Efficacy and prognostic impact of Pericarpium Trichosanthis injection combined with nicorandil for intractable angina pectoris in elderly patients: A retrospective study

BACKGROUND Coronary artery disease(CAD)is a leading cause of global cardiovascular morta-lity.Refractory angina pectoris,a manifestation of CAD,requires effective drug treatments.Pericarpium Trichosanthis injection,a traditional Chinese medicine,improves cardiovascular symptoms,while nicorandil alleviates spasms and angina.Both have potential in treating CAD.AIM To investigate the therapeutic effects of combining Pericarpium Trichosanthis injection and nicorandil in elderly patients suffering from refractory angina caused by coronary heart disease.METHODS A retrospective analysis was conducted on the data of 130 patients diagnosed with refractory coronary heart disease.Based on the different treatment regimens administered during hospitalization,the patients were divided into a control group(58 cases)and a study group(72 cases).The control group received conven-tional treatment,which included aspirin,statins,and nitrate vasodilators.In addition to the conventional medication,the study group received a combination treatment of Pericarpium Trichosanthis injection and nicorandil.RESULTS After treatment,the study group showed significantly higher left ventricular ejection fraction and cardiac output,and lower brain natriuretic peptide and C-reactive protein levels compared to the control group.The study group also exhibited improvements in angina,quality of life,exercise endurance,and lipid profiles.Multivariate logistic regression analysis revealed a relationship of lipid levels and heart function with the combined treatment.Some patients in the study group experienced headaches during treatment,but no significant adverse reactions were observed.Follow-up showed that the treatment was well-tolerated,with no drug-related adverse reactions detected.CONCLUSION Combination of Pericarpium Trichosanthis injection and nicorandil is more effective than conventional treatment in improving symptoms and heart function in elderly patients with refractory angina pectoris.

Gualoupi (Pericarpium Trichosanthis) injection in combination with convention therapy for the treatment of angina pectoris: a Meta-analysis

OBJECTIVE: To use a Meta-analysis to review the efficacy and safety of Gualoupi(Pericarpium Trichosanthis) injection(PTI) in the treatment of angina pectoris.METHODS: We searched the available literature up to January 2015 using Chinese National Knowledge Infrastructure(CNKI), Chinese Scientific Journal Database(VIP), the Wanfang database, Pub Med and other English language databases to identify randomized controlled trials of PTI for the treatment of angina pectoris. Two reviewers independently retrieved and extracted the information. Software Review Manager 5.3 was used for statistics analysis.RESULTS: Fourteen studies involving 1621 patients were identified. Compared with conventional therapy alone or conventional therapy plus other Traditional Chinese Injections(TCMIs), PTI plus conventional therapy significantly improved clinical efficacy [odds ratio(OR) = 3.56, 95% confidence interval(CI)(2.65, 4.77)](based on 14 studies), electrocardiograph efficacy [OR = 3.20, 95% CI(2.26, 4.51)](based on 7 studies), and efficacy for Traditional Chinese Medicine Syndromes [OR = 3.13, 95% CI(1.43, 6.89)](based on 3 studies). Moreover, compared with conventional therapy alone or conventional therapy plus other TCMIs, PTI plus conventional therapy significantly decreased the levels of plasma viscosity [mean difference(MD) =- 0.47,95% CI(-0.76,-0.17)](based on 3 studies), and plasma low-density lipoprotein [MD =-0.94, 95%CI(-1.57,-0.30)](based on 3 studies). Eleven studies reported some mild adverse reactions, and no seriousadversedrugreactionswereobserved.CONCLUSION: PTI was found to be effective and safe for the treatment of angina pectoris. This study had certain limitations; thus, more rigorously designed, multi-center, randomized controlled trials in larger populations should be performed to support this observation.

Optimization of the extraction process of total flavonoids from Trichosanthis Fructus by Box-Behnken response surface method combined with differential spectrophotometry

Objective:To optimize the extraction process of total flavones in Trichosanthis Fructus(composed of Trichosanthis pericarpium and Trichosanthis semen in certain proportion).Methods:The effects of the mixture ratio of Trichosanthis pericarpium and Trichosanthis semen,ethanol concentration,ultrasonic extraction time and extraction temperature on the extraction rate of total flavonoids in Trichosanthis Fructus were investigated.The extraction process of total flavonoids in Trichosanthis Fructus was optimized by Box-Behnken response surface method combined with differential spectrophotometry.Results:The optimum extraction conditions of total flavonoids in Trichosanthis Fructus were as follows:The mixture ratio of Trichosanthis pericarpium and Trichosanthis semen was 4:6,the ethanol concentration was 70%,the ultrasonic extraction time was 60min and the extraction temperature was 40℃.Conclusion:Box-Behnken response surface method combined with differential spectrophotometry can optimize the extraction process of total flavonoids from Trichosanthis Fructus,which can provide reference for the extraction and application of total flavonoids in Trichosanthis Fructus.