BACKGROUND The specific benefits of Yangxinshi tablet(YXST)in the treating chronic heart failure(CHF)remain uncertain.AIM To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.METHODS Rand...BACKGROUND The specific benefits of Yangxinshi tablet(YXST)in the treating chronic heart failure(CHF)remain uncertain.AIM To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.METHODS Randomized controlled trials(RCTs)investigating YXST for CHF treatment were retrieved from eight public databases up to November 2023.Meta-analyses of the included clinical studies were conducted using Review Manager 5.3.RESULTS Twenty RCTs and 1845 patients were included.The meta-analysis results showed that the YXST combination group,compared to the conventional drug group,significantly increased the clinical efficacy rate by 23%[relative risk(RR)=1.23,95%CI:1.17-1.29],(P<0.00001),left ventricular ejection fraction by 6.69%[mean difference(MD)=6.69,95%CI:4.42-8.95,P<0.00001]and 6-min walk test by 49.82 m(MD=49.82,95%C:38.84-60.80,P<0.00001),and reduced N-terminal pro-Btype natriuretic peptide by 1.03 ng/L[standardized MD(SMD)=-1.03,95%CI:-1.32 to-0.74,P<0.00001],brain natriuretic peptide by 80.95 ng/L(MD=-80.95,95%CI:-143.31 to-18.59,P=0.01),left ventricular end-diastolic diameter by 3.92 mm(MD=-3.92,95%CI:-5.06 to-2.78,P<0.00001),and left ventricular endsystolic diameter by 4.34 mm(MD=-4.34,95%CI:-6.22 to-2.47,P<0.00001).Regarding safety,neither group reported any serious adverse events during treatment(RR=0.54,95%CI:0.15-1.90,P=0.33).In addition,Egger's test results indicated no significant publication bias(P=0.557).CONCLUSION YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile,suggesting its potential as a therapeutic strategy for CHF.展开更多
Improving exercise tolerance is indisputably beneficial for long-term survival in patients treated with percutaneous coronary intervention(PCI).Although previous studies suggested that Yangxinshi tablets effectively i...Improving exercise tolerance is indisputably beneficial for long-term survival in patients treated with percutaneous coronary intervention(PCI).Although previous studies suggested that Yangxinshi tablets effectively improve exercise tolerance in patients with coronary heart disease,the evidence is limited due to the lack of high-quality randomized trials.The Effects of Yangxinshi Tablets on Exercise Tolerance Compared with Trimetazidine in Patients after PCI(HEARTRIP)trial is a multicenter,double-blind,double-dummy,active drug-controlled,randomized trial designed to test if the effects of Yangxinshi tablets on exercise tolerance are non-inferior to those of trimetazidine in patients undergoing PCI.A total of 668 patients who have undergone PCI for the first time and completed a cardiopulmonary exercise test(CPET)will be enrolled and randomly assigned,in a 1:1 ratio,to receive Yangxinshi tablets(3 tablets,3 times/d)plus trimetazidine-placebo or trimetazidine(20 mg,3 times/d)plus Yangxinshi-placebo for 24 weeks.The primary endpoint is metabolic equivalent of tasks(METs)measured by CPET at 24 weeks after randomization.The secondary endpoints include comprehensive CPET indicators,incidence of major adverse cardiac and cerebrovascular events,and depression(Patient Health Questionnaire-9),anxiety(Generalized Anxiety Disorder-7),and quality of life(Seattle Angina Questionnaire)scores.This study will appraise current clinical evidence on the beneficial effect of Yangxinshi tablets on improving exercise tolerance after PCI and may substantiate their use as an effective pharmacological option for cardiac rehabilitation patients.The HEARTRIP study protocol received approval from the ethics committee of the General Hospital of Northern Theater Command(Shenyang,China).The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines.The results will be published following the guidelines of the CONSORT statement in a peer-reviewed scientific journal(Trial registration number:NCT03809273).展开更多
Objective:The objective of this study was to observe the effect of Yangxinshi tablets on the phenotype and function of peripheral blood monocytes in patients with unstable angina of coronary heart disease(CHD)and to e...Objective:The objective of this study was to observe the effect of Yangxinshi tablets on the phenotype and function of peripheral blood monocytes in patients with unstable angina of coronary heart disease(CHD)and to explore the possible mechanism of Yangxinshi tablets in the treatment of CHD.Methods:A total of 100 patients with unstable angina of CHD were randomly divided into two groups:Group A–treatment group and Group B–control group.The phenotypic and functional changes in blood monocytes and the changes in serum inflammatory factors before and after treatment were compared in the two groups.Results:The expression of CD14^+CD163^+interleukin(IL)-10^+was significantly higher in the control group than in the patients with unstable angina of CHD,whereas the expression of CD14^+CD163-IL-12^+was lower.The concentration of IL-10 was higher in the control group than in the patients with unstable angina,whereas the concentration of tumor necrosis factor-α(TNF-α)and IL-12 was significantly lower.In Group A,the expression of CD14^+CD163^+,CD14^+CD206^+,and CD14^+CD163^+CD206^+in peripheral blood monocytes increased after treatment than before treatment,whereas the expression of CD14^+CD163-CD206-decreased.The expression of CD14^+CD163-IL-12^+decreased after treatment than before,whereas CD14^+CD163^+IL-10^+expression increased.The serum concentration of IL-10 in Group A was higher after treatment than before,whereas that of IL-12 and TNF-αwas lower.In Group B,the phenotype and function of the peripheral blood monocytes remained unchanged.Conclusion:Yangxinshi tablet therapy can change the phenotype of the peripheral blood monocytes in patients with unstable angina of CHD.Yangxinshi tablet therapy changes the inflammatory state in patients with an increase in the expression of anti-inflammatory factors and a decrease in the expression of inflammatory factors.展开更多
目的:基于网状Meta分析方法,评价医保目录中6种益气活血类中成药治疗冠心病心绞痛的疗效。方法:选取养心氏片、参松养心胶囊、芪参益气滴丸、脑心通胶囊、麝香保心丸和血栓心脉宁(片或胶囊)6种中成药,利用计算机检索中国知网、维普数据...目的:基于网状Meta分析方法,评价医保目录中6种益气活血类中成药治疗冠心病心绞痛的疗效。方法:选取养心氏片、参松养心胶囊、芪参益气滴丸、脑心通胶囊、麝香保心丸和血栓心脉宁(片或胶囊)6种中成药,利用计算机检索中国知网、维普数据库、万方数据库和中国生物医学文献服务系统,以及PubMed和Web of Science,搜索上述6种中成药分别联合常规西药治疗对比单独采用常规西药治疗用于冠心病心绞痛的随机对照试验,检索时限为数据库建立至2022年6月12日。下载全文、提取文献数据并进行质量评价后,采用Stata 15.1及R 4.0.3软件进行统计分析。结果:共纳入87项研究。网状Meta分析结果显示,在心绞痛疗效方面,累积概率排序为养心氏片+常规西药>参松养心胶囊+常规西药>芪参益气滴丸+常规西药>脑心通胶囊+常规西药>血栓心脉宁(片或胶囊)+常规西药>麝香保心丸+常规西药>常规西药;在心电图疗效方面,累积概率排序为养心氏片+常规西药>芪参益气滴丸+常规西药>脑心通胶囊+常规西药>血栓心脉宁(片或胶囊)+常规西药=参松养心胶囊+常规西药>麝香保心丸+常规西药>常规西药。综合2个结局指标,养心氏片+常规西药的疗效最好,其次为芪参益气滴丸+常规西药。结论:以常规西药治疗为基础,分别联合使用6种益气活血类中成药治疗冠心病心绞痛均能显著提高疗效,其中养心氏片联合常规西药治疗效果最佳。但因纳入文献数量及质量方面的局限性,该结论还需开展更多高质量研究来验证。展开更多
目的评价养心氏片治疗冠心病稳定型心绞痛的临床疗效及安全性。方法采用随机双盲、平行对照的方法,选择诊断明确的冠心病稳定型心绞痛病人60例,随机分为试验组和对照组,每组30例。试验组给予基础用药+养心氏片治疗;对照组给予基础用药+...目的评价养心氏片治疗冠心病稳定型心绞痛的临床疗效及安全性。方法采用随机双盲、平行对照的方法,选择诊断明确的冠心病稳定型心绞痛病人60例,随机分为试验组和对照组,每组30例。试验组给予基础用药+养心氏片治疗;对照组给予基础用药+养心氏片模拟安慰剂治疗。观察两组用药前及用药后4周、8周心电图平板运动试验(ETT)、动态心电图及西雅图量表积分改善情况。安全性指标包括体格检查、不良事件及不良反应监测、血尿常规、肝肾功能检查。结果试验组与对照组总有效率分别为76.7%和43.3%,两组比较差异有统计学意义(P<0.01)。ETT的总持续时间(TED)试验组与对照组均能得以改善(P<0.01),但试验组治疗4周后即有明显改善(P<0.05),试验组ETT总持续时间增加到(43.483±28.537)s。在接受4周治疗后,试验组ETT中发生ST段出现下移大于0.1 m V的病例数明显减少(P<0.01),而对照组第8周开始出现明显减少(P<0.05);两组比较在治疗后第4周差异有统计学意义(P<0.01)。试验组动态心电图较用药前有改善。试验组在西雅图积分方面也有改善。结论联合应用养心氏片能较好地改善冠心病稳定型心绞痛病人心肌缺血的发生,增加运动耐量,改善生活质量,且无明显的不良反应发生。展开更多
目的:对养心氏片治疗经皮冠状动脉介入治疗术(PCI)后胸痛的有效性及安全性进行Meta分析,为其临床应用提供参考。方法:检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、China Biology Medicine d...目的:对养心氏片治疗经皮冠状动脉介入治疗术(PCI)后胸痛的有效性及安全性进行Meta分析,为其临床应用提供参考。方法:检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、China Biology Medicine disc、PubMed、Embase、Web of science及Cochrane图书馆数据库,检索年限为建库至2021年8月。根据检索策略及纳入排除标准筛选养心氏片治疗经皮冠状动脉介入治疗术后胸痛的随机对照临床试验,结合“Cochrane偏倚风险评估”工具、改良Jadad量表对纳入的文献进行质量评价,Rev Man 5.3软件进行Meta分析。结果:纳入文献8篇,697例患者,养心氏片组349例,对照组348例。文献质量评价5篇4分,3篇3分。Meta分析显示,养心氏片组治疗PCI术后胸痛有效[6项研究,n=505;RR(95%CI)=1.29(1.16~1.42),P<0.001];具有改善PCI术后中医证候的趋势,但差异无统计学意义[2项研究,n=149;RR(95%CI)=1.56(0.85~2.85),P=0.15];改善PCI术后7 d心电图ST段压低幅度[2项研究,n=163;MD(95%CI)=0.07(0.05~0.09),P<0.001];降低PCI术后主要不良心血管事件发生率[2项研究,n=163,RR(95%CI)=0.41(0.25~0.70),P<0.001];增加PCI术后6 min步行距离[2项研究,n=150;MD(95%CI)=80.30,(23.12~137.47),P<0.01];不增加不良反应发生率[2项研究,n=198,RR(95%CI)=1.35(0.77~2.37),P=0.29]。结论:在规范化西药治疗基础上联合应用养心氏片,对经皮冠状动脉介入治疗术后胸痛具有改善作用,且具有较好的安全性,期待未来更多高质量的研究开展,为养心氏片的临床应用提供更多证据。展开更多
基金Supported by Hunan Provincial Chinese Medicine Research Program Commissioned Key Projects,No.D2023005。
文摘BACKGROUND The specific benefits of Yangxinshi tablet(YXST)in the treating chronic heart failure(CHF)remain uncertain.AIM To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.METHODS Randomized controlled trials(RCTs)investigating YXST for CHF treatment were retrieved from eight public databases up to November 2023.Meta-analyses of the included clinical studies were conducted using Review Manager 5.3.RESULTS Twenty RCTs and 1845 patients were included.The meta-analysis results showed that the YXST combination group,compared to the conventional drug group,significantly increased the clinical efficacy rate by 23%[relative risk(RR)=1.23,95%CI:1.17-1.29],(P<0.00001),left ventricular ejection fraction by 6.69%[mean difference(MD)=6.69,95%CI:4.42-8.95,P<0.00001]and 6-min walk test by 49.82 m(MD=49.82,95%C:38.84-60.80,P<0.00001),and reduced N-terminal pro-Btype natriuretic peptide by 1.03 ng/L[standardized MD(SMD)=-1.03,95%CI:-1.32 to-0.74,P<0.00001],brain natriuretic peptide by 80.95 ng/L(MD=-80.95,95%CI:-143.31 to-18.59,P=0.01),left ventricular end-diastolic diameter by 3.92 mm(MD=-3.92,95%CI:-5.06 to-2.78,P<0.00001),and left ventricular endsystolic diameter by 4.34 mm(MD=-4.34,95%CI:-6.22 to-2.47,P<0.00001).Regarding safety,neither group reported any serious adverse events during treatment(RR=0.54,95%CI:0.15-1.90,P=0.33).In addition,Egger's test results indicated no significant publication bias(P=0.557).CONCLUSION YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile,suggesting its potential as a therapeutic strategy for CHF.
基金supported by a nonprofit grant for external investigator-initiated research from SPH Qingdao Growful Pharmaceutical Co.,Ltd.(Qingdao,China).
文摘Improving exercise tolerance is indisputably beneficial for long-term survival in patients treated with percutaneous coronary intervention(PCI).Although previous studies suggested that Yangxinshi tablets effectively improve exercise tolerance in patients with coronary heart disease,the evidence is limited due to the lack of high-quality randomized trials.The Effects of Yangxinshi Tablets on Exercise Tolerance Compared with Trimetazidine in Patients after PCI(HEARTRIP)trial is a multicenter,double-blind,double-dummy,active drug-controlled,randomized trial designed to test if the effects of Yangxinshi tablets on exercise tolerance are non-inferior to those of trimetazidine in patients undergoing PCI.A total of 668 patients who have undergone PCI for the first time and completed a cardiopulmonary exercise test(CPET)will be enrolled and randomly assigned,in a 1:1 ratio,to receive Yangxinshi tablets(3 tablets,3 times/d)plus trimetazidine-placebo or trimetazidine(20 mg,3 times/d)plus Yangxinshi-placebo for 24 weeks.The primary endpoint is metabolic equivalent of tasks(METs)measured by CPET at 24 weeks after randomization.The secondary endpoints include comprehensive CPET indicators,incidence of major adverse cardiac and cerebrovascular events,and depression(Patient Health Questionnaire-9),anxiety(Generalized Anxiety Disorder-7),and quality of life(Seattle Angina Questionnaire)scores.This study will appraise current clinical evidence on the beneficial effect of Yangxinshi tablets on improving exercise tolerance after PCI and may substantiate their use as an effective pharmacological option for cardiac rehabilitation patients.The HEARTRIP study protocol received approval from the ethics committee of the General Hospital of Northern Theater Command(Shenyang,China).The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines.The results will be published following the guidelines of the CONSORT statement in a peer-reviewed scientific journal(Trial registration number:NCT03809273).
文摘Objective:The objective of this study was to observe the effect of Yangxinshi tablets on the phenotype and function of peripheral blood monocytes in patients with unstable angina of coronary heart disease(CHD)and to explore the possible mechanism of Yangxinshi tablets in the treatment of CHD.Methods:A total of 100 patients with unstable angina of CHD were randomly divided into two groups:Group A–treatment group and Group B–control group.The phenotypic and functional changes in blood monocytes and the changes in serum inflammatory factors before and after treatment were compared in the two groups.Results:The expression of CD14^+CD163^+interleukin(IL)-10^+was significantly higher in the control group than in the patients with unstable angina of CHD,whereas the expression of CD14^+CD163-IL-12^+was lower.The concentration of IL-10 was higher in the control group than in the patients with unstable angina,whereas the concentration of tumor necrosis factor-α(TNF-α)and IL-12 was significantly lower.In Group A,the expression of CD14^+CD163^+,CD14^+CD206^+,and CD14^+CD163^+CD206^+in peripheral blood monocytes increased after treatment than before treatment,whereas the expression of CD14^+CD163-CD206-decreased.The expression of CD14^+CD163-IL-12^+decreased after treatment than before,whereas CD14^+CD163^+IL-10^+expression increased.The serum concentration of IL-10 in Group A was higher after treatment than before,whereas that of IL-12 and TNF-αwas lower.In Group B,the phenotype and function of the peripheral blood monocytes remained unchanged.Conclusion:Yangxinshi tablet therapy can change the phenotype of the peripheral blood monocytes in patients with unstable angina of CHD.Yangxinshi tablet therapy changes the inflammatory state in patients with an increase in the expression of anti-inflammatory factors and a decrease in the expression of inflammatory factors.
文摘目的:基于网状Meta分析方法,评价医保目录中6种益气活血类中成药治疗冠心病心绞痛的疗效。方法:选取养心氏片、参松养心胶囊、芪参益气滴丸、脑心通胶囊、麝香保心丸和血栓心脉宁(片或胶囊)6种中成药,利用计算机检索中国知网、维普数据库、万方数据库和中国生物医学文献服务系统,以及PubMed和Web of Science,搜索上述6种中成药分别联合常规西药治疗对比单独采用常规西药治疗用于冠心病心绞痛的随机对照试验,检索时限为数据库建立至2022年6月12日。下载全文、提取文献数据并进行质量评价后,采用Stata 15.1及R 4.0.3软件进行统计分析。结果:共纳入87项研究。网状Meta分析结果显示,在心绞痛疗效方面,累积概率排序为养心氏片+常规西药>参松养心胶囊+常规西药>芪参益气滴丸+常规西药>脑心通胶囊+常规西药>血栓心脉宁(片或胶囊)+常规西药>麝香保心丸+常规西药>常规西药;在心电图疗效方面,累积概率排序为养心氏片+常规西药>芪参益气滴丸+常规西药>脑心通胶囊+常规西药>血栓心脉宁(片或胶囊)+常规西药=参松养心胶囊+常规西药>麝香保心丸+常规西药>常规西药。综合2个结局指标,养心氏片+常规西药的疗效最好,其次为芪参益气滴丸+常规西药。结论:以常规西药治疗为基础,分别联合使用6种益气活血类中成药治疗冠心病心绞痛均能显著提高疗效,其中养心氏片联合常规西药治疗效果最佳。但因纳入文献数量及质量方面的局限性,该结论还需开展更多高质量研究来验证。
文摘目的评价养心氏片治疗冠心病稳定型心绞痛的临床疗效及安全性。方法采用随机双盲、平行对照的方法,选择诊断明确的冠心病稳定型心绞痛病人60例,随机分为试验组和对照组,每组30例。试验组给予基础用药+养心氏片治疗;对照组给予基础用药+养心氏片模拟安慰剂治疗。观察两组用药前及用药后4周、8周心电图平板运动试验(ETT)、动态心电图及西雅图量表积分改善情况。安全性指标包括体格检查、不良事件及不良反应监测、血尿常规、肝肾功能检查。结果试验组与对照组总有效率分别为76.7%和43.3%,两组比较差异有统计学意义(P<0.01)。ETT的总持续时间(TED)试验组与对照组均能得以改善(P<0.01),但试验组治疗4周后即有明显改善(P<0.05),试验组ETT总持续时间增加到(43.483±28.537)s。在接受4周治疗后,试验组ETT中发生ST段出现下移大于0.1 m V的病例数明显减少(P<0.01),而对照组第8周开始出现明显减少(P<0.05);两组比较在治疗后第4周差异有统计学意义(P<0.01)。试验组动态心电图较用药前有改善。试验组在西雅图积分方面也有改善。结论联合应用养心氏片能较好地改善冠心病稳定型心绞痛病人心肌缺血的发生,增加运动耐量,改善生活质量,且无明显的不良反应发生。
文摘目的:对养心氏片治疗经皮冠状动脉介入治疗术(PCI)后胸痛的有效性及安全性进行Meta分析,为其临床应用提供参考。方法:检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、China Biology Medicine disc、PubMed、Embase、Web of science及Cochrane图书馆数据库,检索年限为建库至2021年8月。根据检索策略及纳入排除标准筛选养心氏片治疗经皮冠状动脉介入治疗术后胸痛的随机对照临床试验,结合“Cochrane偏倚风险评估”工具、改良Jadad量表对纳入的文献进行质量评价,Rev Man 5.3软件进行Meta分析。结果:纳入文献8篇,697例患者,养心氏片组349例,对照组348例。文献质量评价5篇4分,3篇3分。Meta分析显示,养心氏片组治疗PCI术后胸痛有效[6项研究,n=505;RR(95%CI)=1.29(1.16~1.42),P<0.001];具有改善PCI术后中医证候的趋势,但差异无统计学意义[2项研究,n=149;RR(95%CI)=1.56(0.85~2.85),P=0.15];改善PCI术后7 d心电图ST段压低幅度[2项研究,n=163;MD(95%CI)=0.07(0.05~0.09),P<0.001];降低PCI术后主要不良心血管事件发生率[2项研究,n=163,RR(95%CI)=0.41(0.25~0.70),P<0.001];增加PCI术后6 min步行距离[2项研究,n=150;MD(95%CI)=80.30,(23.12~137.47),P<0.01];不增加不良反应发生率[2项研究,n=198,RR(95%CI)=1.35(0.77~2.37),P=0.29]。结论:在规范化西药治疗基础上联合应用养心氏片,对经皮冠状动脉介入治疗术后胸痛具有改善作用,且具有较好的安全性,期待未来更多高质量的研究开展,为养心氏片的临床应用提供更多证据。
