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To explore the real world clinical application characteristics and the drug combination regularity of Ciwujia Injection, 12 554 cases of patients with Ciwujia Injection were extracted from the information systems of 24 class Ⅲ grade A hospitals in China, and a standardized analysis was carried out. Most of the patients were middle-aged and old-aged, and the main departments were cardiovascular department(22.50%) and neurology department(17.92%). Before 2008, 93.77% of the patients were single overdose users, which reduced to only 2.07% after 2011. The course of treatment was mostly between 8-14 days(32.98%). The top three di-seases diagnosed by Western medicine were hypertension(11.78%), cerebral infarction(9.47%), and coronary heart disease(8.15%), and the most common traditional Chinese medicine syndrome was the deficiency of liver and kidney(18.59%). The most commonly used Western medicine was Acetylsalicylic Acid(51.07%), and the most commonly used traditional Chinese medicine was Danshen Injection(9.67%). The most commonly used Western medicine in combined application was calcium channel blocker(46.88%), and the most commonly used traditional Chinese medicine in combined application was stasis removing agent(93.21%). And the drug combination with the highest support was Isosorbide Mononitrate + Acetylsalicylic Acide, with a high recovery rate after discharge(96.81%). The results showed that Ciwujia Injection had certain regularity. It considered underlying concurrent diseases, anticoagulation and blood circulation, with a wide range of effects in strengthening the body and regulating the mind. The results could expand the understanding of Ciwujia Injection and provide a more detailed real world basis and reference for optimizing therapeutic regimen in clinic.
Subject(s)
Aged , Humans , Middle Aged , Aspirin , China , Drug Combinations , Drugs, Chinese Herbal , Eleutherococcus , Medicine, Chinese TraditionalABSTRACT
To investigate the clinical characteristics and the rule of administration of Ciwujia Injection in patients with cardiovascular disease by correlation analysis and frequency analysis. The information of 5 904 patients who used Ciwujia Injection to treat cardiovascular disease for at least three times in the hospital information system(HIS) of 19 comprehensive tertiary hospitals nationwide. The frequency analysis method was used to analyze the higher frequency variables, and the algorithm of Apriori correlation analysis method was used to analyze the clinical characteristics and medication laws of Ciwujia Injection in treating patients with cardiovascular disease. Among the 5 904 patients, the median age of the patients was 70 years, and the number of patients between 65-75 years old was up to 2 096(35.5%). There were more women than men in terms of diagnosis and treatment, and the women at age of 45-65 and 65-75 years old were more than men. The top three diagnoses by Western medicine were coronary heart disease in 8 104 cases(65.66%), dyslipidemia in 2 515 cases(20.38%), and cardiac function grade Ⅱ-Ⅲ in 581 cases(4.71%), while the largest number of syndromes in traditional Chinese medicine(TCM) at discharge was 1 109(21.37%) in other type, followed by 739 cases(14.24%) of Qi deficiency and blood stasis syndrome, and 698(13.46%) of liver and kidney Yin deficiency syndrome. The most frequently used Western medicine in combined use was Nifedipine in 2 567 cases(7.21%), and most frequently used TCM was Compound Xianzhuli Liquid leachate in 766 cases(3.53%). From the results of pharmacological analysis, the frequency of using Ciwujia Injection + stasi-seliminating agent + calcium channel blocking drugs was highest when using 1 Chinese medicine combined with 1 or 2 Western medicines. In the use of 2 Chinese medicines combined with 1 Western medicine, Ciwujia Injection + heat-clearing agent + stasis-eliminating agent + calcium channel blocker was the most common. This study demonstrated that Ciwujia Injection was more common in middle-aged and elderly patients and more in women than men. Treatment should be based on different cardiovascular disease treatment guidelines to reduce complications caused by underlying diseases, and attention should be paid to the prevention and treatment of cardio-vascular disease risk factors such as hypertension, diabetes and abnormal lipid metabolism. According to the analysis of frequency distribution and association rules, it was concluded that Ciwujia Injection was mainly used in combination with calcium channel blockers and stasis-eliminating agents in the treatment of cardiovascular disease. In the treatment of cardiovascular diseases by Ciwujia Injection in combination with other Chinese and Western medicines, in order to avoid pharmacological changes and avoid affecting the efficacy of the drug, it is necessary to closely observe whether adverse reactions occur and ensure that the medication is safe and effective. This study provides a good reference for the follow-up clinical guidance of Ciwujia Injection.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Cardiovascular Diseases , Drugs, Chinese Herbal , Eleutherococcus , Medicine, Chinese Traditional , Yin DeficiencyABSTRACT
Objective: Though especially efficient for cardiovascular and cerebrovascular diseases treatment, many serious anaphylactic diseases could be induced by Ciwujia Injection (CWJI). However, study of the mechanism and detection of allergies have been investigated by the unknown sources of allergenic substances. In this study, a guinea pig model which could mimic the symptoms of anaphylactic reactions induced by Ciwujia Injection (CWJI) was modeled and used to screen the allergenic substance of CWJI. Methods: Guinea pigs were sensitized three times every other day with CWJI and excitated 14 d after the last sensitization administration. Then, the histamine, trypsin, IL-4 and IFN-γ levels, and the Annexin V positive rate of peritoneal mast cells (PMC) were detected, the numbers of B lymphocyte and the pathological changes were also analyzed to verify the guinea pig allergy model, PCA test and IgE antibody levels were determined to study the mechanism. Results: The levels of total IgE, histamine, and trypsin were significantly increased after CWJI sensitization, IL-4 level was elevated, Annexin V positive of PMC cell rate, local skin reactions, and declined IFN-γ were observed after excitation. Histological examination showed that mild pathological changes in lungs were found. Conclusion: This guinea pig model may provide a powerful tool to study the mechanism in CWJI induced anaphylaxis and screen the allergic source of CWJI.
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Objective To investigate the protective effect of Ciwujia Injection (CI) on the decrease of cardiac contractile function induced by doxorubicin hydrochloride, and provide experimental basis for its clinical application. Methods The cardiotoxicity model in rats was established by ip injection of doxorubicin hydrochloride with a dose of 2.5 mg/kg every week for 6 weeks, and the total cumulative dose was 15 mg/kg. Rats were equally divided into five groups with 10 rats in each group (e.g. model group, three test groups of CI, positive group). In addition, a normal control group of 10 rats was injected intraperitoneally with normal saline (NS) once a week for 6 weeks. Normal control and model group were given NS intravenously. The test groups were given CI and the positive group was given Shenqi Fuzheng Injection. The CI and Shenqi Fuzheng Injection were infused by tail vein for 1 h when doxorubicin hydrochloride administrated. The parameters of left ventricular systolic function including ejection fraction (EF), shortening fraction (FS), the maximal rate of rise of left ventricular pressure (+LVdp/dtmax), and heart geometric shape were measured. Cardiomyocyte apoptosis was measured with immunohistochemistry, apoptosis-related protein and oxidative stress factors such as SOD, MDA, and LPO were measured with enzyme-linked immune sorbent assay, or chemical method. The ultrastructural changes of myocardium under electron microscope were observed. Results Compared with model group, after CI treatment (50, 100, and 200 mg/kg), the cardiac systolic function was improved; the declined EF, FS, and + LVdp/dtmax increased (P < 0.05, 0.01). The heart geometric shape was improved significantly with CI treatment, the expanded LVIDs and LVVs decreased (P < 0.05, 0.01). CI can inhibit myocardial cell apoptosis (P < 0.01), the myocardial apoptosis rate decreased (P < 0.01), and the Bax/Bcl-2 decreased (P < 0.01). In addition, CI (100 and 200 mg/kg) can decline the generation of LPO, MDA and increase the activity of SOD. Conclusion CI can effectively relieve cardiotoxicity induced by doxorubicin hydrochloride in rats, increase cardiac function, improve the cardiac configuration, and reduce the damage of myocardial ultrastructure. The mechanism may be related to decreasing oxidative stress and inhibition of apoptosis in impaired myocardial cells.
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Objective To study the efficacy of Ciwujia injection combined with electric acupuncture in the treatment of arteria vetaebralis vertigo.Methods 66 cases with arteria vertebralis vertigo were randomly recruited into a control group with 30 cases and a treatment group with 36 cases.The treatment group was administered with Ciwujia injection and electric acupuncture for 10 days,and the control group was administered with flunarizine and Danshen injection for 10 days.Resuits After 10 days'therapy,thetotal effective rate and the cure ratewas 91.7%and 30.6%in the treatment group,and the total effective rate and the cure rate was 63.3%and 16.7%in the control group.There was statistical diflerence between the two groups(P＜0.05).Conclusion The therapy of Ciwujia injection and electric acupuncture has good effect in treating arteria vertebralis vertigo.
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Objective To investigate the clinical effects of treatment of chronic pulmonary heart disease (CPHD) at acute stage with sodium ferulate and Ciwujia injection. Methods 90 cases of CPHD at acute stage were recruited into treatment group 1, treatment group 2 and control group. The control group was treated with consistent inhalation of oxygen,antibiotics, and symptomatic therapies like relieving cough, removing sputum, and stopping wheeze. The treatment group 1was treated with sodium ferulate, Ⅳ 0.2g, once daily for successive 14days, in addition to the conventional treatment. The treatment group 2 was treated with Ciwujia Injection, 100ml Ⅳ, once daily for successive 14 days. Observe the curative effect and the changes of blood gas analysis indexes (PAo2, PaCO2, SAO2) and bemorheological indexes (whole blood high-cutting viscosity, whole blood low-cutting viscosity, whole blood recovery viscosity, erythrocyte aggregation index, and HCT) before and after treatment. Result Compared with the control group, both treatment groups got improvement in blood gas analysis indexes and hemorheological indexes and curative effect, but no significant difference between the two groups (P＞0.05).Conclusion both sodium ferulate and Ciwujia injection had good results in treating CPHD at acute stage, and there was no difference between the two medicines in terms of curative effects.
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Objective To establish the determination method of syringin and syringaresinol in Ciwujia Injection with RP-HPLC. Methods C18 ODS was used as a stationary phase. The mobile phase consists of water and acetonitrile. The gradient condition was 0→20 min, A:90%→50%. The flow rate was 1.0 mL/min. The detective wavelength was set at 220 nm. Results The linear range of syringin was 0.03～0.16 ?g (r =0.999 7, n=5) and the linear range of Syringaresinol was 0.02～0.13 ?g (r =0.999 3, n=5). The average recovery of syringin was 99.34% and RSD=0.58%. The average recovery of Syringaresinol was 99.22% and RSD=0.71%. Conclusions The method was simple, convenient and accurate, and can be used for content determination of syringin and syringaresinol in Giwujia injection.
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Objective:To investigate the effect of ciwujia Injection and Jiangxianmei combination for acute cerebral infarction. Methods:86 patients with cerebral infarction were divided into 2 groups. 43 cases in the treatment group were dripped intravenously with 60ml ciwujia Injection and 250ml physiological saline. 43 cases in the control group were treated only with Jiangxianmei. Both of groups were also treated with other therapeutic method. The hemorheology and blood fat of patients in two groups before and after treatment were determined. Results:The cure rate of the treatment groups in two weeks was 41.86%, which is superior to the control group (20.93%) ( x 2=4.37,P0.05). The treatment group was superior to the control group in improving hemorheological index and blood fat metabolism ( P