为0.327~1.962、0.140~0.840、0.7105~4.263μg(均r>0.999);平均加样回收率依次为92.30%(RSD=1.65%,n=6)、101.28%(RSD=0.81%,n=6)、98.99%(RSD=0.65%,n=6);3种成分的平均含量依次为0.2017、0.0847、1.3829 mg·g^(-1)。结论该成型工艺稳定可行,可为复方麝香黄芪滴丸的开发及应用提供参考;建立的气相色谱法能同时测定复方麝香黄芪滴丸中龙脑、麝香酮和藁本内酯的含量,可用于复方麝香黄芪滴丸的质量控制。

Effects of FuFangDanShenDiWan on cell adhesion molecules, endothelin and platelet aggregation rate in senile patients with carotid atherosclerosis

Objective: To observe the effects of FuFangDanShenDiWan on cell adhesion molecules, inflammatory response factors and endothelin in senile patients with carotid atherosclerosis. Methods From January 2017 to November 2018, 106 patients with carotid atherosclerosis sampled from a hospital were selected as the research objects. All patients included in this study were divided into Compound Danshen Dripping Pill group and western medicine group according to the order of visit. Patients in the western medicine group were given routine treatment and calcium atorvastatin. Compound Danshen Dripping Pill group was given Compound Danshen Dripping Pill on the basis of the treatment of control group. The changes of soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), monocyte chemotactic protein-l (MCP-1), tumor necrosis factor (TNF-actor (TNF--or (TNF-ic protein-l (MCP-1hs-CRP), nitric oxide (NO), endothelin (ET), platelet maximum aggregation rate (PAGM), and thrombin B2 (TXB2) were compared between the two groups before and after treatment. Results The level of cell adhesion molecules, inflammatory response factors, NO, ET, PAGM, TXB2 were not statistically significant between the two groups before treatment (P>0.05). After 6 courses of treatment, the level of sICAM-1, sVCAM-1, MCP-1, TNF-1, hs-CRP, ET, PAGM, TXB2 of patients in the FuFangDanShenDiWan group and western medicine group were significantly lower than those before treatment (P<0.05). The level of sICAM-1, sVCAM-1, MCP-1, TNF-M, hs-CRP, ET, PAGM, TXB2 in Compound Danshen Dripping Pill group were significantly lower than those in western medicine group (P<0.05). The levels of NO in the FuFangDanShenDiWan group and western medicine group was significantly higher than that before treatment (P<0.05). In addition, The levels of NO in the Compound Danshen Dripping Pill group was significantly higher than that in the western medicine group (P<0.05). Conclusion Compound Danshen Dripping Pill assisted atorvastatin calcium in the treatment of senile carotid atherosclerosis has a significant effect. Taking Compound Danshen Dripping Pill can effectively reduce the inflammatory reaction of the body of senile carotid atherosclerosis patients, regulate the expression of immune cell adhesion molecules, have a positive effect on the endothelial function and platelet function of patients, reduce the formation of thrombosis, and effectively alleviate the progression of senile carotid atherosclerosis.

复方丹参滴丸联合西药治疗老年冠心病合并慢性心力衰竭临床研究

目的:观察复方丹参滴丸联合西药治疗老年冠心病合并慢性心力衰竭的临床疗效。方法:采用随机数字表法将2020年3月—2023年5月杭州市西湖区蒋村街道社区卫生服务中心收治的116例老年冠心病合并慢性心力衰竭患者分为试验组和对照组各58例。对照组给予西药治疗,试验组在对照组基础上联合复方丹参滴丸治疗。2组均连续治疗6个疗程。比较2组治疗前后美国纽约心脏病协会(NYHA)心功能分级、心功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)]及血清脂蛋白相关磷脂酶A2(LP-PLA2)、心型脂肪酸结合蛋白(hFABP)、可溶性生长刺激表达基因2蛋白(sST2)的水平,并评估2组临床疗效及不良反应发生情况。结果:治疗后,试验组总有效率94.83%(55/58),高于对照组79.31%(46/58)(P<0.05)。治疗后,2组NYHA心功能分级较治疗前减轻(P<0.05),且试验组NYHA心功能分级轻于对照组(P<0.05)。治疗后,2组中医证候积分及LVEDD、LVESD、hFABP、LP-PLA2、sST2水平均较治疗前降低(P<0.05),LVEF水平升高(P<0.05),且试验组中医证候积分及LVEDD、LVESD、hFABP、LP-PLA2、sST2水平低于对照组(P<0.05),LVEF水平高于对照组(P<0.05)。试验组不良反应发生率1.72%(1/58),低于对照组12.07%(7/58)(P<0.05)。结论:复方丹参滴丸联合西药治疗老年冠心病合并慢性心力衰竭疗效确切,能有效增强患者心功能,降低心肌炎性损伤,安全性较高。

基于网络药理学和分子对接探究复方丹参滴丸治疗骨关节炎的作用机制

目的基于网络药理学和分子对接方法预测复方丹参滴丸(CDDP)治疗骨关节炎(OA)的作用机制。方法利用TCMSP数据库筛选CDDP主要化合物及靶点信息;查询GeneCards、OMIM、DisGenet数据库搜集OA相关蛋白靶点;利用Venn在线工具构建药物和疾病共同靶点;利用String 11.0平台构建蛋白质相互作用网络;采用Cytoscape 3.9.1软件构建药物-成分-靶点-疾病网络;使用R包clusterProfiler进行基因本体(GO)及京都基因与基因组百科全书(KEGG)通路富集分析;采用AutoDock Vina进行分子对接。结果CDDP与OA交集靶点有44个,KEGG通路富集发现,磷脂酰肌醇3-激酶/蛋白激酶B及白细胞介素-17信号通路等与药物作用通路相关;分子对接显示槲皮素、芹菜素和木犀草素与11个核心靶点结合良好,尤其槲皮素与金属蛋白酶9。结论CDDP可能通过多成分、多靶点、多通路共同发挥抗OA的作用.

复方丹参滴丸配合阿托伐他汀对冠心病患者行经皮冠状动脉介入术后血管内皮功能和血管炎性反应的影响

目的分析复方丹参滴丸配合阿托伐他汀对冠状动脉粥样硬化性心脏病(简称冠心病)患者行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后血管内皮功能和血管炎性反应的影响。方法选取2023年1月—2024年1月中南大学湘雅医院收治的94例冠心病患者为研究对象,所有患者均接受PCI,按治疗方法不同分组,每组47例。单药组采用阿托伐他汀治疗,联合组给予复方丹参滴丸、阿托伐他汀联合治疗,对比两组临床疗效、血管内皮功能、血管炎性反应。结果联合组临床总有效率为95.74%(45/47),高于单药组的74.47%(35/47),差异有统计学意义(χ^(2)=9.598,P<0.05)。治疗8周后,联合组的血管性血友病因子、内皮素-1、肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平低于单药组,血清一氧化氮水平高于单药组,差异有统计学意义(P均<0.05)。结论冠心病患者PCI术后应用复方丹参滴丸配合阿托伐他汀治疗,可有效抑制炎症因子释放,改善血管内皮功能,临床疗效显著。

复方丹参滴丸联合阿托伐他汀钙治疗慢性心力衰竭临床观察

目的探讨复方丹参滴丸联合阿托伐他汀钙对慢性心力衰竭(congestive heart failure,CHF)患者心功能及细胞因子的影响。方法选取2020年8月—2022年8月就诊于济宁市中医院CHF患者92例进行研究,按照随机数字表法分为2组,各46例。对照组予以阿托伐他汀钙片进行治疗,观察组在对照组基础上采用复方丹参滴丸进行治疗,于治疗3个月后评估。对比2组临床疗效、心功能、细胞因子、血管活性物质、不良反应。结果观察组治疗总有效率(95.65%)高于对照组(80.43%),差异有统计学意义(P<0.05)。治疗前2组心功能、细胞因子、血管活性物质对比,差异无统计学意义(P>0.05);与对照组对比,观察组治疗后左室射血分数(left ventricular ejection fractions,LVEF)高,左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)低,6 min步行距离(six minute walk distance,6MWD)长,可溶性生长刺激表达基因2蛋白(soluble growth stimulation expression gene 2 protein,sST2)、半乳糖凝集素-3(galectin-3)水平均低,内皮素-1(endothelin-1,ET-1)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、脑利钠肽(brain natriuretic peptide,BNP)水平均低(P<0.05)。观察组不良反应(13.04%)与对照组(10.87%)对比,差异无统计学意义(P>0.05)。结论CHF患者经复方丹参滴丸与阿托伐他汀钙治疗后心功能得到显著改善,且血清细胞因子水平趋于正常,血管活性物质生成有效一致,且安全性高。

复方丹参滴丸联合常规西医治疗冠心病合并糖尿病有效性及安全性的Meta分析

目的对复方丹参滴丸联合常规西医治疗冠心病合并糖尿病的有效性和安全性进行系统评价。方法通过检索万方数据库(Wanfang)、中国知网(CNKI)、维普中文期刊(VIP)、中国生物医学文献数据库(SinoMed),以及Cochrane Library、PubMed、Embase和Web of Science等数据库,收集从建库至2023年5月复方丹参滴丸联合常规西医治疗冠心病合并糖尿病的随机对照试验(RCT),由2位研究人员独立完成文献筛选、数据整理和偏倚风险评价;应用RevMan 5.4软件进行Meta分析。结果纳入24项RCT,共2546例患者。Meta分析结果显示,复方丹参滴丸联合常规西医治疗在提高冠心病合并糖尿病的总有效率[OR=4.93,95%CI(3.49,6.98),P<0.00001]、血浆脂联素[MD=2.79,95%CI(2.30,3.27),P<0.00001],降低空腹血糖[SMD=-1.06,95%CI(-1.24,-0.88),P<0.00001]、餐后2 h血糖[MD=-1.53,95%CI(-1.71,-1.35),P<0.00001]、糖化血红蛋白[MD=-1.56,95%CI(-2.01,-1.11),P<0.00001]、同型半胱氨酸[MD=-8.47,95%CI(-8.89,-7.97),P<0.00001]、低密度脂蛋白[MD=-0.46,95%CI(-0.69,-0.24),P<0.0001]、总胆固醇[MD=-0.45,95%CI(-1.11,-0.20),P=0.005]、甘油三酯[MD=-0.42,95%CI(-0.50,-0.34),P<0.00001]、白细胞介素6[SMD=-1.34,95%CI(-1.61,-1.07),P<0.00001]、心血管不良事件[OR=0.35,95%CI(0.19,0.64),P=0.0006]、不良反应发生率[OR=0.45,95%CI(0.24,0.86),P=0.01]方面均优于常规西医治疗。结论复方丹参滴丸联合西医常规治疗冠心病合并糖尿病的疗效优于单纯西医治疗,而且安全性较好。但受纳入研究质量等因素的限制,上述结论仍需更多高质量的临床试验验证。

复方丹参滴丸联合羟苯磺酸钙治疗糖尿病性视网膜病变临床效果的meta分析

目的系统评价复方丹参滴丸辅助羟苯磺酸钙治疗糖尿病性视网膜病变(DR)的临床效果。方法检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、PubMed、Embase、Web of Science和Cochrane Library建库至2023年7月复方丹参滴丸联合羟苯磺酸钙治疗DR的临床随机对照试验。结果共纳入11项临床随机对照试验,共848例患者,观察组425例,对照组423例。meta分析结果显示,与对照组比较,试验组视野灰度值[均值差(MD)(95%CI):-0.92(-0.96,-0.88),P<0.00001]、血管瘤体积[MD(95%CI):-3.11(-3.33,-2.89),P<0.00001]、出血斑面积[MD(95%CI):-0.76(-0.85,-0.67),P<0.00001]、黄斑厚度[MD(95%CI):-55.62(-62.59,-48.65),P<0.00001]、血管内皮生长因子水平[MD(95%CI):-17.63(-21.6,-13.59),P<0.00001]、肿瘤坏死因子-α水平[MD(95%CI):-13.3(-16.09,-10.68),P<0.00001]更低,视力[MD(95%CI):0.13(0.05,0.20),P<0.00001]更好。无明显不良反应或事件发生。敏感性分析检验证实模型稳定性高,结论可信度高。结论根据目前临床证据,复方丹参滴丸与羟苯磺酸钙联用可提高DR的临床疗效。

中药复方基于Wnt/β-catenin信号通路调控糖尿病肾病研究进展

糖尿病肾病是糖尿病最常见的微血管并发症之一,也是造成终末期肾病的主要原因。Wnt/β-catenin信号通路与糖尿病肾病肾小管间质纤维化密切相关,主要通过足细胞、肾小球系膜细胞、肾小管上皮细胞等来改善糖尿病肾病。中药复方基于调控Wnt/β-catenin信号通路来改善肾脏病变及纤维化,保护肾脏功能,进而延缓病程进展,在治疗中发挥激活自噬、减少炎症反应及减弱氧化应激等作用。目前,关于中药复方基于Wnt/β-catenin信号通路的研究仍存在以下不足之处:(1)在中药复方的研究中,能够得出中药复方可通过Wnt/β-catenin信号通路发挥作用,但由于中药复方成份复杂多样,大多数仅仅发现相关性,而没有分析其具体的活性成分;(2)Wnt/β-catenin信号通路的相关研究并未深入探索该信号通路在肾纤维化中的作用机制;(3)目前关于中医药的大部分实验为动物体内实验,缺乏体外细胞的相关实验探究。今后,需加强对中药复方活性成分的研究,并开展更多的体外细胞实验,进行深层次的作用机制及靶点研究。

复方丹参滴丸联合丁苯酞治疗急性脑梗死的疗效及对患者血清炎性因子的影响

目的基于核转录因子(NF-κB)信号通路探究复方丹参滴丸联合丁苯酞对急性脑梗死(ACI)患者炎性反应的影响。方法选取2020年7月至2022年5月平顶山市第一人民医院收治的ACI患者118例,按随机数表法分为观察组和对照组各59例。对照组患者予以丁苯酞注射液治疗,观察组患者在对照组治疗的基础上联合复方丹参滴丸治疗,均连续治疗两周。治疗两周后,比较两组患者的疗效,以及治疗前、治疗一周后、两周后的美国国立研究院卒中量表(NIHSS)、简易智能状态量表(MMSE)、Barthel指数(BI)评分、脑神经因子[神经生长因子(NGF)及神经营养因子(NTF)]、NF-κB信号通路相关蛋白、mRNA和NF-κB信号通路相关因子[白细胞介素(IL)-1β、IL-6、IL-8、肿瘤坏死因子(TNF)-α]水平,同时比较两组患者治疗期间的不良反应发生情况。结果观察组患者的临床治疗总有效率为94.92%,明显高于对照组的81.36%,差异有统计学意义(P<0.05);治疗一周和两周后,两组患者的NIHSS评分均呈下降趋势,且观察组明显低于对照组,MMSE及BI评分呈升高趋势,且观察组明显高于对照组,差异均有统计学意义(P<0.05);治疗一周和两周后,两组患者的NGF、NTF均呈升高趋势,且观察组明显高于对照组,差异均有统计学意义(P<0.05);治疗一周后、两周后,两组患者的NF-κB p50蛋白、NF-κB p50 mRNA、NF-κB p65蛋白、NF-κB p65 mRNA均呈下降趋势,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗一周后、两周后,两组患者的NF-κB信号通路相关因子IL-1β、IL-6、IL-8、TNF-α均呈下降趋势,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗期间,观察组患者不良反应总发生率为11.86%,略高于对照组的8.47%,但差异无统计学意义(P>0.05)。结论复方丹参滴丸联合丁苯酞可通过调控NF-κB信号通路,抑制炎性反应,加速神经功能缺损恢复,临床应用效果显著且安全性较高。

复方丹参滴丸联合西医常规治疗冠心病心绞痛的回顾性队列研究

[目的]观察复方丹参滴丸联合西医常规治疗冠心病心绞痛的临床疗效,分析其临床疗效优势。[方法]采用回顾性队列研究方法,收集天津市6家医院病案管理系统中的冠心病心绞痛患者,采集时间为2014年1月—2022年6月。将这些患者分为暴露组和非暴露组,暴露组使用复方丹参滴丸联合西医常规治疗,非暴露组单独使用西医常规治疗,两组按照1∶1比例进行匹配,每组各612例。观察两组患者住院期间心血管事件发生率、临床生化指标及颈部血管彩超。[结果]暴露组谷草转氨酶、乳酸脱氢酶、C反应蛋白、凝血酶时间、D-二聚体、血糖、糖化血红蛋白、肌酐、尿酸、谷丙转氨酶、总胆红素、白细胞计数、颈动脉内中膜厚度、颈动脉斑块检出率低于非暴露组,差异具有统计学意义(P<0.05)。[结论]复方丹参滴丸联合西医常规治疗的冠心病心绞痛患者心血管事件发生率较低,凝血功能、肾功能、肝功能、血糖、血脂水平较稳定,颈动脉内中膜厚度较小,斑块发生率较低。