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Origin of and therapeutic approach to cardiac syndrome x:Results of the proton pump inhibitor therapy for angina-like lingering pain trial (PITFALL trial)

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World Journal of Gastroenterology 2008年第42期14卷 6506-6512页

作者： Christoph G Dietrich Susanne Laupichler Sven Stanzel Ron Winograd Oliver Al-Taie Carsten Gartung Andreas Geier Department of Gastroenterology Aachen University Aachen 52074 Germany Department of Gastroenterology Klinikum Aschaffenburg Aschaffenburg 63739 Germany Department of Medical Statistics AachenUniversity Aachen 52074 Germany Department of Gastroenterology University Hospital Zurich Zurich 8091 Switzerland

AIM: To investigate the frequency of gastroen-terological diseases in the etiology and the efficacy of proton pump inhibitors (PPIs) in the treatment of cardiac syndrome x (CSx) as a subform of non-cardiac chest pain (NCCP). METHODS: We investigated 114 patients with CSx using symptom questionnaires. A subgroup of these patients were investigated regarding upper gastrointestinal disorders (GIs) and treated with PPI. Patients not willing to participate in investigation and treatment served as control group. RESULTS: Thirty-six patients denied any residual symptoms and were not further evaluated. After informed consent in 27 of the remaining 78 patients, we determined the prevalence of disorders of the upper GI tract and quantifi ed the effect of treatment with pantoprazole. We found a high prevalence of gastroenterological pathologies (26/27 patients, 97%)with gastritis, gastroesophageal reflux disease (GERD) and acid reflux as the most common associated disorders. If treated according to the study protocol, these patients showed a significant improvement in the symptom score. Patients treated by primary care physicians, not according to the study protocol had a minor response to treatment (n = 19, -43%), while patients not treated at all (n = 26) had no improvement of symptoms (-0%). CONCLUSION: Disorders of the upper GI tract are a frequent origin of CSx in a German population and can be treated with pantoprazole if given for a longer period.

关键词： Non-cardiac chest pain Gastroesophageal reflux disease Proton pump inhibitor cardiac syndrome x

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Contemporary Treatment of Western and Chinese Medicine for cardiac syndrome x

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Chinese Journal of Integrative Medicine 2011年第4期17卷 314-320页

作者：毕颖斐毛静远王贤良王恒和葛永彬张振鹏 Tianjin University of Traditional Chinese Medicine Cardiovascular Department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine Cardiovascular Department of Guang'anmen Hospital of China Academy of Chinese Medical Sciences

Clinical reports on cardiac syndrome x（CSx） have been increasing in recent *** general, CSx does not increase the cardiovascular mortality,but it can affect the patient＇s quality of life（QOL） and increase the incidence rates of cardiovascular and cerebrovascular *** a variety of drugs and therapies have been utilized in the clinical treatment,the management of CSx still represents a major challenge due to its unclear *** is necessary to explore more effective treatment *** attempts have been made on trials of the Chinese medicine（CM） treatment for CSx and proved that CM has a certain advantage in efficacy to improve clinical symptoms and *** may provide a new approach for the effective treatment of CSx.

关键词： cardiac syndrome x angina pectoris Western medicine Chinese medicine

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Summary of 32 Patients with cardiac syndrome x Treated by TCM Therapy of Regulating Qi Relieving Chest Stuffiness and Promoting Blood Circulation

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Chinese Journal of Integrative Medicine 2007年第1期13卷 17-21页

作者：毛静远葛永彬王恒和王强张运虞东玲张宇黄芪赵志强赵桂峰王占武马学鹏张振鹏李明邵磊赵春燕 Cardiovascular Department the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine Guang'anmen Hospital of China Academy of Chinese Medical Sciences Tianjin University of Traditional Chinese Medicine

Objective： To evaluate the clinical effect of Liqi Kuanxiong Huoxue method （宽胸活血,LKH, traditional Chinese medicine, TCM therapeutic method for regulating qi, relieving chest stuffiness and promoting blood circulation） in treating patients with cardiac syndrome x （CSx）. Methods： The prospective, non-randomized controlled study was conducted on 51 selected patients with CSx, who were non-randomly assigned to 2 groups, the treated group treated with LKH in addition to the conventional treatment （32 patients）, and the control group treated with conventional treatment （19 patients） like nitrate, diltiazem hydrochloride, etc. The treatment course was 14 days. The changes of such symptoms as angina pectoris, TCM syndrome and indexes of treadmill exercise test before and after treatment were observed. Results： After treatment, such symptoms as chest pain and stuffy feeling and palpitation in the treated group were improved more than those in the control group （P〈0.05）; the total effective rate on angina pectoris and TCM syndrome in the treated group was better than that in the control group （P〈0.05）. The treadmill exercise test showed that the maximal metabolic equivalent （Max MET）, the time of angina onset and ST segment depression by 0.1 mV were obviously improved after treatment in both groups, but the improvement in the treated group was better than that in the control group respectively （P〈0.05）. Conclusion： The LKH method could reduce the frequency of angina attacks and improve the clinical condition of patients with CSx.

关键词： cardiac syndrome x qi stagnation phlegm obstruction and blood stasis regulating qi relieving chest stuffiness and promoting blood circulation method

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Tongxinluo Capsule(通心络胶囊)for cardiac syndrome x：A Systematic Review and Meta-Analysis

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Chinese Journal of Integrative Medicine 2018年第4期24卷 296-303页

作者： MAO Hui-min LIU Mi QU Hua WANG Li-qiong SHI Da-zhuo Graduate School Beijing University of Chinese Medicine Beijing 100029 China Cardiovascular Disease Center xiyuan Hospital China Academy of Chinese Medical Sciences Beijing 100091 China

Objective： To evaluate the efficacy and safety of Tongxinluo Capsule（通心络胶囊, TxL） for patients with cardiac syndrome x（CSx）. Methods： Randomized controlled trials（RCTs） regarding TxL in the treatment of CSx were searched in Chinese Biomedicine Literature Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, Pub Med, EMBASE, Cochrane Central Register of Controlled Trial, websites of the Chinese and International Clinical Trial Registry platform up to June 30, 2015. The intervention was either TxL alone or TxL combined with conventional treatment, while the control intervention was conventional treatment with or without placebo. Data extraction, methodological quality assessment and data analyses were performed according to the Cochrane criteria. The primary outcome was a composite event of death, acute myocardial infarction（AMI）, angina requiring hospitalization, revascularization, and heart failure. The secondary outcome measures were angina symptom improvement, electrocardiograph（ECG） improvement, and serum endothelin-1（ET-1） level. The adverse events were also recorded. RevMan 5.3 software was applied for data analyses. Results： Twelve RCTs（696 patients） were included. Compared with conventional treatment, the addition of TxL to conventional treatment showed some benefits on relieving angina symptoms [risk ratio（RR）： 1.46, 95% confidence interval（CI）（1.25, 1.71）, P〈0.01], and improving ECG [RR： 1.45, 95% CI（1.21, 1.74）, P〈0.01]. The pooled result did not support a benefit of TxL on reducing the incidence of primary outcome [RR： 0.20, 95% CI（0.02, 1.61）, P=0.13]. In addition, TxL decreased serum ET-1 concentration of CSx patients [standardized mean number： –1.63, 95% CI（–2.29, –0.96）, P〈0.01]. No serious adverse events were reported. Conclusions： TxL documents potential benefits on attenuating angina symptoms, improving ECG and decreasing serum ET-1 level for CSx patients. However, more rigorous RCTs with high qual

关键词： Tongxinluo Capsule cardiac syndrome x randomized controlled trial systematic review Chinese medicine

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Therapeutic efficacy observation on auricular point sticking therapy for cardiac syndrome x in women

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Journal of Acupuncture and Tuina Science 2020年第3期18卷 203-206页

作者： Zhang Ya-mei Wang Jun xiaoshan Hospital of Zhejiang Province Hangzhou 310013China Hangzhou Red Cross Hospital Hangzhou 310003China

Objective:To observe the clinical effect of auricular point sticking therapy for cardiac syndrome x(CSx)in ***:A total of 64 patients were randomized into two groups by the random number table,with 32 cases in each *** in the control group received conventional treatment for angina,while patients in the treatment group received auricular point sticking therapy on the basis of conventional *** 8 weeks of treatment,the levels of serum estradiol(E2),nitric oxide(NO)and endothelium-1(ET-1)were compared to evaluate the therapeutic ***:After 8 weeks of treatment,the total effective rate and markedly effective rate in the treatment group were significantly higher than those in the control group,and the between-group comparisons showed statistical significance(both P0.05),while the E2,NO and ET-1 contents in the treatment group changed significantly after treatment and were significantly different from those in the control group(all Px in women,and is worth clinical application.

关键词： Acupoint Therapy Auricular Point Sticking Otopoint,Heart (CO15) Otopoint,Liver (CO12) Otopoint,Kidney (CO10) Microvascular Angina cardiac syndrome x Women

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Helicobacter pylori infection and susceptibility to cardiac syndrome x:A systematic review and meta-analysis

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World Journal of Meta-Analysis 2021年第2期9卷 208-219页

作者： Mohsen Karbalaei Amirhossein Sahebkar Masoud Keikha Department of Microbiology and Virology Faculty of MedicineJiroft University of Medical SciencesJiroft 43317803Iran Biotechnology Research Center Pharmaceutical Technology InstituteMashhad University of Medical SciencesMashhadIran Applied Biomedical Research Center Mashhad University of Medical SciencesMashhadIran Department of Microbiology and Virology Faculty of MedicineMashhad University of Medical SciencesMashhad ***Iran

BACKGROUND cardiac syndrome x(CSx)is characterized by persistent angina with normal coronary *** pathophysiologic mechanisms have been introduced,particularly Helicobacter pylori(***)*** To investigate the association between *** infection and *** All studies related to *** infection and CSx were evaluated by comprehensive searches of global databases such as ISI Web of Knowledge,PubMed,Scopus,EMBASE,and Google *** analyses of selected articles were evaluated based on the summary odds ratio(OR).Finally,heterogeneity and publication bias were estimated using the I2 statistic and Cochrane Q-test as well as Begg’s and Egger’s *** A total of 11 studies met our inclusion criteria and 1435 patients(63%female,and 37%male)were reviewed.A significant association was observed between female patients and this syndrome(P=0.02).Our results showed a positive association between infection with this pathogen and presence of CSx(OR:5.65;95%confidence interval[CI]:4.17-7.64;I2:82.20).However,no significant association was observed with cagA-positive H. pylori strains and this syndrome (OR: 0.97;0.56-1.70 with 95%CI). Given the heterogeneity and publication bias, the resultsneed to confirmed by further prospective *** on our results, H. pylori infection is associated with an increased risk ofCSx. This bacterium appears to play a major role in the pathogenesis of CxS byinducing persistent inflammation.

关键词： Helicobacter pylori cardiac syndrome x Cardiovascular disease Infection Meta-analysis Coronary diseases

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