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Asymmetric Dimethylarginine Predicts One-year Recurrent Cardiovascular Events: Potential Biomarker of "Toxin Syndrome" in Coronary Heart Disease

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Chinese Journal of Integrative Medicine 2019年第5期25卷 327-333页

作者： XU Hao CHEN zhuo SHANG Qing-hua gao zhu-ye YU Chang-an SHI Da-zhuo CHEN Ke-ji Cardiovascular Diseases Center Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing(100091)China Department of Cardiology China-Japan Friendship HospitalBeijing(100029)China

Objective: To examine the prognostic value of serum levels of asymmetric dimethylarginine(ADMA)in patients with stable coronary heart disease(CHD) thus explore a potential biomarker of "toxin syndrome" in ***: In this prospective nested case-control study, 36 of 1,503 Chinese patients with stable CHD experienced at least 1 recurrent cardiovascular event(RCE) during 1-year fol ow-up. Serum levels of ADMA at the start of fol ow-up were compared between these 36 cases and 36 controls which matched to cases in terms of gender, age, history of hypertension, and myocardial infarction. Results: Based on the crude model, subjects in the 2 highest ADMA quartiles showed signi?cantly higher risk of developing RCE than those in the lowest ADMA quartile [odds ratio(OR) 4.09, 95%confidence interval(CI) 1.01 to 16.58; OR 6.76, 95% CI 1.57 to 29.07]. This association was also observed in the case-mix model(OR 5.51, 95% CI 1.23 to 24.61; OR 7.83, 95% CI 1.68 to 36.41) and multivariable model(OR 6.64,95% CI 1.40 to 31.49; OR 13.14, 95% CI 2.28 to 75.71) after adjusting for confounders. The multivariable model which combined ADMA and high-sensitivity C-reactive protein(hs CRP) showed better predictive power with areas under the receiver operator characteristic curves(0.779) than the model of either ADMA(0.694) or hs CRP(0.636). Conclusion:Serum ADMA level may be a potential biomarker of "toxin syndrome" in CHD which shows favorable prognostic value in predicting 1-year RCE in patients with stable CHD. [The registration number is Chi CTR-PRNRC-07000012]

关键词： asymmetric dimethylarginine recurrent cardiovascular event nested case-control study coronary heart disease toxin syndrome

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Diagnostic Criterion of Blood Stasis Syndrome for Coronary Heart Disease

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Chinese Journal of Integrative Medicine 2016年第11期22卷 803-804页

作者： Chen Ke-ji Shi Da-zhuo Fu Chang-geng gao zhu-ye Xu Hao Lv Shu-zheng You Shi-jie Huang Li activating blood circulation committee of chinese association of integrative medicine

The diagnostic criterion of blood stasis syndrome（BSS） established in 1986 is a milestone in BSSdifferentiation of Chinese medicine （CM）. However,different disease has its own characteristics in BSS,thus establishing a BBS criterion of disease-syndromecombination has significance in clinical and basicstudies. BSS is the most common syndrome typeof CM in coronary heart disease （CHD）, but thereis not diagnostic criterion of BSS for CHD based ondisease-syndrome combination to date.

关键词： Diagnostic Criterion Syndrome

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Effectiveness of Integrative Medicine Therapy on Coronary Artery Disease Prognosis: A Real-World Study

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Chinese Journal of Integrative Medicine 2019年第1期25卷 9-15页

作者： ZHAO Kang TIAN Jin-fan ZHAO Cong YUAN Fei gao zhu-ye LI Li-zhi LIU Hong-xu WANG Xian GE Chang-jiang LU Shu-zheng Department of Cardiology Beijing Anzhen Hospital Affiliated to Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases Center for Cardiovascular Diseases Xiyuan Hospital China Academy of Chinese Medical Sciences Department of Cardiology Beijing Chinese Medicine Hospital Affiliated to Capital Medical University Department of Cardiology Dongzhimen Hospital Affiliated to Beijing University of Traditional Chinese Medicine

Objective: To evaluate the effectiveness of integrative medicine(IM) on patients with coronary artery disease(CAD) and investigate the prognostic factors of CAD in a real-world setting. Methods: A total of 1,087 hospitalized patients with CAD from four hospitals in Beijing, China were consecutively selected between August 2011 and February 2012. The patients were assigned to two groups based on the treatment: Chinese medicine(CM) plus conventional treatment, i.e., IM therapy(IM group); or conventional treatment alone(CT group). The endpoint was major adverse cardiac events [MACE; including cardiac death, myocardial infarction(MI), and revascularization]. Results: A total of 1,040 patients finished the 2-year follow-up. Of them, 49.4%(514/1,040) received IM therapy. During the 2-year follow-up, the total incidence of MACE was 11.3%. Most of the events involved revascularization(9.3%). Cardiac death/MI occurred in 3.0% of cases. For revascularization, logistic stepwise regression analysis revealed that age 65 years [odds ratio(OR), 2.224], MI(OR, 2.561), diabetes mellitus(OR, 1.650), multi-vessel lesions(OR, 2.554), baseline high sensitivity C-reactive protein level 3 mg/L(OR, 1.678), and moderate or severe anxiety/depression(OR, 1.849) were negative predictors(Pyears(OR, 6.389) and heart failure(OR, 7.969) were negative predictors(P<0.05), while statin use(OR, 0.323) was a protective predictor(P<0.05) and IM therapy showed a beneficial tendency(OR, 0.587), although the difference was not statistically significant(P=0.218). Conclusion: In a real-world setting, for patients with CAD, IM therapy was associated with a decreased incidence of revascularization and showed a potential benefit in reducing the incidence of cardiac death or MI.

关键词： coronary artery disease Chinese medicine integrative medicine effectiveness real-world study

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302例冠心病合并糖尿病心力衰竭患者的中药应用分析

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中国中药杂志 2008年第19期33卷 2253-2256页

作者：荆鲁高铸烨中国中医科学院西苑医院北京100091 北京中医药大学北京100029

目的：回顾性分析302例冠心病合并糖尿病心力衰竭患者的临床资料，探讨冠心病合并糖尿病心衰患者的用药特点。方法：利用冠心病中医临床研究数据平台，采集2003年1月～2006年9月京津地区9家三甲医院冠心病合并糖尿病心力衰竭住院患者的... 详细信息

目的：回顾性分析302例冠心病合并糖尿病心力衰竭患者的临床资料，探讨冠心病合并糖尿病心衰患者的用药特点。方法：利用冠心病中医临床研究数据平台，采集2003年1月～2006年9月京津地区9家三甲医院冠心病合并糖尿病心力衰竭住院患者的信息，对其临床证候及中西药物治疗情况进行调查分析。结果：302例冠心病合并糖尿病心衰患者中药注射剂以葛根素、丹参、生脉、三七总皂苷、灯盏细辛注射液为主。中药治疗以益气、活血、化痰为主，中药口服煎剂中茯苓的使用频率最高，应用频度依次为：茯苓、甘草、黄芪、丹参、白术、半夏等。结论：京津地区9家三甲医院冠心病合并糖尿病心衰患者多采用中西医结合治疗，中药应用特点以益气、活血、化痰为主。

关键词：心力衰竭冠心病糖尿病药物分析

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病因病机研究与提高中西医结合临床水平

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中国中西医结合杂志 2011年第3期31卷 293-294页

作者：史大卓高铸烨中国中医科学院西苑医院心血管病中心北京100091

病因病机研究是提高中医药临床水平的重要方面。早在两千多年前的《黄帝内经》中即有＂夫百病之所生者,必起于燥湿、寒暑、风雨、阴阳、喜怒、饮食、居处＂的病因认识,强调辨证治疗过程中应＂审察病机,无失气宜＂;并将特定病因致病的病... 详细信息

病因病机研究是提高中医药临床水平的重要方面。早在两千多年前的《黄帝内经》中即有＂夫百病之所生者,必起于燥湿、寒暑、风雨、阴阳、喜怒、饮食、居处＂的病因认识,强调辨证治疗过程中应＂审察病机,无失气宜＂;并将特定病因致病的病理变化归纳为＂病机十九条＂,以执简驭繁,指导临床。

关键词：病因病机中西医结合临床《黄帝内经》水病机十九条辨证治疗病理变化

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Long-Term Follow-Up of Chinese Herbal Medicines Combined with Conventional Treatment in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: A Multicenter Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2017年第10期23卷 740-746页

作者： WANG Pei-li ZHANG Lei WANG Shao-li YANG Qiao-ning gao zhu-ye DU Jian-peng ZHANG Da-wu FU Chang-geng GU Feng XU Hao Li Li-zhi WANG Cheng-long SHI Da-zhuo Institute of Cardiovascular Diseases Xiyuan Hospital China Academy of Chinese Medical Sciences Department of Gastroenterology Guang'anmen Hospital China Academy of Chinese Medical Sciences

Objective： To evaluate the prognosis effect of Chinese herbal medicines（CHMs） for benefiting qi and activating blood circulation adjunctive to conventional treatment in patients with acute coronary syndrome（ACS） after percutaneous coronary intervention（PCI）. Methods： A total of 702 patients with ACS who underwent PCI were enrolled and randomly assigned to receive conventional treatment plus CHMs for benefiting qi and activating blood circulation（treatment group, 351 cases） or conventional treatment alone（control group, 351 cases） for 6 months. Six months later, all patients received conventional treatment alone. Follow-ups were scheduled at 6th, 12 th, 18 th, 24 th month after enrollment in April 2008, and the final follow-up visit was during September 2011 and November 2011. The primary endpoint was the composite of cardiac death, nonfatal myocardial infarction or revascularization（PCI or coronary artery bypass grafting）; and the secondary endpoint was the composite of re-admission for ACS, congestive heart failure, nonfatal stroke or other thrombus events. Results： A total of 621（88.59%） patients completed 35.4±3.8 months follow-up, while 80（11.41%） patients withdrew from the trial（41 in the treatment group and 39 in the control group）. The incidence of primary endpoint was 5.7%（20 patients） in the treatment group versus 10.86%（38 patients） in the control group [relative risk（RR）： 0.53; 95% confidence interval（CI）： 0.30, 0.88; P=0.013; absolute risk reduction（ARR）： –0.052, 95% CI： –0.06, 0.01]. The incidence of secondary endpoint was 5.98%（21 patients） in the treatment group versus 10.28%（36 patients） in control group（RR： 0.58, 95% CI： 0.33, 0.97, P=0.037; ARR： –0.043, 95% CI： 0.06, 0.01）. Most of the primary and secondary endpoints were occurred in 18 months（84.50% in the treatment group versus 78.10% in the control group）. Conclusion： CHMs for benefiting qi and activating blood circulation adjunctive to conventional treatment improved clinical outcomes for patie

关键词： long-term follow-up Chinese medicine benefit qi and activate blood circulation acute coronary syndrome percutaneous coronary intervention

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Effectiveness and Safety of Qishen Yiqi Dripping Pill in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention:3-year Results from a Multicentre Cohort Study

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Chinese Journal of Integrative Medicine 2024年第10期30卷 877-885页

作者： BAI Rui-na GU Feng CHE Qian-zi ZHANG Xuan CAI Ya-jie XI Rui-xi ZHAO Yang GUO Ming DONG Guo-ju gao zhu-ye FU Chang-geng WANG Pei-li DU Jian-peng ZHANG Da-wu DUAN Wen-hui LI Li-zhi YANG Qiao-ning SHI Da-zhuo Department of Cardiovascular Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing100091China National Clinical Research Center for Chinese Medicine Cardiology Beijing100091China Department of Evidence-Based Medicine Basic Research Laboratory Institute of Basic Research in Clinical MedicineChina Academy of Chinese Medical SciencesBeijing100700China Department of Traditional Chinese Medicine Beijing Shangdi HospitalBeijing100193China National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Traditional Chinese MedicineBeijing100091China

Objectives:To evaluate the effectiveness and safety of Qishen Yiqi Dripping Pill(QSYQ)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods:This multicentre prospective cohort study was conducted at 40 centers in *** with ACS after PCI entered either the QSYQ or Western medicine(WM)groups naturally based on whether they had received QSYQ before *** group received QSYQ(0.52 g,3 times a day for 12 months)in addition to *** primary endpoint included cardiac death,non-fatal myocardial infarction,and urgent *** secondary endpoint included rehospitalization due to ACS,heart failure,stroke,and other thrombotic *** of life was assessed by the Seattle Angina Questionnaire(SAQ).Results:A total of 936 patients completed follow-up of the primary endpoint from February 2012 to December ***,487 patients received QSYQ and *** a median follow-up of 566 days(inter quartile range,IQR,517–602),the primary endpoint occurred in 46(9.45%)and 65(14.48%)patients in QSYQ and WM groups respectively[adjusted hazard ratio(HR)0.60,95%confidence interval(CI)0.41–0.90;P=0.013].The secondary endpoint occurred in 61(12.53%)and 74(16.48%)patients in QSYQ and WM groups,respectively(adjusted HR 0.76,95%CI 0.53–1.09;P=0.136).In sensitivity analysis,the results still demonstrated that WM combined with QSYQ reduced the risk of the primary endpoint(HR 0.67,95%CI 0.46–0.98;P=0.039).Moreover,QSYQ improved the disease perception domain of the SAQ(P<0.05).Conclusions:In patients with ACS after PCI,QSYQ combined with WM reduced the incidence of the primary *** findings provide a promising option for managing ACS after PCI and suggest the potential treatment for reducing the risk of primary endpoint included cardiac death,non-fatal myocardial infarction,and urgent revascularization through intermittent administration of QSYQ.(Registration *** CTR-OOC-14005552).

关键词： Qishen Yiqi Dripping Pill acute coronary syndrome percutaneous coronary intervention primary and secondary endpoint

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1864例老年冠心病患者诊疗状况及其预后的前瞻性研究

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中华老年医学杂志 2008年第8期27卷 617-622页

作者：徐浩高铸烨陈可冀中日友好医院全国中西医结合心血管病中心北京市100029 中国中医科学院西苑医院心血管病中心

目的探讨老年冠心病患者住院治疗和二级预防存在问题与防治策略。方法对北京市和天津市三级甲等中医或中西医结合医院老年冠心病患者进行前瞻性研究，利用冠心病个体化诊疗信息采集平台，采用纵向临床流行病学调查方法．实时采集冠心病... 详细信息

目的探讨老年冠心病患者住院治疗和二级预防存在问题与防治策略。方法对北京市和天津市三级甲等中医或中西医结合医院老年冠心病患者进行前瞻性研究，利用冠心病个体化诊疗信息采集平台，采用纵向临床流行病学调查方法．实时采集冠心病住院患者临床资料及出院后1年的终点指标和事件发生情况，以相关指南为评价依据，评价老年冠心病患者诊疗状况，对影响终点指标和事件的相关因素进行单因素和多因素分析。结果1864例老年冠心病患者符合入选标准，男性1113例，女性751例，年龄60～98岁，平均（72．2±6．8）岁，主要并存疾病是高血压、糖尿病、脑血管病、高脂血症。入院时并存高脂血症患者血脂水平达标率分别为总胆固醇（TC）74．1％（1381例）、三酰甘油（TG）32．9％（613例）、低密度脂蛋白胆固醇（LDL-C）19．4％（362例）、高密度脂蛋白胆固醇87．8％（1637例）；高血压患者收缩压达标率64．6％（857／1327），舒张压达标率84．7％（1124／1327）。住院期间药物使用率：β受体阻滞剂69．6％（1297例），血管紧张素转化酶抑制剂或血管紧张素受体拮抗剂（ACEI或ARB）68．4％（1275例），他汀类调脂药63．6％（1186例），血运重建29.1％（391例）。1682例患者完成随访观察，112例（6．0％）失访．随访期间心原性死亡72例（4．3％），其他原因死亡5例（0．3％），急性心肌梗死（AMI）9例（0．5％），血运重建15例（0．8％）。多因素Logistic回归分析，可导致终点事件发牛的因素有急性心肌梗死、心功能不全。可防止终点事件发生的因素有他汀调脂药物、无并存周围血管疾病、血运重建、中西医结合治疗、年龄〈75岁。结论北京市和天津市中医及中西医结合医院老年冠心病患者在血脂达标（TG、LDL-C）方面不足，血运重建有待加强，ACEI或ARB、β受体阻滞剂和他汀类调脂药和相关指南的要求尚有差距，冠心病二级预防有待加强，规范地遵循指南从事医疗实践，多种危险因素共同控制、综合干预是顶防老年冠心病患者心血管事件的主要策略。

关键词：冠状动脉疾病中西医结合疗法临床分析治疗方法

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基于肝藏血主疏泄脏象理论辨治围绝经期综合征

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中华中医药杂志 2019年第11期34卷 5460-5462页

作者：曲华高铸烨史大卓中国中医科学院西苑医院

围绝经期综合征的发生发展与肝藏血、主疏泄功能的失调密切相关。文章结合流行病学调查、当代医家临证与临床实践发现肝失疏泄、肝血不充是围绝经期综合征的重要病因病机;并提出了围绝经期综合征补肝柔肝、条畅气机等治疗大法。并在此... 详细信息

围绝经期综合征的发生发展与肝藏血、主疏泄功能的失调密切相关。文章结合流行病学调查、当代医家临证与临床实践发现肝失疏泄、肝血不充是围绝经期综合征的重要病因病机;并提出了围绝经期综合征补肝柔肝、条畅气机等治疗大法。并在此基础上,根据兼证不同加减处方用药。

关键词：脏象理论围绝经期综合征中医药辨治

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单细胞转录组测序技术在心梗后中药心脏保护作用机制研究中的应用研究进展

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中国实验方剂学杂志 2022年第5期28卷 242-249页

作者：彭菊琴任钧国高铸烨中国中医科学院西苑医院北京100091

心梗(MI)后心脏病理改变复杂,涉及心肌细胞、内皮细胞、成纤维细胞、巨噬细胞等多种细胞及分子机制。采用具有多靶点作用效应的中药进行治疗能够发挥良好的心脏保护作用,但多组分剂中药复杂的作用机制一直未被充分的阐明,限制了中药的... 详细信息

心梗(MI)后心脏病理改变复杂,涉及心肌细胞、内皮细胞、成纤维细胞、巨噬细胞等多种细胞及分子机制。采用具有多靶点作用效应的中药进行治疗能够发挥良好的心脏保护作用,但多组分剂中药复杂的作用机制一直未被充分的阐明,限制了中药的广泛使用。单细胞转录组测序(scRNA-seq)技术具有超高通量,可在单次实验中完成不同处理条件下几百种药物的单细胞转录组的分析,识别出不同的细胞及细胞亚型对药物治疗的响应差异。利用scRNA-seq技术能够了解从急性缺血事件到慢性心脏瘢痕形成过程中,心脏重构确切细胞和分子机制。将scRNA-seq技术应用于MI后中药心脏保护作用机制研究,能够加快中药研发的进程,同时能够获得更丰富、更全面、更准确的信息,有助于理解中药基于复杂网络而发挥药效的作用机制。本文通过总结目前中药心脏保护作用机制研究进展,介绍scRNA-seq技术的发展概况及其在MI中的应用现况,以此来探讨scRNA-seq在MI后中药心脏保护作用机制研究中可能的应用前景,为中药现代化研究提供思路。

关键词：单细胞转录组测序心梗中药机制研究

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