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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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黄连-莪术药对配伍规律研究

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中国中西医结合杂志 2024年第5期44卷 554-557页

作者：袁蛀鱼曲华史大卓北京大学中医药临床医学院(西苑) 北京100191 北京大学医学部中西医结合学系北京100191 中国中医科学院西苑医院临床药理研究所北京100191 中国中医科学院西苑医院国家中医心血管病临床医学研究中心北京100191

目的通过数据挖掘方法分析黄连-莪术的配伍规律。方法筛选史大卓教授门诊开具处方中含黄连-莪术药味的病例,收集患者性别、年龄、舌脉、中西医诊断和处方用药信息,并进行数据规范化及统计分析。结果含黄连-莪术药对方剂应用人群的舌... 详细信息

目的通过数据挖掘方法分析黄连-莪术的配伍规律。方法筛选史大卓教授门诊开具处方中含黄连-莪术药味的病例,收集患者性别、年龄、舌脉、中西医诊断和处方用药信息,并进行数据规范化及统计分析。结果含黄连-莪术药对方剂应用人群的舌质以暗红和紫暗为主,舌体多胖大,苔多腻,脉象以沉弦和沉弦细为主。西医主治疾病主要为冠状动脉粥样硬化性心脏病,中医主治证候主要为心血瘀阻证。黄连:莪术配伍比例一般为0.7、0.5。与黄连-莪术药对共同使用的中药主要包括丹参、赤芍、川芎和黄芪。结论含黄连-莪术药对的方剂主要用于治疗心血瘀阻证的冠状动脉粥样硬化性心脏病。临床根据血瘀、热毒、痰湿、气虚等病证的轻重变化,配伍比例有所变化,并酌情配伍活血化瘀、清热、补虚和理气中药。

关键词：药对配伍数据挖掘用药规律黄连莪术中药

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Integrative Medicine Intervention for Chronic Disease Management——Cardiovascular Disease

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Chinese Journal of Integrative Medicine 2018年第12期24卷 883-885页

作者： shi da-zhuo Center of Cardiology Xiyuan HospitalChina Academy of Chinese Medical Sciences

Cardiovascular disease （CVD） is a leading life-threatening chronic disease in China. In the primary and secondary prevention, remarkable achievements have been made during past decades. In treating coronary artery disease （CAD）, for example, the advanced treatment approaches, suchas percutaneous coronary intervention （PCI） guided by intracoronary imaging, minimally-invasive coronary artery bypass graft （CABG）, and novel drugs for better control of the risk factors including hypertension, hyperglycemia and dyslipidemia, have been widely used in clinical practice.

关键词： ACS Cardiovascular Disease CVD PCI

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Antiplatelet Effect of Active Components Derived from Chinese Herbal Medicine

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Chinese Journal of Integrative Medicine 2018年第8期24卷 632-640页

作者： ZHANG Ying MA Xiao-juan shi da-zhuo Graduate School Beijing University of Chinese Medicine Cardiovascular Diseases Center Xiyuan HospitalChina Academy of Chinese Medical Sciences China Heart Institute of Chinese Medicine China Academy of Chinese Medical Sciences

Atherothrombosis is the major cause of acute coronary syndromes and cardiovascular *** participate in the processes of forming and extending atherosclerotic ***,antiplatelet therapy is a milestone in the primary and second prevention of atherothrombotic *** with the longterm use of antiplatelet agents,the safety and drug resistance has become a big concern in clinic and new drugs possessing higher effectiveness and fewer adverse effects are *** recent data support that traditional Chinese herbs may be a good alternative and complementary choice of new antiplatelet *** review highlights the progress of antiplatelet effect of active components derived from traditional Chinese herbs based on their chemical structures.

关键词： Chinese herbal medicine antiplatelet active components

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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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基于氧化三甲胺—肠道菌群从脾胃论治动脉粥样硬化

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中国中西医结合杂志 2020年第7期40卷 854-857页

作者：王少丽史大卓中国中医科学院广安门医院脾胃病科北京100053 中国中医科学院西苑医院心血管病中心北京100091

氧化三甲胺依赖肠道菌群参与动脉粥样硬化的发生发展。通过调节肠道菌群,减少氧化三甲胺形成,可能成为防治心血管疾病新的有效途径。现代中医学认为,动脉粥样硬化与脾胃关系密切;临床研究显示,肠道菌群失调是中医脾胃失其健运的一个生... 详细信息

氧化三甲胺依赖肠道菌群参与动脉粥样硬化的发生发展。通过调节肠道菌群,减少氧化三甲胺形成,可能成为防治心血管疾病新的有效途径。现代中医学认为,动脉粥样硬化与脾胃关系密切;临床研究显示,肠道菌群失调是中医脾胃失其健运的一个生物学基础,临床从脾胃论治动脉粥样硬化显示有一定疗效。本文拟从氧化三甲胺与肠道菌群、中医脾胃、动脉粥样硬化的相关性入手,结合中医学理论和现代医学认识,论述中医学从脾胃治疗动脉粥样硬化的前景。

关键词：氧化三甲胺肠道菌群脾胃动脉粥样硬化

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急性冠脉综合征瘀毒互结证诊断标准研究

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中国中西医结合杂志 2024年第5期44卷 543-547页

作者：田文得鞠建庆高洁付长庚高铸烨薛梅徐浩史大卓陈可冀中国中医科学院西苑医院心血管病中心国家中医心血管病临床医学研究中心北京100091

目的基于冠心病“瘀毒”病因病机的理论认识,建立急性冠脉综合征瘀毒互结证诊断标准。方法采用文献系统分析与横断面临床研究构建条目池,采用德尔菲法专家咨询对条目进行筛选,采用层次分析法确定各条目权重。在此基础上,结合条目权重... 详细信息

目的基于冠心病“瘀毒”病因病机的理论认识,建立急性冠脉综合征瘀毒互结证诊断标准。方法采用文献系统分析与横断面临床研究构建条目池,采用德尔菲法专家咨询对条目进行筛选,采用层次分析法确定各条目权重。在此基础上,结合条目权重及临床实用性原则建立诊断标准。结果文献系统分析筛选条目43个,横断面临床研究纳入患者400例,筛选条目39个,归纳分类后形成包含67个条目的条目池;经过两轮德尔菲专家咨询,筛选保留条目28个;通过层次分析法,确定高权重类条目(0.0430~0.1976)9个、中权重类条目(0.0153~0.0289)9个与低权重类条目(0.0060~0.0147)10个。结合临床实用性原则,优化形成包括必要指标(心绞痛程度进行性加重、近1个月反复发作性心绞痛等)、理化指标(心脏肌钙蛋白或肌酸激酶同工酶升高等)及舌象脉象(舌青紫或紫暗等、脉弦细或脉涩)3个维度的急性冠脉综合征瘀毒互结证诊断标准。两轮专家问卷咨询肯德尔和谐系数分别为0.368、0.395,格朗巴赫系数为分别为0.967、0.893,提示专家意见一致性好,结果可信度高。结论该诊断标准涵盖了反映瘀毒互结致病特点的宏观表征和理化指标,可指导急性冠脉综合征瘀毒互结证的诊断。

关键词：急性冠脉综合征瘀毒互结证德尔菲法层次分析法诊断标准

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Combination of Activating Blood Circulation and Detoxifying Chinese Medicines Played an Anti-Inflammatory Role in Unstable Angina Patients after Percutaneous Coronary Intervention: A Multicenter, Open-Labeled, Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2021年第11期27卷 803-810页

作者： MA Xiao-juan DUAN Wen-hui ZHANG Ying GAO Jie GUAN Bao-yi CHEN Ke-ji shi da-zhuo National Clinical Research Center for Chinese Medicine Cardiology Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing100091China Cardiovascular Diseases Center Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing100091China

Objective To investigate the combined anti-inflammatory effect of activating blood circulation and detoxifying Chinese medicines in unstable angina(UA)*** This study was an open-labeled,randomized controlled trial conducted in 5 centers in Beijing.A total of 154 patients were randomized into two groups at a 1:1 ratio by random *** on the conventional treatment,patients in the activating blood circulation(ABC)group were treated with Guanxin danshen Droping Pill(冠心丹参滴丸,0.4 g,thrice daily),and patients in the activating blood circulation and detoxifying(ABCD)group were treated with Guanxin danshen Droping Pill(0.4 g,thrice daily)and Andrographis tablet(0.2 g,thrice daily)for 4 *** primary outcome was the serum level of high sensitive C reaction protein(hs-CRP),and the secondary outcome index included the serum levels of tumor necrosis factorα(TNF-α),interleukin 6(IL-6),soluble CD40 ligand(sCD40L),thrombomodulin(TM),the score of angina pectoris,the score of blood stasis syndrome,and the score of Chinese medicine symptoms,observed at week 0 and week *** A total of 144 patients completed the trial(ABC group,n=70;ABCD group,n=74).There were no significant differences in the clinical baseline characteristics between the two *** compared with the ABC group,ABCD group showed better performance in reducing the level of inflammatory factors,especially hs-CRP(Pdanshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients,which is superior to single Guanxin danshen Dropping Pill.(Registration ***-TRC-13004072)

关键词： Chinese medicine unstable angina inflammation randomized controlled trial

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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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Panax Notoginseng Saponin Attenuates Gastric Mucosal Epithelial Cell Injury Induced by Dual Antiplatelet Drugs through COX and PI3K/Akt/ VEGF-GSK-3β-RhoA Network Pathway

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Chinese Journal of Integrative Medicine 2021年第11期27卷 819-824页

作者： WANG Ming-ming XUE Mei XIN Zhong-hai WANG Yan-hui LI Rui-jie JIANG Hong-yan shi da-zhuo Beijing First Hospital of Integrated Chinese and Western Medicine Beijing100039China Center for Cardiovascular Disease Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing100091China Wangjing Hospital China Academy of Chinese Medical SciencesBeijing100102China

Objective To elucidate the underlying mechanism of Panax notoginseng saponin(PNS)on gastric epithelial cell injury and barrier dysfunction induced by dual antiplatelet(da).Methods Human gastric mucosal epithelial cell(GES-1)was cultured and divided into 4 groups:a control,a da,a PNS+da and a LY294002+PNS+da ***-1 apoptosis was detected by flow cytometry,cell permeability were detected using Transwell,level of prostaglandins E2(PGE2),6-keto-prostaglandin F1α(6-keto-PGF1α)and vascular endothelial growth factor(VEGF)in supernatant were measured by enzyme linked immunosorbent assay(ELISA),expression of phosphatidylinositide 3-kinase(PI3K),phosphorylated-PI3K(p-PI3K),Akt,phosphorylated-Akt(p-Akt),cyclooxygenase-1(COX-1),cyclooxygenase-2(COX-2),glycogen synthase kinase-3β(GSK-3β)and Ras homolog gene family member A(RhoA)were measured by *** da induced apoptosis and hyper-permeability in GES-1,reduced supernatant level of PGE2,6-keto-PGF1αand VEGF(Pda,restored the concentration of PGE2,6-keto-PGF1αand VEGF(Pda,up-regulated p-PI3K/p-Akt,down-regulated RhoA and GSK-3β.LY294002 mitigated the effects of PNS on cell apoptosis,cell permeability,VEGF concentration,and expression of RhoA and GSK-3β*** PNS attenuates the suppression on COX/PG pathway from da,alleviates da-induced GES-1 apoptosis and barrier dysfunction through PI3K/Akt/VEGF-GSK-3β-RhoA network pathway.

关键词： Panax notoginseng saponins dual antiplatelet permeability cyclooxygenase PI3K

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