Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective ef...Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.展开更多
Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idi...Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.展开更多
Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiag...Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiagnose.Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here.Absence of common causes of stroke including hypoperfusion,blood system diseases,carotid and aortic dissection,and eosinophil elevation,the symptoms of the 2 patients met the diagnostic criteria of VBD.Both patients displayed symptoms that were in line with the Traditional Chinese Medicine(TCM)syndrome pattern of"Qi deficiency and blood stasis".Accordingly,they were comprehensively treated with Supplementing Qi and activating blood circulation method.The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up.A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD.TCM treatment based on syndrome identification might be a promising candidate for VBD management.展开更多
Objective: To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome (ACS) after successful percuta...Objective: To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome (ACS) after successful percutaneous coronary intervention (PCI). Methods: One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine (WM) treatment group (WMG) and a combined treatment group (CMG) treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The follow- up was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association (NYHA) functional class, Chinese medicine (CM) symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events (MACE) were observed, serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and hyper-sensitivity C-reactive protein (Hs-CRP) were measured, an echocardiogram was conducted to examine left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), inter-ventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), and ventricular wall motion index (VWMI). Results: Compared with the baseline, LVEF significantly increased (P〈0.01), and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased (P〈0.01) in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI (P〉0.05). VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG (P〈0.05 or P〈0.01) at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that P value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG (6% vs 22%, P〈0.05). Conclusion: Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.展开更多
Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.M...Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...展开更多
This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic my...This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before, and to explore the underlying mechanism. The acute myocardial infarction (AMI) model was established by ligating the left anterior descending (LAD) coronary artery, then the model rats were randomly divided into the model group, the Metoprolol group, the replenishing qi nourishing yin (RN) group, the activating blood circulation (AB) group, and the replenishing qi, nourishing yin and activating blood circulation (RA) group. In addition, the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations, and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Realtime fluorescence quantitative PCR (QPCR), and the activities of related enzymes were detected by colorimetric assay. The main results were as follows: the histological changes were observed by HE staining, and cardiocyte swelling, inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group, while the pathomorphological changes in all medication groups did not show obvious changes. Two genes related to energy metabolism, COX5a and ATP5e, were selected as the target genes which were downregulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly (P<0.05). The results indicated that the abnormal expression of genes involved in energy metabolism pathways could be one of the molecular mechanisms of AMI. The compatibility of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation affects the expression of energyrelative gene COX5a, ATP5e, which is probably the mechanism of myocardial preservation, and is more effective than single herb of replenishing qi and nourishing yin or activating blood circulation.展开更多
Objective: To explore the therapeutic effect and the possible working mechanism in using Chinese herbal medicine (CHM) for supplementing Kidney and Qi, and activating blood circulation in treating intrauterine growth ...Objective: To explore the therapeutic effect and the possible working mechanism in using Chinese herbal medicine (CHM) for supplementing Kidney and Qi, and activating blood circulation in treating intrauterine growth retardation of fetus (IUGR). Methods: Fifty-five cases of IUGR were divided into two groups, 30 cases in the CHM group treated with CHM and the 25 in the control group treated with amino acids. The effect of CHM treatment was observed and compared with that of the control group, normal pregnancy group and non-treated IUGR group. Results: Body weight of the newborns in the CHM was markedly higher than that in the control group. Not only the maternal fundal height (FH) and the abdominal circumference (AC), but also the fetal growth parameters, including biparietal diameter, head circumference (HC), and femur length (FL) in the CHM group increased much faster than those in the control group. After CHM treatment, the maternal serum levels of estriol (E3) and human placental lactogen (hPL) approached to those in the normal pregnancy group, but the control group,in comparison with the normal pregnancy group, was significantly different. The umbilical venous plasma concentration of essential amino acids in both treated groups improved, but the improvement in the CHM group was more significant than that in the control group. No apparent adverse effect of CHM was observed in either mother or fetus.Conclusion: CHM for supplementing Kidney and Qi and activating blood circulation was more effective in improving placental function and enhancing amino acid transportation than amino acid展开更多
Objective: To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ (IFN-γ,)/interleukin-4 (IL-4) in peripheral blood and di...Objective: To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ (IFN-γ,)/interleukin-4 (IL-4) in peripheral blood and disease activity in primary Sjogren's syndrome (pSS) patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. Methods: A total of 66 pSS patients were randomized with tossing coins method into two groups: the integrative therapy group (34 cases) and the control group (32 cases); and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G (IgG), erythrocyte sedimentation rate (ESR), IFN-γand IL-4 in peripheral blood were measured before and after treatment. Results: Compared with the normal group, the levels of IgG, ESR, IFN- γ and IL-4 were significantly increased in pSS patients (P〈0.05). Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN- and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment (P〈0.05). The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN- γ, and the ratio of IFN- γ/IL-4 in the integrative theraphy group were significantly lower than the control group (P〈0.05). For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. Conclusion: Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.展开更多
OBJECTIVE: To investigate the effects of tonifying Qi and activating blood circulation(SQABC), a method in Traditional Chinese Medicine(TCM), on end-point events in patients with myocardial infarction(MI) in this retr...OBJECTIVE: To investigate the effects of tonifying Qi and activating blood circulation(SQABC), a method in Traditional Chinese Medicine(TCM), on end-point events in patients with myocardial infarction(MI) in this retrospective cohort study.METHODS: Clinical data were obtained from the medical records of patients with acute MI(AMI),both during hospitalization and follow-up, and included general demographic information(age, gender, and contact information), TCM regimens used,and end-point events.RESULTS: A total of 1596 patients with AMI were enrolled to this study, but data of only 1210 casesare accessible till follow-up. We classified the patients based on the exposure levels of SQABC.When comparing the results between all exposure and non-exposure groups, significant differences were identified, both during hospitalization and follow-ups. During hospitalization, cardiac death(4.40% vs 21.55%, P < 0.05) and cardiac shock(3.04% vs 11.62%, P < 0.05) were significantly lower in the exposure group than the non-exposure group. Similarly, during the follow-up, cardiac death(12.04% vs 20.49%, P < 0.05), acute heart failure(7.27% vs 11.81%, P < 0.05), composite endpoint of reinfarction and stroke(9.11% vs 15.28%,P < 0.05), and rehospitalization due to angina(25.49% vs 34.38%, P < 0.05) were significantly lower in the exposure group than the non-exposure group.CONCLUSION: Our findings suggest that SQABC can significantly benefits the subjects in the management of high-risk AMI in them.展开更多
ABSTRACT Objective: To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with pr...ABSTRACT Objective: To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren's syndrome (pSS). Methods: Seventy pSS patients were randomly assigned to two groups using a randomized digital table: the integrative therapy group (36 cases) and the control group (34 cases). Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol (E2), testosterone (T), luteinizing hormone (LH), prolactin (PRL) by radioimmunoassay and immunoglobulin (IgG) by immunodiffusion, erythrocyte sedimentation rate (ESR) by Westergren, interferon-γ (IFN-γ) and interleukin-4 (IL-4) by enzyme linked immunosorbent assay were determined. Results: E2 and T levels in all patients were lower than those of normal subjects before treatment (P〈0.05) and were increased significantly after 6-month treatment (P〈0.05). ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN --γ/IL in the patients were higher than those of normal subjects before the treatments (P〈0.05), and were reduced significantly after the treatments (P〈0.05). The T and IFN -γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group (P〈0.05). However, the PRL levels before and after treatment were not significantly changed in the two groups (P〉0.05). The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment (P〈0.05). Conclusions: The ratios of E2/T and IFN - γ/ IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.展开更多
OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)form...OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)formula in patients with acute ischemic stroke(AIS)within a 72 h time window.METHODS:In this randomized,multicenter,doubleblinded,placebo-controlled trial,500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+TQABC group or control group.In addition to guidelinebased standard medical care,participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days,while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively.The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization.The secondary outcome measures will include the scores on the modified Rankin Scale,Barthel Index,Patient-Reported Outcomes,TCM symptom pattern(Zheng-hou)evaluation Scale,and the incidence of in-hospital complications.Safety assessment will include the physical examination,laboratory detection,any adverse events or serious adverse events,and the proportion of any complications during hospitalization.DISCUSSION:The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on“integrating disease and symptom pattern”for patients with AIS.展开更多
Objective: To observe the effect of acute lung injury after abdominal surgical operations treated with herbs activating blood circulation and dispersing stasis. Methods: Forty-four patients complication with acute lu...Objective: To observe the effect of acute lung injury after abdominal surgical operations treated with herbs activating blood circulation and dispersing stasis. Methods: Forty-four patients complication with acute lung injury after abdominal operation were analyze with multiple clinical and laboratory parameters and were treated early with herbs activating blood circulation and dispersing stasis. Results: After 2 days of medication,arterial oxygen saturation (SaO2 ) and partial pressure of oxygen in artery (PaO2 ) markedly improved, with significant difference as compared with those before medication (P < 0. 01 ). After continous medication for 4 days, SaO2, PaO2 and chest X-ray as well as synthetic physiologic parameters obviously improved, prostaglandin F1a,thromboxane B2 (TXB2 ), C-reactive protein (CRP), erythrocyte C3b were very significantly different from those medication (P < 0. 01 ), the synthetic physiological parameters returned generally to normal. After 5 days of herbal medication, all parameters resumed normal with satisfactory physiologic criteria. Conclusions: Early application of herbs activating blood circulation and dispersing stasis could obviously improve hypoxemia and the lung lesions, and consequently the general condition of the patient.展开更多
Objective: To investigate the efficacy and safety of the Chinese herbal therapeutic regimen of activating blood circulation (TRABC) in treatment of hypertensive intracerebral hemorrhage (HICH). Methods: This was...Objective: To investigate the efficacy and safety of the Chinese herbal therapeutic regimen of activating blood circulation (TRABC) in treatment of hypertensive intracerebral hemorrhage (HICH). Methods: This was a multi-center prospective randomized open-label blinded-endpoint (PROBE) trial with HICH admitted to 12 hospitals. Totally 240 participants were randomized to the treatment group treated with TRABC in addition to conventional Western treatment or the control group with conventional Western treatment equally for 3 months. Primary outcome was degree of disability as measured by modified Rankin Scale (mRS). Secondary outcomes were the absorption of hematoma and edema, National Institutes of Health Stroke Scale (NIHSS) scores and patient-reported outcome measures for stroke and Barthel activities of daily living index. Adverse events and mortality were also recorded. Results: After 3 months of treatment, the rate of mRS 0-1 and mRS 0-2 in the treatment group was 72.5% and 80.4%, respectively, and in the control group 48.1% and 63.9%, respectively, with a significant difference between groups (P〈0.01). Hematoma volume decreased significantly at day 7 of treatment in the treatment group than the control group (P=0.038). Average Barthel scores in the treatment group after treatment was 89.11 + 19.93, and in the control group 82.18 + 24.02 (P=0.003). NIHSS scores of the two groups after treatment decreased significantly compared with before treatment (P=0.001). Patient-reported outcomes in the treatment group were lower than the control group at day 21 and 3 months of treatment (P〈0.05). There were 4 deaths, 2 in each group, and 11 adverse events, 6 in the treatment group and 5 in the control group. Conclusion: The integrative therapy combined TRABC with conventional Western treatment for HICH could promote hematoma absorption thus minimize neurologic impairment, without increasing intracerebral hematoma expansion and re-bleeding.展开更多
The development of novel and efficient antiplatelet agents that have few adverse effects and methods that improve antiplatelet resistance has long been the focus of international research on the prevention and treatme...The development of novel and efficient antiplatelet agents that have few adverse effects and methods that improve antiplatelet resistance has long been the focus of international research on the prevention and treatment of cardiovascular and cerebrovascular diseases.Recent advances in platelet proteomics have provided a technology platform for high-quality research of platelet pathophysiology and the development of new antiplatelet drugs.The study of blood stasis syndrome(BSS)and activated blood circulation of traditional Chinese medicine(TCM)is one of the most active fields where the integration of TCM and western medicine in China has been successful.Activated blood circulation herbs(ABC herbs)of Chinese medicine are often used in the treatment of BSS.Most ABC herbs have antiplatelet and anti-atherosclerosis activity,but knowledge about their targets is lacking.Coronary heart disease(CHD),BSS,and platelet activation are closely related.By screening and identifying activated platelet proteins that are differentially expressed in BSS of CHD,platelet proteomics has helped researchers interpret the antiplatelet mechanism of action of ABC herbs and provided many potential biomarkers for BSS that could be used to evaluate the clinical curative effect of new antiplatelet drugs.In this article the progress of platelet proteomics and its advanced application for research of BSS and ABC herbs of Chinese medicine are reviewed.展开更多
文摘Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.
基金Scientific Research Special Project of Capital Health Development in 2018(No.First issues 2018-1-4192)TCM Science and Technology Development Fund of Beijing in 2020(No.JJ-2020-42)。
文摘Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.
基金the 2019 Major Difficult Diseases Clinical Collaboration Capacity Building Project of Traditional Chinese and Western Medicine-cerebral Infarction(No.YW082)。
文摘Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiagnose.Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here.Absence of common causes of stroke including hypoperfusion,blood system diseases,carotid and aortic dissection,and eosinophil elevation,the symptoms of the 2 patients met the diagnostic criteria of VBD.Both patients displayed symptoms that were in line with the Traditional Chinese Medicine(TCM)syndrome pattern of"Qi deficiency and blood stasis".Accordingly,they were comprehensively treated with Supplementing Qi and activating blood circulation method.The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up.A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD.TCM treatment based on syndrome identification might be a promising candidate for VBD management.
基金Supported by the Key Projects in the National Science and Technology Pillar Program during the Eleventh Five-year Plan Period(No.2006BA104A01)
文摘Objective: To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome (ACS) after successful percutaneous coronary intervention (PCI). Methods: One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine (WM) treatment group (WMG) and a combined treatment group (CMG) treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The follow- up was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association (NYHA) functional class, Chinese medicine (CM) symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events (MACE) were observed, serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and hyper-sensitivity C-reactive protein (Hs-CRP) were measured, an echocardiogram was conducted to examine left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), inter-ventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), and ventricular wall motion index (VWMI). Results: Compared with the baseline, LVEF significantly increased (P〈0.01), and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased (P〈0.01) in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI (P〉0.05). VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG (P〈0.05 or P〈0.01) at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that P value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG (6% vs 22%, P〈0.05). Conclusion: Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.
基金Supported by the National Key Technologies Research and Development Program of China during the 10th Five-Year Plan Period(No.2003BA712A11)
文摘Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...
基金Supported by the National Natural Science Foundation of China (Grant No. 30572430)
文摘This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before, and to explore the underlying mechanism. The acute myocardial infarction (AMI) model was established by ligating the left anterior descending (LAD) coronary artery, then the model rats were randomly divided into the model group, the Metoprolol group, the replenishing qi nourishing yin (RN) group, the activating blood circulation (AB) group, and the replenishing qi, nourishing yin and activating blood circulation (RA) group. In addition, the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations, and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Realtime fluorescence quantitative PCR (QPCR), and the activities of related enzymes were detected by colorimetric assay. The main results were as follows: the histological changes were observed by HE staining, and cardiocyte swelling, inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group, while the pathomorphological changes in all medication groups did not show obvious changes. Two genes related to energy metabolism, COX5a and ATP5e, were selected as the target genes which were downregulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly (P<0.05). The results indicated that the abnormal expression of genes involved in energy metabolism pathways could be one of the molecular mechanisms of AMI. The compatibility of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation affects the expression of energyrelative gene COX5a, ATP5e, which is probably the mechanism of myocardial preservation, and is more effective than single herb of replenishing qi and nourishing yin or activating blood circulation.
文摘Objective: To explore the therapeutic effect and the possible working mechanism in using Chinese herbal medicine (CHM) for supplementing Kidney and Qi, and activating blood circulation in treating intrauterine growth retardation of fetus (IUGR). Methods: Fifty-five cases of IUGR were divided into two groups, 30 cases in the CHM group treated with CHM and the 25 in the control group treated with amino acids. The effect of CHM treatment was observed and compared with that of the control group, normal pregnancy group and non-treated IUGR group. Results: Body weight of the newborns in the CHM was markedly higher than that in the control group. Not only the maternal fundal height (FH) and the abdominal circumference (AC), but also the fetal growth parameters, including biparietal diameter, head circumference (HC), and femur length (FL) in the CHM group increased much faster than those in the control group. After CHM treatment, the maternal serum levels of estriol (E3) and human placental lactogen (hPL) approached to those in the normal pregnancy group, but the control group,in comparison with the normal pregnancy group, was significantly different. The umbilical venous plasma concentration of essential amino acids in both treated groups improved, but the improvement in the CHM group was more significant than that in the control group. No apparent adverse effect of CHM was observed in either mother or fetus.Conclusion: CHM for supplementing Kidney and Qi and activating blood circulation was more effective in improving placental function and enhancing amino acid transportation than amino acid
文摘Objective: To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ (IFN-γ,)/interleukin-4 (IL-4) in peripheral blood and disease activity in primary Sjogren's syndrome (pSS) patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. Methods: A total of 66 pSS patients were randomized with tossing coins method into two groups: the integrative therapy group (34 cases) and the control group (32 cases); and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G (IgG), erythrocyte sedimentation rate (ESR), IFN-γand IL-4 in peripheral blood were measured before and after treatment. Results: Compared with the normal group, the levels of IgG, ESR, IFN- γ and IL-4 were significantly increased in pSS patients (P〈0.05). Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN- and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment (P〈0.05). The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN- γ, and the ratio of IFN- γ/IL-4 in the integrative theraphy group were significantly lower than the control group (P〈0.05). For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. Conclusion: Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.
基金Supported by National Natural Science Foundation-funded Project:the Method of Establishing End Point Index Based on Principal Component Analysis Combined with Frequency Statistics for Evaluating TCM Efficacy(No.81373827)
文摘OBJECTIVE: To investigate the effects of tonifying Qi and activating blood circulation(SQABC), a method in Traditional Chinese Medicine(TCM), on end-point events in patients with myocardial infarction(MI) in this retrospective cohort study.METHODS: Clinical data were obtained from the medical records of patients with acute MI(AMI),both during hospitalization and follow-up, and included general demographic information(age, gender, and contact information), TCM regimens used,and end-point events.RESULTS: A total of 1596 patients with AMI were enrolled to this study, but data of only 1210 casesare accessible till follow-up. We classified the patients based on the exposure levels of SQABC.When comparing the results between all exposure and non-exposure groups, significant differences were identified, both during hospitalization and follow-ups. During hospitalization, cardiac death(4.40% vs 21.55%, P < 0.05) and cardiac shock(3.04% vs 11.62%, P < 0.05) were significantly lower in the exposure group than the non-exposure group. Similarly, during the follow-up, cardiac death(12.04% vs 20.49%, P < 0.05), acute heart failure(7.27% vs 11.81%, P < 0.05), composite endpoint of reinfarction and stroke(9.11% vs 15.28%,P < 0.05), and rehospitalization due to angina(25.49% vs 34.38%, P < 0.05) were significantly lower in the exposure group than the non-exposure group.CONCLUSION: Our findings suggest that SQABC can significantly benefits the subjects in the management of high-risk AMI in them.
基金Supported by the National Natural Science Foundation of China(No.81473604)
文摘ABSTRACT Objective: To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren's syndrome (pSS). Methods: Seventy pSS patients were randomly assigned to two groups using a randomized digital table: the integrative therapy group (36 cases) and the control group (34 cases). Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol (E2), testosterone (T), luteinizing hormone (LH), prolactin (PRL) by radioimmunoassay and immunoglobulin (IgG) by immunodiffusion, erythrocyte sedimentation rate (ESR) by Westergren, interferon-γ (IFN-γ) and interleukin-4 (IL-4) by enzyme linked immunosorbent assay were determined. Results: E2 and T levels in all patients were lower than those of normal subjects before treatment (P〈0.05) and were increased significantly after 6-month treatment (P〈0.05). ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN --γ/IL in the patients were higher than those of normal subjects before the treatments (P〈0.05), and were reduced significantly after the treatments (P〈0.05). The T and IFN -γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group (P〈0.05). However, the PRL levels before and after treatment were not significantly changed in the two groups (P〉0.05). The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment (P〈0.05). Conclusions: The ratios of E2/T and IFN - γ/ IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.
基金Supported by the National Key Research and Development Program of China(Evidence-based Evaluation of TCM Key Syndrome Differentiation and Treatment for Acute Ischemic Stroke,No.2018YFC1705002)
文摘OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)formula in patients with acute ischemic stroke(AIS)within a 72 h time window.METHODS:In this randomized,multicenter,doubleblinded,placebo-controlled trial,500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+TQABC group or control group.In addition to guidelinebased standard medical care,participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days,while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively.The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization.The secondary outcome measures will include the scores on the modified Rankin Scale,Barthel Index,Patient-Reported Outcomes,TCM symptom pattern(Zheng-hou)evaluation Scale,and the incidence of in-hospital complications.Safety assessment will include the physical examination,laboratory detection,any adverse events or serious adverse events,and the proportion of any complications during hospitalization.DISCUSSION:The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on“integrating disease and symptom pattern”for patients with AIS.
文摘Objective: To observe the effect of acute lung injury after abdominal surgical operations treated with herbs activating blood circulation and dispersing stasis. Methods: Forty-four patients complication with acute lung injury after abdominal operation were analyze with multiple clinical and laboratory parameters and were treated early with herbs activating blood circulation and dispersing stasis. Results: After 2 days of medication,arterial oxygen saturation (SaO2 ) and partial pressure of oxygen in artery (PaO2 ) markedly improved, with significant difference as compared with those before medication (P < 0. 01 ). After continous medication for 4 days, SaO2, PaO2 and chest X-ray as well as synthetic physiologic parameters obviously improved, prostaglandin F1a,thromboxane B2 (TXB2 ), C-reactive protein (CRP), erythrocyte C3b were very significantly different from those medication (P < 0. 01 ), the synthetic physiological parameters returned generally to normal. After 5 days of herbal medication, all parameters resumed normal with satisfactory physiologic criteria. Conclusions: Early application of herbs activating blood circulation and dispersing stasis could obviously improve hypoxemia and the lung lesions, and consequently the general condition of the patient.
基金Supported by the Beijing Committee on Science and Technology,Project on Research on Two Standards of Traditional Chinese Medicine Treatment for Stroke(No.D101107049310003)
文摘Objective: To investigate the efficacy and safety of the Chinese herbal therapeutic regimen of activating blood circulation (TRABC) in treatment of hypertensive intracerebral hemorrhage (HICH). Methods: This was a multi-center prospective randomized open-label blinded-endpoint (PROBE) trial with HICH admitted to 12 hospitals. Totally 240 participants were randomized to the treatment group treated with TRABC in addition to conventional Western treatment or the control group with conventional Western treatment equally for 3 months. Primary outcome was degree of disability as measured by modified Rankin Scale (mRS). Secondary outcomes were the absorption of hematoma and edema, National Institutes of Health Stroke Scale (NIHSS) scores and patient-reported outcome measures for stroke and Barthel activities of daily living index. Adverse events and mortality were also recorded. Results: After 3 months of treatment, the rate of mRS 0-1 and mRS 0-2 in the treatment group was 72.5% and 80.4%, respectively, and in the control group 48.1% and 63.9%, respectively, with a significant difference between groups (P〈0.01). Hematoma volume decreased significantly at day 7 of treatment in the treatment group than the control group (P=0.038). Average Barthel scores in the treatment group after treatment was 89.11 + 19.93, and in the control group 82.18 + 24.02 (P=0.003). NIHSS scores of the two groups after treatment decreased significantly compared with before treatment (P=0.001). Patient-reported outcomes in the treatment group were lower than the control group at day 21 and 3 months of treatment (P〈0.05). There were 4 deaths, 2 in each group, and 11 adverse events, 6 in the treatment group and 5 in the control group. Conclusion: The integrative therapy combined TRABC with conventional Western treatment for HICH could promote hematoma absorption thus minimize neurologic impairment, without increasing intracerebral hematoma expansion and re-bleeding.
基金supported by the National Natural Science Foundation of China(30901949,81073086,81030063,81102845)
文摘The development of novel and efficient antiplatelet agents that have few adverse effects and methods that improve antiplatelet resistance has long been the focus of international research on the prevention and treatment of cardiovascular and cerebrovascular diseases.Recent advances in platelet proteomics have provided a technology platform for high-quality research of platelet pathophysiology and the development of new antiplatelet drugs.The study of blood stasis syndrome(BSS)and activated blood circulation of traditional Chinese medicine(TCM)is one of the most active fields where the integration of TCM and western medicine in China has been successful.Activated blood circulation herbs(ABC herbs)of Chinese medicine are often used in the treatment of BSS.Most ABC herbs have antiplatelet and anti-atherosclerosis activity,but knowledge about their targets is lacking.Coronary heart disease(CHD),BSS,and platelet activation are closely related.By screening and identifying activated platelet proteins that are differentially expressed in BSS of CHD,platelet proteomics has helped researchers interpret the antiplatelet mechanism of action of ABC herbs and provided many potential biomarkers for BSS that could be used to evaluate the clinical curative effect of new antiplatelet drugs.In this article the progress of platelet proteomics and its advanced application for research of BSS and ABC herbs of Chinese medicine are reviewed.