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 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.

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)

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。

复方丹参滴丸对冠心病合并糖尿病患者介入治疗后造影剂肾病的预防作用

[目的]探讨复方丹参滴丸对冠心病合并糖尿病患者介入治疗后造影剂肾病(CIN)的预防作用。[方法]纳入天津市胸科医院心内三科2022年1月—2023年1月收治的冠心病合并糖尿病且行冠状动脉介入治疗的患者180例,采用简单随机分组方法,将入选患者随机分为观察组(90例)与对照组(90例)。对照组患者使用常规水化疗法预防CIN,观察组患者在对照组基础上应用复方丹参滴丸,比较两组患者的CIN发病率差异,比较两组患者治疗前及治疗后72 h肾功能:血肌酐(Scr)、尿素氮(BUN)、计算估算肾小球滤过率(eGFR)、血β2微球蛋白、尿中蛋白与肌酐比值(ACR)以及尿中性粒细胞明胶酶相关性脂蛋白(NGAL),炎性指标包括超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6),氧化应激指标包括超氧化物歧化酶(SOD)水平、丙二醛(MDA)水平的变化。对2组入选患者随访6个月,记录2组患者主要心脏不良事件(MACE)发生情况。[结果]1)复方丹参滴丸组CIN发病率低于对照组(4.4%vs 16.7%),差异有统计学意义(P<0.05)。2)治疗前,两组患者一般情况无差异(P>0.05)。与治疗前相比,两组患者治疗后72 h血肌酐、尿素、血β2微球蛋白、hs-CRP、IL-6、丙二醛水平、尿ACR、尿NGAL水平升高,而eGFR水平、SOD水平降低(P<0.05)。治疗后72 h,观察组肌酐、尿素、血β2微球蛋白、hs-CRP、IL-6、丙二醛水平、尿ACR、尿NGAL水平低于对照组,eGFR水平、SOD水平明显高于对照组(P<0.05)。3)随访6个月,观察组心脏MACE发生率低于对照组(10.0%vs 31.3%),差异有统计学意义(P<0.05)。4)多因素logistic回归分析显示,复方丹参滴丸对预防冠心病合并糖尿病的患者介入术后CIN有保护作用[OR=0.136,95%CI(0.035,0.527),P=0.004]。[结论]复方丹参滴丸对预防冠心病合并有糖尿病患者冠状动脉介入治疗后CIN的发生可能起到一定作用。

复方丹参滴丸抑制活性氧介导的内皮细胞损伤机制

目的探讨复方丹参滴丸抑制活性氧介导的内皮细胞损伤的机制。方法使用过氢化氢(H_(2)O_(2))构建内皮细胞损伤模型,将细胞分为正常组、模型组、复方丹参滴丸(50、100、150μg/mL)组,CCK-8检测细胞增殖情况,LDH试剂盒及ATP试剂盒检测细胞毒性及ATP产生,比色法检测内皮细胞MDA含量及SOD活力;ROS荧光探针检测细胞中ROS含量;Western blot及实时荧光定量PCR检测各组细胞中Bcl-2、Bax及Cleaved caspase-3的蛋白及mRNA表达情况。在上述模型的基础上使用ROS清除剂(NAC)构建ROS清除模型,将细胞分为正常组,H_(2)O_(2)组,H_(2)O_(2)+复方丹参100μg/mL组、H_(2)O_(2)+复方丹参100μg/mL+NAC组,免疫荧光探针、CCK-8、LDH及ATP试剂盒、比色法检测细胞ROS、增殖、毒性、ATP、MDA、SOD的含量及活力;Western blot及实时荧光定量PCR检测凋亡蛋白及mRNA表达情况。结果H_(2)O_(2)刺激后,细胞增殖被抑制,细胞毒性增强,ROS及MDA表达上调,ATP及SOD表达下调,Bcl-2表达下调,Bax及Cleaved caspase-3表达下调,复方丹参滴丸干预后可逆转内皮细胞损伤,以100μg/mL剂量组最显著。ROS清除剂抑制ROS的产生,并减弱100μg/mL复方丹参滴丸逆转内皮细胞损伤作用。结论复方丹参滴丸可逆转氧化应激产生的内皮细胞损伤,此作用可能是通过抑制ROS/Bcl-2/Bax信号通路实现的。

他汀联合DSP治疗CHD-HLP效果的Meta分析

运用Meta分析,探讨他汀联合复方丹参滴丸(DSP)治疗冠心病合并高脂血(CHD-HLP)患者的疗效。结果表明:联合治疗CHD-HLP,(1)血脂水平,TG效应值SMD为-1.71,TC为-1.30,LDL-C为-0.81、HDL-C为0.99;(2)心功能,CI的SMD为0.62、CO为0.84,以上指标均有统计学意义。结论表明:联合治疗比常规他汀治疗更具降脂、提高心功能等优势。

复方丹参滴丸联合单硝酸异山梨酯治疗冠心病心绞痛meta分析

目的分析复方丹参滴丸联合单硝酸异山梨酯治疗冠心病心绞痛有效性及安全性。方法计算机检索中国知网、维普、万方、PubMed、Web of Science数据库,检索时限为自建库起至2023年2月28日,搜集相关临床随机对照试验(RCT),根据纳排标准选择RCT,使用Review Manager 5.3软件进行meta分析。结果纳入14项RCT,meta分析结果显示,观察组的总有效率[OR=5.01,95%CI(3.39,7.42),P<0.00001]、心绞痛发作次数[MD=-1.75,95%CI(-2.43,-1.07),P<0.00001]、心绞痛发作持续时间[MD=-1.87,95%CI(-2.47,-1.26)、P<0.00001]、总胆固醇[MD=-0.96,95%CI(-1.19,-0.73),P<0.00001]、三酰甘油[MD=-0.52,95%CI(-0.65,-0.40),P<0.00001]、不良反应[OR=0.64,95%CI(0.43,0.97),P=0.03]均优于对照组。结论复方丹参滴丸联合单硝酸异山梨酯+常规西药治疗冠心病心绞痛临床疗效显著,安全性高,但需更多设计严谨的多样本、多中心、双盲RCT提供证据支持。

复方丹参滴丸联合美托洛尔治疗慢性心力衰竭合并阵发性房颤患者的效果

目的:观察复方丹参滴丸联合美托洛尔治疗慢性心力衰竭(CHF)合并阵发性房颤(PAF)患者的效果。方法:回顾性分析2021年1月至2023年3月该院收治的150例CHF合并PAF患者的临床资料,按照治疗方法不同将其分为研究组与对照组各75例。对照组口服琥珀酸美托洛尔缓释片治疗,研究组在对照组基础上口服复方丹参滴丸治疗。比较两组临床疗效,治疗前后临床症状(心率、房颤发作次数和房颤发作持续时间)、心肌损伤标志物[肌酸激酶同工酶(CK-MB)、生长分化因子15(GDF-15)、N末端脑钠肽前体(NT-proBNP)]水平、血管内皮功能指标[内皮素-1(ET-1)、同型半胱氨酸(Hcy)]水平,以及不良反应发生率。结果:研究组治疗总有效率为92.00%(69/75),高于对照组的80.00%(60/75),差异有统计学意义(P<0.05);治疗后,研究组心率低于对照组,房颤发作次数少于对照组,房颤发作持续时间短于对照组,差异均有统计学意义(P<0.05);研究组CK-MB、NT-proBNP、GDF-15、ET-1、Hcy水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:复方丹参滴丸联合美托洛尔治疗CHF合并PAF患者效果显著,可减轻房颤症状,降低心率,减轻心肌损伤,保护血管内皮功能,效果优于单用美托洛尔治疗。

复方丹参滴丸联合氯吡格雷治疗冠心病稳定型心绞痛的效果分析

目的:探究复方丹参滴丸联合氯吡格雷治疗冠心病稳定型心绞痛的效果。方法:选择2021年5月—2023年4月在贵州茅台医院治疗的冠心病稳定型心绞痛患者98例,应用随机数字表法将其分为对照组(氯吡格雷)及观察组(联合复方丹参滴丸),各49例。对比两组24 h动态心电图变化情况[缺血发作次数、持续时间]、血管内皮功能[一氧化氮(NO)、内皮素-1(ET-1)、血管内皮生长因子(VEGF)、可溶性血栓调节蛋白(sTM)]、心脏自主神经功能[低频功率/高频功率(LF/HF)、RR间期标准差(SDNN)、相邻NN间期差值的均方根(RMSSD)]、氧化应激反应[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]。结果:治疗前,两组24 h心电图变化比较,差异均无统计学意义(P>0.05);治疗后,两组缺血发作次数均较治疗前减少,缺血持续时间较治疗前均缩短,观察组均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组NO、VEGF、ET-1、sTM比较,差异均无统计学意义(P>0.05);治疗后,两组NO、VEGF均较治疗前升高、ET-1、sTM均降低,观察组NO、VEGF均高于对照组、ET-1、sTM均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组LF/HF、SDNN、RMSSD比较,差异均无统计学意义(P>0.05);治疗后,两组LF/HF、SDNN、RMSSD均较治疗前升高,且观察组均高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组SOD、GSH-Px、MDA比较,差异均无统计学意义(P>0.05);治疗后,两组MDA均较治疗前降低,SOD、GSH-Px均升高,观察组MDA低于对照组,SOD、GSH-Px均高于对照组,差异均有统计学意义(P<0.05)。结论:复方丹参滴丸联合氯吡格雷治疗冠心病稳定型心绞痛,可改善心肌缺血情况,降低氧化应激反应,改善血管内皮、心脏自主神经功能。

复方丹参滴丸对慢性心衰患者血管活性物质及炎性因子水平的影响

目的:探讨慢性心力衰竭(Chronic heart failure,CHF)患者采用复方丹参滴丸治疗的效果。方法:将医院2020年1月~2022年6月收治的CHF患者80例按照随机数表法分为2组,各40例。对照组采用常规治疗,观察组加用复方丹参滴丸治疗,均治疗8周,比较两组治疗效果、血管活性物质及炎症因子水平。结果:观察组治疗总有效率95.00%(38/40),比对照组77.50%(31/40)高(P<0.05);治疗后,两组血管紧张素Ⅱ(Angiotensin II,AngⅡ)、内皮素1(Endothelin 1,ET-1)及脑利钠肽(Brain natriuretic peptide,BNP)水平均比治疗前低,且观察组比对照组低(P<0.05);治疗后,两组超敏C反应蛋白(Hypersensitivity C reactive protein,hs CRP)水平、白细胞介素(Interleukin 6,IL-6)水平均比治疗前低,且观察组比对照组低(P<0.05)。结论:CHF患者采用复方丹参滴丸治疗效果满意,可抑制血管活性物质生存,调节炎性因子水平。

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.

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.

麝香保心丸、复方丹参滴丸与脑心通胶囊治疗冠心病稳定型心绞痛的药物经济学评价

目的:评价麝香保心丸、复方丹参滴丸与脑心通胶囊治疗冠心病稳定型心绞痛的经济性。方法:从卫生体系角度出发,构建决策树模型,采用成本-效用分析,对麝香保心丸、复方丹参滴丸与脑心通胶囊治疗冠心病稳定型心绞痛进行药物经济学评价。结果:与麝香保心丸组比较,脑心通胶囊组方案的增量成本-效用比为3501593.41,>3倍人均GDP,麝香保心丸组方案更具有经济性;与复方丹参滴丸组比较,麝香保心丸组方案的成本更低,效果更好;因此,麝香保心丸组方案最具有经济性。敏感性分析显示结果具有稳健性。结论:与复方丹参滴丸、脑心通胶囊比较,麝香保心丸治疗冠心病稳定型心绞痛更具有药物经济学优势。

复方丹参滴丸联合阿托伐他汀治疗冠心病合并心绞痛疗效及对患者氧化应激指标的影响

目的:研究复方丹参滴丸联合阿托伐他汀用于冠心病合并心绞痛患者的治疗疗效及对患者氧化应激指标的影响。方法:选择114例冠心病合并心绞痛患者作为研究对象,按单双号法随机分配到联合组(n=57)和单一组(n=57),均给予常规治疗,其中单一组加以阿托伐他汀治疗,联合组加用复方丹参滴丸,比较两组患者治疗前及治疗2个月后临床疗效、心绞痛改善情况、心功能指标、血液流变学指标、血清氧化应激指标,并比较治疗期间两组患者不良心血管事件总发生率。结果:治疗2个月后,联合组总有效率为92.98%,显著高于单一组的82.46%(P<0.05);两组患者心绞痛发作频率、发作时间较治疗前显著降低(P<0.05),联合组显著低于单一组(P<0.05);治疗2个月后,两组患者左心室射血分数(LVEF)、6分钟步行距离(6MWD)均较治疗前显著提高(P<0.05),左心室收缩末内径(LVESD)、左心室舒张末期内径(LVEDD)均较治疗前显著降低(P<0.05),联合组治疗后比较差异有统计学意义(P<0.05);治疗2个月后,两组患者全血高切黏度、全血低切黏度、血浆黏度较治疗前显著降低(P<0.05),两组患者血清总超氧化物歧化酶(T-SOD)、谷胱甘肽过氧化物酶(GSH-Px)活力较治疗前显著提高(P<0.05),联合组显著高于单一组(P<0.05);丙二醛(MDA)、乳酸(LD)含量较治疗前显著降低(P<0.05),联合组显著低于单一组(P<0.05);治疗期间,联合组和单一组不良心血管事件总发生率分别为3.51%和1.76%,比较差异无统计学意义(P>0.05)。结论:复方丹参滴丸联合阿托伐他汀治疗冠心病合并心绞痛效果良好,能明显降低心绞痛的发生情况、改善患者心功能和血液流变学,同时缓解氧化应激状态,药物方案安全性良好,值得临床应用。