Qishen Yiqi Dripping Pills for Cardiovascular Diseases: Effects and Mechanisms / 中国结合医学杂志

Qishen Yiqi Dripping Pills (QSYQ) is a compound of Chinese medicine, which has been used to treat coronary heart disease and cardiac dysfunction. Its natural components include astragaloside IV, flavonoids, danshensu, protocatechualdehyde, salvianolic acid B, salvianolic acid A, ginsenosides Rg1, ginsenosides Rb1, and essential oils, etc. It exerts effects of nourishing qi and promoting blood circulation to relieve pain. In this review, the bioactive components of QSYQ and its effects for treating cardiovascular diseases and possible mechanism were summarized, providing references for further study and clinical application of QSYQ.

Molecular mechanism of Qishen Yiqi Dripping Pills in treating myocardial ischemia:a study based on HIF-1 signaling pathway / 中国中药杂志

Qishen Yiqi Dripping Pills(QSYQ) are used clinically to treat various myocardial ischemic diseases, such as angina pectoris, myocardial infarction, and heart failure; however, the molecular mechanism of QSYQ remains unclear, and the scientific connotation of traditional Chinese medicine(TCM) compatibility has not been systematically explained. The present study attempted to screen the critical pathway of QSYQ in the treatment of myocardial ischemia by network pharmacology and verify the therapeutic efficacy with the oxygen-glucose deprivation(OGD) model, in order to reveal the molecular mechanism of QSYQ based on the critical pathway. The key targets of QSYQ were determined by active ingredient identification and target prediction, and underwent pathway enrichment analysis and functional annotation with David database to reveal the biological role and the critical pathway of QSYQ. Cell counting Kit-8(CCK-8), lactate dehydrogenase(LDH), and Western blot tests were launched on high-content active ingredients with OGD cell model to reveal the molecular mechanism of QSYQ based on the critical pathway. The results of network pharmacology indicated that QSYQ, containing 18 active ingredients and 82 key targets, could protect cardiomyocytes by regulating biological functions, such as nitric oxide biosynthesis, apoptosis, inflammation, and angiogenesis, through TNF signaling pathway, HIF-1 signaling pathway, PI3 K-Akt signaling pathway, etc. HIF-1 signaling pathway was the critical pathway. As revealed by CCK-8 and LDH tests, astragaloside Ⅳ, salvianic acid A, and ginsenoside Rg_1 in QSYQ could enhance cell viability and reduce LDH in the cell supernatant in a concentration-dependent manner(P<0.05). As demonstrated by the Western blot test, astragaloside Ⅳ significantly down-regulated the protein expression of serine/threonine-protein kinase(Akt1) and hypoxia-inducible factor 1α(HIF-1α) in the HIF-1 signaling pathway, and up-regulated the protein expression of vascular endothelial growth factor A(VEGFA). Salvianic acid A significantly down-regulated the protein expression of upstream phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(PIK3 CA) and downstream HIF-1α of Akt1. Ginsenoside Rg_1 significantly down-regulated the expression of HIF-1α protein and up-regulated the expression of VEGFA. The therapeutic efficacy of QSYQ on myocardial ischemia was achieved by multiple targets and multiple pathways, with the HIF-1 signaling pathway serving as the critical one. The active ingredients of QSYQ could protect cardiomyocytes synergistically by regulating the targets in the HIF-1 signaling pathway to inhibit its expression.

Clinical Observation of Rosuvastatin Calcium Tablets Combined with Qishen Yiqi Dripping Pills in the Treatment of Chronic Heart Failure / 中国药房

OBJECTIVE:To investigate clinical efficacy and safety of Rosuvastatin calcium tablets combined with Qishen yiqi dripping pills in the treatment of chronic heart failure (CHF) and it effects on inflammatory level,oxidative stress injury and cardiac function of patients.METHODS:Ninety CHF patients in our hospital during Aug.2014-Apr.2016 were divided into observation group and control group according to random number table,with 45 cases in each group.Control group received routine anti-heart failure treatment as cardiac,diuretic,dilating vessel,and Qishen yiqi dripping pills orally 0.5 g,half an hour after meal,tid;observation group was additionally given Rosuvastatin calcium tablet orally 20 mg,at bedtime,qd,on the basis of control group.Cardiac function,serum inflammatory factor,BNP and oxidative stress levels were compared between 2 groups before and after treatment.Clinical efficacies and the occurrence of ADR were observed in 2 groups.RESULTS:Before treatment,there was no statistical significance in LVEF,LVESD,LVEDD,TNF-α,IL-6,BNP,SOD,MPO and MMP-9 levels between 2 groups (P＞0.05).After treatment,LVEF of 2 groups were increased significantly,while LVEDD,LVESD,TNF-α and IL-6,BNP levels were decreased significantly;the above indexes of observation group was significantly better than those of control group,with statistical significance (P＜0.05).MPO and MMP-9 of observation group were significantly decreased,while SOD level was significantly increased and better than that of control group,with statistical significance (P＜0.05),but there was no statistical significance in SOD and MPO,MMP-9 levels of control group before and after treatment (P＞0.05).The clinical response rate of observation group was 97.8％,which was significantly higher than 82.2％ of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Rosuvastatin calcium tablets combined with Qishen yiqi dripping pills show significant therapeutic efficacy for CHF,can effectively reduce inflammatory level,relieve oxidant stress injury,delay the process of ventricular remodeling,and improve cardiac function with good safety.