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Objective:This study aimed to systematically evaluate the efficacy of Chinese medicine injection (CMI) in the treatment of heart failure (HF) after acute myocardial infarction (AMI).Methods:China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, The Cochrane Library, PubMed, and EMbase databases were electronically searched from inception to October 2021 to identify randomized controlled trials (RCTs) on CMI for treating HF after AMI. Two reviewers independently screened literature, extracted data, and evaluated the bias risk of included studies. Network meta-analysis was then performed by ADDIS1.16.6 software and Stata 16.0 software.Results:A total of 55 studies were included involving 4 760 patients with HF after AMI and 3 types of CMIs, including Shenmai, Shenfu, Xinmailong injections. The results of network meta-analysis showed that Xinmailong injection was superior to Shenmai injection and Shenfu injection in improving the total effective rate and reducing left ventricular end diastolic diameter (LVEDD); Shenmai injection was superior to Xinmailong injection and Shenfu injection in reducing B-type natriuretic peptide (BNP); Shenfu injection was superior to Shenmai injection and Xinmailong injection in increasing left ventricular ejection fraction (LVEF) and reducing heart rate (HR).Conclusions:The combined 3 types of CMIs for treating HF after AMI can improve the clinical efficacy when compared with conventional Western medicine treatment. Among them, Xinmailong injection is better in improving the total effective rate and reducing LVEDD, Shenmai injection is more advantageous in reducing BNP, and Shenfu injection has the best efficacy in improving LVEF and reducing HR.
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To systematically evaluate the clinical efficacy and safety of Xinmailong Injection in the treatment of heart failure after acute myocardial infarction. Seven Chinese and English databases, namely CNKI, VIP, Wanfang, SinoMed and PubMed, EMbase, Cochrane Library, were retrieved from the establishment of the database to March 2020. Randomized controlled trials for Xinmailong Injection in the treatment of heart failure after acute myocardial infarction were screened out. Cochrane collaboration network bias risk assessment tool was used to evaluate the literature quality of the studies included, and RevMan 5.3 software was used for Meta-analysis. A total of 926 relevant literatures were retrieved, and 12 studies were finally included, involving 972 patients, including 486 patients in the treatment group and 486 patients in the control group. The quality of the literatures included was generally low. The results of Meta-analysis showed that Xinmailong Injection combined with Western medicine could decrease the levels of BNP(SMD=-5.90, 95%CI[-8.45,-3.36], P<0.000 01) and NT-proBNP(SMD=-2.28, 95%CI[-3.13,-1.43], P<0.000 01) and decrease the levels of cTnI(SMD=-2.91, 95%CI[-4.21,-1.60], P<0.000 1), increase LVEF(MD=4.67, 95%CI[4.19, 5.16], P<0.000 01), increased 6 MWT(MD=73.90, 95%CI[67.51, 80.28], P<0.000 01], decreased LVEDD(MD=-5.46, 95%CI[-9.66,-1.25], P=0.01), reduce the level of serum inflammatory factor(hs-CRP, CRP, IL-6). In terms of safety, less adverse reactions occurred in the study, with no impact on the treatment. The results showed that clinical use of Xinmailong Injection combined with Western medicine in the treatment of heart failure after acute myocardial infarction can further alleviate clinical symptoms and relevant indexes, with less adverse reactions. However, due to the limitations in quantity and quality of the clinical studies included, the positive results can only be used as a hint and reference for clinical diagnosis and treatment, and more high-quality studies are needed to further confirm its efficacy.
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Humans , Drugs, Chinese Herbal/therapeutic use , Heart Failure/drug therapy , Injections , Myocardial Infarction/drug therapyABSTRACT
Objective Observation of the effects of Xinmailong injection on NGAL, hs-cTnT and RAAS in elderly patients with type 2 cardio-renal syndrome (CRS) , and EvaluatIon of the clinical efficacy and safety.Methods A total of 86 elderly patients who were collected from November 2015 to February 2017 were diagnosed as type 2 CRS in our department of geriatrics. According to the random number table method, they were randomly divided into two groups. Control group (43 cases) were treated with conventional medical therapy and xinmailong group (43 cases) were treated with xinmailong injection with a dose of 5 mg/kg twice a day for 15 days. The value of sneutrophil gelatin-associated apolipoprotein (NGAL) , hypersensitive troponin T (hs-cTnT) , brain natriuretic peptide (BNP) , plasma renin activity (PRA) , and angiotensin Ⅱ (Ang Ⅱ) , aldosterone (ALD) , left ventricular ejection fraction (LVEF) , six-minute walking test and other indicators were measured before and after treatment. Results After treatment, the value of NGAL, hs-cTnT, BNP, PRA, AngⅡ and ALD decreased in both groups, the value of LVEF and six-minute walking distance increased compared with those before treatment (P <0.05); The above indicators in the xinmailong group experienced a more significant alteration than in control group in the same period (P < 0.05); no side effect occurred in both two groups during the experiment. Conclusion Xinmailong injection can reduce the levels of NGAL, hs-cTnT and BNP in elderly patients with type 2 cardio-renal syndrome, improve heart and kidney function, and have curative positive effect and good safety. This study underlined the mechanism of Xinmailong injection may be related to the inhibition of RAAS activity.
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OBJECTIVE:To investigate the effectiveness and economy of Xinmailong injection combined with basic treatment plan in the treatment of heart failure with reduced left ventricular ejection fraction (HFREF).METHODS:In prospective randomized central group and open programmatic clinical trials,HFREF patients enrolled in 27 general hospitals during Feb.2014-Nov.2016 were divided into control group (n=253) and trial group (n=872) according to 1∶3.Control group received basic treatment,while trial group was additionally given Xinmailong injection intravenously for a treatment course (5 d) at least.Cost-effectiveness analysis was conducted from the perspective of the whole society by using the total response rate of cardiac functional grading,left ventricular ejection fraction (LVEF) improved data,Minnesota heart failure quality scale (MLHFQ) improved data and re-hospitalization rate.RESULTS:Total response rates of cardiac functional grading in control group and trial group were 61.54％ and 81.06％ in 3 months.The improved data of LVEF were about 3.05％ and 7.35％;MLHFQ improved data were 24.39 and 26.63,and re-hospitalization rates were 19.43％ and 10.02％.There were statistical significance in 2 groups (P＜0.05),which indicated that clinical efficacy of trial group was better than that of control group.Pharmacoeconomics results showed that cost-effectiveness ratio of positive indicators as the improved data of LVEF and chronic cardiac insufficiency QOL scale (MLHFQ) in trial group were lower than control group (189.35 vs.243.46,576.38 vs.614.29).The cost-effectiveness ratio of re-hospitalization rate and fatality rate in trial group were higher than control group (2 019.61 vs.925.42).CONCLUSIONS:Xinmailong injection combined with basic treatment plan is better than basic treatment plan in the treatment of HFREF,and shows a better economy in cost-effectiveness analysis.
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Objective: To study the influence of Xinmailong injection (XML) on the isolated thoracic aorta of rats in different states.Methods: A cumulative dosing method was utilized to evaluate the influence of XML on the isolated thoracic aorta of rats in resting state, and KCl or noradrenaline (NA) induced contracted state.Different tool drugs were used to analyze the mechanism of the effects.Results: Compared with the control group, a specific concentration range of XML could excite the isolated thoracic aorta in resting state, further increase the vascular tension after KCl action, while decrease the vascular tension after NA action.The vasodilative effect of XML on blood vessel after NA action was inhibited by propranolol and diclofenac, while showed no influence from Nω-Nitro-L-arginine.Conclusion: XML has different effects on the isolated thoracic aorta of rats in different states, and the mechanisms of the effects are related to calcium channel, β-receptor and prostaglandins.
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OBJECTIVE:To observe clinical efficacy and safety of Xinmailong injection combined with trimetazidine in the treatment of chronic heart failure of coronary heart disease(CHD)(Qi Yang deficiency ). METHODS:A total of 80 patients with Qi Yang deficiency chronic heart failure of CHD were selected from our hospital during Jan. 2011-Dec. 2105 were divided into ob-servation group and control group according to random number table,with 40 cases in each group. Both groups received routine treatment. Control group was additionally given Trimetazidine dihydrochloride tablets 20 mg,tid,for consecutive 6 months,on the basis of routine treatment. Observation group was additionally given Xinmailong injection 5 mg/kg added into 0.9％ Sodium chlo-ride injection 500 mL,ivgtt,at speed of 30 drops/min,bid,medication interval>6 h,for consecutive 5 days,on the basis of con-trol group. Efficacies of cardiac function improvement,TCM symptom efficacies as well as LVEF before and after treatment were observed in 2 groups. The occurrence of ADR was compared between 2 groups. RESULTS:Total response rates of cardiac function and TCM symptom were 90.00％ and 95.00％ in observation group,which were significantly higher than 62.50％ and 55.00％ of control group,with statistical significance (P0.05). After treatment,LEVF levels of 2 groups were increased significantly,and the observation group was signifi-cantly higher than the control group,with statistical significance(P0.05). CONCLUSIONS:Xinmailong injection combined with trimetazidine in the treatment of Qi Yang deficiency chronic heart failure of CHD show significant therapeutic efficacy and improve LEVF level with good safety.
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Objective To investigate the effect of Xinmailong injection combined with Qiliqiangxin capsule on serum BNP , NF-kappa B and cystatin C in the treatment of chronic heart failure in the elderly .Methods 78 cases of elderly patients with chronic heart failure were selected and randomly divided into two groups according to the random number table, 39 cases in each group.All patients received basic treatment, the control group received standard treatment, and the study group received more with Xinmailong injection combined with Qiliqiangxin capsule,and levels of serum B-type natriuretic peptide(BNP), cystatin C(CysC) and NF-κB were compared, left ventricular function and 6 min walking test were detected and the clinical curative effect were compared after the treatment.Results Compared with before treatment, levels of serum BNP, CysC and NF-κB in 2 groups decreased(P<0.01), left ventricular ejection fraction(LVEF) increased(P<0.05), left ventricular end-systolic volume(LVESV) reduced(P<0.05), 6 min walking distance increased(P<0.01), scores of symptom decreased(P<0.01), compared with the control group, levels of serum BNP, CysC and NF-κB in study group were lower, LVEF were higher ( P<0.05 ) , levels of LVEDV and LVESV were lower ( P<0.05 ) , scores of 6 min walking distance were higher(P<0.01), scores of symptom were lower (P<0.01), the effective rate was higher(P<0.05).Conclusion Xinmailong injection combined with Qiliqiangxin capsule in the treatment of chronic heart failure in the elderly was effective , and it can improve left ventricular function, the possible mechanism related to the decrease of BNP, CysC and NF-κB levels.
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Objective:To observe the effect of Xinmailong injection (XI) on free calcium ( Ca2+) content in rat myocardial cells. Methods:Free Ca2+content in rats treated with various dosages of XI were measured by fluorospectrophotometry. Results:Xinmailong injection significantly increased free Ca2+content and the content was 169.18?11.64, 233.26?10.69 and 164.25?10.34 nmol?L-1 in 0.19 g?L-1 , 0.38 g?L-1 and 0.76 g?L-1 XI group respectively, the differences being significant as compared with 120.64?3.02 nmol?L-1 in the control group (P