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Based on the correlation between Qi and blood in traditional Chinese medicine， the collateral disease theory puts forward that the Qi-collateral go hand in hand with the vessel-collateral of the brain， and to be as close as lips to teeth in structure and function， which is an important basis for the function of brain governing mind. And this theory proposes that deficiency/stagnancy of collateral-Qi， stagnation of collaterals and loss of consciousness are the main pathogenesis of Alzheimer's disease（AD）， which is different from the research strategy of modern medicine focusing on neurons. It is suggested that it is necessary to treat AD from two aspects， including neuronal protection（elimination of pathological products such as β-amyloid and phosphorylated tau protein） and cerebral microvascular protection（protection of cerebral microvascular structure and function， promotion of therapeutic angiogenesis and increase of cerebral blood flow. Tongxinluo capsules is a representative drug for dredging collaterals developed under the guidance of the therapeutic principle of collaterals need circulation， it can protect microvessels and play a neuroprotective role mediated by vascular protection. Clinical studies have confirmed that Tongxinluo capsules can effectively treat AD， vascular dementia and cognitive impairment related diseases， which can provide new ideas and effective treatment ways to prevent and treat AD from neurovascular protection in a comprehensive manner.
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Objective:To evaluate the clinical efficacy rate, vascular endothelial relaxation factor NO and safety of five different Chinese patent medicines combined with western medicine in the treatment of coronary microvascular disease (CMVD).Methods:Randomized controlled trials (RCTs) of Shexiang Baoxin Pills, Tongxinluo Capsules, Compound Danshen Dripping Pills, Yindan Xinnaotong Soft Capsules, and Xinkeshu Tablets combined with conventional western medicine therapy in the treatment of CMVD were retrieved from China National Knowledge Infrastructure (CNKI), China Academic Journal Database (Wanfang Data), Chinese Science and Technology Journal Database (Chongqing VIP), China Biomedical Literature Service System (SinoMed), PubMed, Cochrance Library and Embase databases from the establishment of the database to June 2022. The literature was imported and screened by EndNote software, and the risk quality of literature bias was evaluated by Revman 5.4 software. StataSE16 (64-bit) software was used for reticular meta analysis to compare the differences in clinical efficacy and drug safety of five proprietary Chinese medicines combined with western medicine.Results:A total of 24 RCT studies were included, 24 of which were double-arm studies, and five kinds of proprietary Chinese medicine combined with western medicine were compared. The results of reticular meta analysis: in terms of improving the clinical effective rate, the order of the five proprietary Chinese medicine combination groups was as follows: Yindan Xinnaotong Soft Capsules group > Shexiang Baoxin Pills group > Tongxinluo Capsules group > Xinkeshu Tablets group > Compound Danshen Dripping Pills group. In terms of regulating vasodilation factor NO, the order of the four proprietary Chinese medicine combination groups is as follows: Yindan Xinnaotong Soft Capsules group > Compound Danshen Dripping Pills group > Tongxinluo Capsules group > Shexiang Baoxin Pills group. In terms of safety, there were 3 reports of adverse reactions in the research literature of the five proprietary Chinese medicines.Conclusions:The clinical efficacy rate of five kinds of proprietary Chinese medicine combined with western medicine routine regimen is better than that of western medicine routine regimen alone, and the combination group of four kinds of proprietary Chinese medicine is superior to western medicine in regulating vasodilation factor NO, and Yindan Xinnaotong Soft Capsules group is superior in clinical efficacy rate and regulation of vasodilation factor NO. However, the quality and samples of this study are different, and the comparison of the curative effect of the combined group of proprietary Chinese medicine still needs a large sample and high-quality RCT study to demonstrate.
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AIM To investigate the effects of Tongxinluo Capsules (Ginseng Radix et Rhizoma,Hirudo,Scorpio,etc.) combined with routine treatment on fibrinogen (Fib) and mean platelet volume (MPV) levels in appropriate patients for coronary artery bypass graft (CABG) surgery.METHODS One hundred and six patients were randomly assigned into control group (n =50) for routine treatment and observation group (n =56) for combination therapy of Tongxinluo Capsules and routine treatment.Both groups had their Fib and MPV levels evaluated,and safety compared.RESULTS Thirty,ninety days after the treatment,the two groups reported less incidence of composite cardiovascular events (refractory angina pectoris,relapsing myocardial infarction or death) (P ＜ 0.01),and the observation group had an even more obviously reduced plasma Fib level (P ＜0.01).The significantly decreased after-treatment MPV levels in the two groups were observed (P ＜ 0.05),and a most distinct decrease extent was found in the observation group after 90 d (P ＜ 0.05).For the bleeding events,the incidence rates of the observation group and the control group were 5.4％ and 4.0％,respectively.CONCLUSION For appropriate candidates of CABG surgery,Tongxinluo Capsules shows its efficacy in dissolving thrombus and improving clinical symptoms without serious bleeding risk.
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OBJECTIVE:To investigate the effects of Tongxinluo capsules on inflammatory cytokines of mice with diabetic pe-ripheral neuropathy. METHODS:40 KK/Upj-Ay mice were randomly divided into model group(pure water),and Tongxinluo low, medium and high dose groups [1,2 and 4 g (medicinial materials)/kg]. 10 C57BL/6 mice were selected into the control group (pure water). The drugs were given once a day for consecutive 12 weeks,ig. The pain perception threshold,motor nerve conduc-tion velocity(MNCV)and sensory nerve conduction velocity(SNCV)were detected for the mice 1 h after the last administration of drugs. The flow cytometry was used to detect the levels of tumor necrosis factor α(TNF-α),interleukin-1β(IL-1β),cyclooxy-genase 2(COX-2)and monocyte chemoattractant protein 1(MCP-1)in serum. Real-time fluorescent quantitative polymerase chain reaction(RT-PCR)and Western blot were respectively employed to detect the mRNA and protein expressions of TNF-α,IL- 1β, COX-2 and MCP-1 in the mice’s sciatic nerves. RESULTS:Compared with control group,pain perception threshold in model group was decreased;MNCV and SNCV were slowed;the levels of TNF-α,IL-1β,COX-2 and MCP-1 in serum were increased;the expressions of mRNA and protein of TNF-α,IL-1β,COX-2,MCP-1 were increased,with significant differences(P<0.01 or P<0.05). Compared with model group,pain perception threshold in Tongxinluo medium and high dose groups were increased;MNCV and SNCV were increased;the levels of TNF-α,IL-1β,COX-2 and MCP-1 in serum were decreased;the expressions of mRNA and protein of TNF-α,IL-1β,COX-2,MCP-1 in sciatic nerves were decreased;the expressions of mRNA of COX-2, MCP-1 and protein of IL-1β,COX-2,MCP-1 in sciatic nerves in Tongxinluo low dose group were decreased,there were statistical significant difference(P<0.01 or P<0.05). CONCLUSIONS:Tongxinluo capsules have certain protective effects on the mice with peripheral nerve in case of diabetes by a mechanism that may be associated with the inhibition of inflammatory cytokines.
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【Objective】To assess the efficacy and safety of Tongxinluo Capsules for cerebrovascular disorders by meta analysis.【Methods】Randomized controlled trials(RCT) of Tongxinluo Capsules for cerebrovascular disorders were got by searching China Journal Full-text Database(from 1996 to May,2006),China Best Doctoral and Master's Dissertations(from 1996 to May,2006),MEDLINE(from 1996 to May,2006),and Cochrane Library with computer,and were screened by manual search.RevMan 4.2 software and SAS were used in Meta-analysis.【Results】Thirty seven RCT were included,in which involved 2791 patients.Among them,1764 patients were treated with Tongxinluo Capsules,and other 1572 served as the controls. Meta-analysis results showed that the difference of the total efficacy in 31 RCT was significant(P