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OBJECTIVE：To systematically evaluate therape utic efficacy of Yixinshu preparation combined with conventional treatment plan for angina pectoris of coronary heart disease （CHD）vs. conventional treatment plan ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from Cochrane library ，PubMed，Embase，CBM，CNKI，Wanfang database and VIP ，randomized controlled trials （RCTs）about Yixinshu preparation combined with conventional treatment plan （trial group ） versus conventional treatment plan （control group ）for angina pectoris of coronary heart disease were collected during Jan. 1st in 2012 to Oct. 1st in 2020. After extracting the data ，the quality of included studies were evaluated with Cochrane System Evaluator Handbook 5.3；Meta-analysis was performed by using Stata 15.0 software. RESULTS ：A total of 23 RCTs involving 2 853 subjects were included. The results of Meta-analysis showed that the efficacy of angina pectoris [RR ＝0.92，95％CI（0.87，0.97），P＜0.05]， the times of angina pectoris attack [SMD ＝－0.98，95％CI（－1.09，－0.87），P＜0.05]，the duration of angina pectoris [SMD ＝ －0.77，95％CI（－0.88，－0.67），P＜0.05]，ECG curative effect [RR ＝0.91，95％CI（0.84，0.98），P＜0.05] and the improve rate of TCM syndromes [RR ＝0.89，95％CI（0.85，0.94），P＜0.05] in trial group were all better than control group ，with statistical significance. CONCLUSIONS ：Yixinshu preparation combined with conventional treatment plan is better than conventional treatment plan in terms of improving therapeutic efficacy of angina pectoris and ECG ，TCM syndrome improvement rate ，as well as reducing the frequency of angina pectoris attack ，angina pectoris attack duration.
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OBJECTIVE： To systematically evaluate the difference in therapeutic efficacy， safety and cardiac function of Chinese patent medicine injection for promoting blood circulation and removing blood stasis combined with routine treatment after percutaneous coronary intervention （PCI）， and to provide evidence-based reference for clinical drug use. METHODS： Retrieved from Cochrane library， PubMed， Embase， CNKI， Wanfang database and Chinese sci-tech periodicals database， RCTs about different Chinese patent medicine injection for promoting blood circulation and removing blood stasis combined with routine treatment （trial group） versus routine treatment （control group） after PCI were collected. After screening the literature and extracting the data， the quality of the included studies was evaluated by modified Jadad scale. Bayesian network Meta- analysis was performed by using Stata 14.0 software and Markov Chain-Monte Carlo method. RESULTS： A total of 15 RCTs involving 1 364 patients were included， involving Salvia miltiorrhiza injection， Puerarin injection， Yiqi fumai injection， Xuebijing injection， Shenfu injection， Shuxuetong injection， Salvia miltiorrhiza and ligustrazine injection， Rhodiola wallichiana injection， Danhong injection. Results of Meta-analysis showed that in the aspect of improving total response rate of ECG， 8 kinds of intervention measures were involved；compared with control group， 7 kinds of intervention measures could improve the total response rate of ECG of trial group except for Shenfu injection （P＞0.05）； network Meta-analysis ranking showed that S. miltiorrhiza injection＞Puerarin injection＞Shenfu injection＞S. miltiorrhiza and ligustrazine injection＞Shuxuetong injection＞R. wallichiana injection＞ Danhong injection＞routine treatment. In terms of reducing adverse cardiovascular events （MACE） incidence，8 kinds of intervention measures were involved； compared with control group， 7 kinds of intervention measures could reduce the MACE incidence of trial group except for Puerarin injection （P＞0.05）； network Meta-analysis ranking showed that S. miltiorrhiza and ligustrazine injection＞Danhong injection＞Xuebijing injection＞Shuxuetong injection＞S. miltiorrhiza injection＞R. wallichiana injection＞ Puerarin injection＞routine treatment. In terms of improving left ventricular ejection fraction （LVEF） after treatment， 8 kinds of intervention measures were involved； compared with control group， 7 intervention measures could significantly improve LVEF after treatment of trial group except for R. wallichiana injection (P＞0.05）； network Meta-analysis ranking showed that S. miltiorrhiza and ligustrazine injection＞Yiqi fumai injection＞Danhong injection＞Shenfu injection＞S. miltiorrhiza injection＞Shuxuetong injection＞R. wallichiana injection＞routine treatment. CONCLUSIONS： Compared with routine treatment， S. miltiorrhiza injection is the best in improving total response rate of ECG； S. miltiorrhiza and ligustrazine injection is the best in reducing MACE incidence and improving LVEF after treatment.
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OBJECTIVE： To study the effects of Tiaopi huxin prescription （TPHXP） on the atherosclerosis （AS） of ApoE－/－ mice， and to investigate its mechanism. METHODS： Forty male ApoE－/－ mice were divided into blank group， model group， simvastatin group （positive control， 5 mg/kg） and TPHXP low-dose and high-dose groups （50， 150 mg/kg）， with 8 mice in each group. Except that blank group was given common diet， other groups were given high-lipid diet to induce AS model. After modeling， administration groups were given relevant medicine intragastrically， and blank group and model group were given constant volume of normal saline intragastrically， once a day， for consecutive 12 weeks. After last medication， the serum levels of TC， TG， LDL-C and HDL-C were determined by spectrophotometry. The serum level of NO was detected by nitrate reduction method. The serum levels of IL-6 and VCAM-1 were determined by ELISA. After separating thoracic aorta， HE staining was used to observe the formation of plaque in the thoracic aorta of mice in each group， and the corrected plaque area was calculated. Western blotting was conducted to determine the expression of NF-κB p65， Cav-1 and eNOS. RESULTS： Compared with blank group， the serum levels of TC， TG， LDL-C， IL-6 and VCAM-1 were increased significantly in model group， while the levels of HDL-C and NO were decreased significantly （P＜0.01）. The plaque of thoracic aorta was obvious and the corrected plaque area were increased significantly （P＜0.01）. The relative expression of NF-κB p65 and Cav-1 were increased significantly， while the relative expression of eNOS was decreased significantly （P＜0.01）. Compared with model group， the serum levels of TC， TG and LDL-C in administration groups， the serum levels of IL-6 and VCAM-1 in simvastatin group and TPHXP high-dose group were decreased significantly， while the serum levels of HDL-C and NO were increased significantly in administration groups （P＜0.05 or P＜0.01）. In administration groups， the plaques of thoracic aorta were reduced and the corrected plaque area was decreased significantly （P＜0.05 or P＜0.01）； the relative expression of NF-κB p65 and Cav-1 were decreased significantly， while the relative expression of eNOS was increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS： TPHXP can regulate the level of blood lipid， decrease the level of inflammatory factors and inhibit the formation of AS plaque， the mechanism of which may be associated with inhibiting Cav-1/NF-κB pathway.
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Activation of inflammatory responses regulates the transmission of pain pathways through an integrated network in the peripheral and central nervous systems. The immunopotentiator thymosin alpha-1 (Tα1) has recently been reported to have anti-inflammatory and neuroprotective functions in rodents. However, how Tα1 affects inflammatory pain remains unclear. In the present study, intraperitoneal injection of Tα1 attenuated complete Freund's adjuvant (CFA)-induced pain hypersensitivity, and decreased the up-regulation of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) in inflamed skin and the spinal cord. We found that CFA-induced peripheral inflammation evoked strong microglial activation, but the effect was reversed by Tα1. Notably, Tα1 reversed the CFA-induced up-regulation of vesicular glutamate transporter (VGLUT) and down-regulated the vesicular γ-aminobutyric acid transporter (VGAT) in the spinal cord. Taken together, these results suggest that Tα1 plays a therapeutic role in inflammatory pain and in the modulation of microglia-induced pro-inflammatory cytokine production in addition to mediation of VGLUT and VGAT expression in the spinal cord.
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OBJECTIVE:To systematically evaluate therapeutic efficacy of modified Shenqi dihuang decoction in the treatment of chronic glomerular nephritis. METHODS:Retrieved from Wanfang database,CNKI,VIP,CBM,Cochrane Library,Medline, EMBase and PubMed,randomized controlled trials(RCTs)about modified Shenqi dihuang decoction combined with conventional therapy and (or) other Chinese patent medicine (trial group) vs. conventional therapy and (or) other Chinese patent medicine (control group)in the treatment of chronic glomerular nephritis were collected. Meta-analysis was carried out by using Rev Man 5.3 software after literature scanning,data extraction and quality evaluation. Stata 14.0 software was used to conduct Egger test to evaluate publication bias. If publication bias existed,the effect of publication bias on outcome was further evaluated by scissor compensation. TSA v0.9 software was used for trial sequential analysis(TSA)of total efficency. RESULTS:A total of 10 RCTs were included,involving 707 patients. The results of Meta-analysis showed that total response rate of trial group [RR＝1.40,95%CI(1.22, 1.61),P＜0.001] was significantly higher than that of control group; the level of urine protein [SMD＝－1.97,95%CI(－2.92,－1.03),P＜0.001] and Scr [MD＝－28.41,95%CI(－38.95,－17.87),P＜0.001] in trial group were significantly lower than control group,with statistical significance. Publication bias test of total response rate was conducted,and results of it showed that there was publication bias,but bias did not affect the results of this study. TSA analysis showed that the evidence of Meta-analysis was false positive. CONCLUSIONS:Therapeutic efficacy of modified Shenqi dihuang decoction for chronic glomerular nephritis need to be proved by more stringent RCTs.
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OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of Toutongning combined with flunarizine vs. flunarizine in the treatment of migraine,and to provide evidence-based reference in clinic. METHODS:Retrieved from PubMed,Cochrane library,Embase,Chinese Journal Full-text Database,Chinese Sci-tech Periodicals Database,Wanfang database and CBM,randomized controlled trials(RCTs)about therapeutic efficacy(total response rate,VAS score,blood potassium and blood magnesium concentration,CGRP level)and safety(the incidence of ADR)of Toutongning combined with flunarizine(trial group)vs. flunarizine in the treatment of migraine(control group)were collected. Meta-analysis of included trials meet inclusion criteria was conducted by using Stata 14.0 software,and trial sequential analysis(TSA)was conducted by using TSA 0.9 software after data extraction and quality evaluation with Cochrane 5.1.0 bias risk evaluation tool and Jadad scale. RESULTS:Totally 16 RCTs were included,involving 1 726 patients. Results of Meta-analysis showed that total response rate [RR=1.21,95%CI(1.16, 1.26),P<0.05],the decrease of VAS score [WMD=-1.04,95%CI(-1.42,-0.66),P<0.001],the decrease of blood potassium [WMD=-2.05,95%CI(-0.32,-0.18),P<0.001],the increase of blood magnesium [WMD=0.09,95%CI(0.04,0.14),P<0.001] and the decrease of CGRP [WMD=-2.22,95%CI(-3.25,-1.18),P<0.001] in trial group were better than control group,with statistical significance. The incidence of ADR in trial group was 2.27% in trial group and 2.89% in control group, without statistical significance(P>0.05). TSA showed that there were extract evidences for total response rate of Toutongning combined with flunarizine in the treatment migraine. CONCLUSIONS:Therapeutic efficacy of Toutongning combined with flunarizine is better than flunarizine in the treatment of migraine,and the ADR is not increased.
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OBJECTIVE:To evaluate the clinical efficacy and safety of Shenqi fuzheng injection combined with chemotherapy in the treatment of colorectal cancer.METHODS:Retrieved from PubMed,EMBase,Clinical Trials,Cochrane Library,CJFD,CBM,Wanfang database and VIP,RCTs about Shenqi fuzheng injection combined with chemotherapy (trial group) vs.chemotherapy alone (control group) in the treatment of colorectal cancer were included.Meta-analysis was performed by Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual.RESULTS:A total of 25 RCTs were included,involving 1 987 patients.Results of Meta-analysis showed that objective remission rate of trial group was significantly higher than control group [RR=1.19,95％ CI (1.02,1.39),P=0.02];the improvement of survival quality was significantly better than control group [RR=1.72,95％CI(1.49,1.99),P＜0.001];CD4VCD8+ was significantly higher than control group [MD=0.40,95％ CI (0.29,0.50),P＜0.001];the incidence of gastrointestinal reaction was significantly higher than control group [RR=0.59,95％CI(0.52,0.68),P＜0.001];the incidence of liver and renal injury was significantly lower than control group [RR=0.52,95％CI(0.41,0.67),P＜0.001],with statistical significance.CONCLUSIONS:Shenqi fuzheng injection combined with chemotherapy can improve objective remission rate of colorectal cancer patients,survival quality and immune function,and reduce the occurrence of toxic reation.
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OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of Yupingfeng powder in adjavant therapy of allergic rhinitis,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from Wanfang database,VIP,CJFD,CBM,Cochrane Library,EMBase and PubMed,RCTs about Yupingfeng powder combined with chemical medicine (trial group)vs. chemical medicine alone in the treatment of allergic rhinitis were collected. Meta-analysis was conducted by using Rev Man 5.2 statistical software after data extraction and quality evaluation according to Cochrane system evaluation method 5.1.0. RESULTS:A total of 15 RCTs were included,invovling 1366 patients. The results of Meta analysis showed that response rate [OR=3.95,95%CI(2.80,5.58),P<0.001],recurrence rate [OR=0.37,95%CI(0.22,0.63),P<0.001] and the incidence of ADR [OR=0.15,95%CI(0.06,0.35),P<0.001] in trial group were significantly higher than control group,with statistical significance. CONCLUSIONS:Yupingfeng powder in adjuvant therapy of allergic rhinitis show good therapeutic efficacy and can reduce recur-rence rate with good safety.
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OBJECTIVE:To systematically evaluate therapeutic efficacy of Xuefu zhuyu decoction in the adjuvant treatment of unstable angina pectoris (UAP),and to provide systematic evidence-based reference in clinic.METHODS:Retrieved from PubMed,EMBase,Cochrane library,CJFD,Wanfang database,VIP and CBM,randomized controlled trials (RCTs) about Xuefu zhuyu decoction+conventional treatment (trial group) vs.single conventional treatment (control group) in the treatment of UAP were collected.Meta-analysis was performed by using Rev Man 5.2 statistical software after data extraction and Cochrane systematic review manual 5.1.0.RESULTS:Totally 12 RCTs were included,involving 1 252 patients.The results of Meta-analysis showed that total response rate [OR=3.56,95％CI(2.49,5.10),P＜0.001],serum HDL[WMD=0.25,95％CI(0.05,0.45),P=0.01] and the rate of ECG improvement [OR=2.76,95％CI(1.97,3.87),P＜0.001] of trial group were significantly higher than those of control group,while serum TC [WMD=-1.14,95％CI(-1.46,-0.82),P＜0.001],TG [WMD=-0.53,95％CI(-0.84,-0.22),P＜0.001] and CRP [WMD =-0.91,95 ％ CI (-1.14,-0.69),P＜ 0.001] levels of trial group were significantly lower than those of control group,with statistical significance.CONCLUSIONS:Therapeutic efficacy of Xuefu zhuyu decoction in adjuvant treatment have good therapeutic efficacy and can significantly improve the blood lipid and inflammatory factors level.
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OBJECTIVE:To systematically evaluate therapeutic efficacy of Xuefu zhuyu decoction in the adjuvant treatment of unstable angina pectoris (UAP),and to provide systematic evidence-based reference in clinic.METHODS:Retrieved from PubMed,EMBase,Cochrane library,CJFD,Wanfang database,VIP and CBM,randomized controlled trials (RCTs) about Xuefu zhuyu decoction+conventional treatment (trial group) vs.single conventional treatment (control group) in the treatment of UAP were collected.Meta-analysis was performed by using Rev Man 5.2 statistical software after data extraction and Cochrane systematic review manual 5.1.0.RESULTS:Totally 12 RCTs were included,involving 1 252 patients.The results of Meta-analysis showed that total response rate [OR=3.56,95％CI(2.49,5.10),P＜0.001],serum HDL[WMD=0.25,95％CI(0.05,0.45),P=0.01] and the rate of ECG improvement [OR=2.76,95％CI(1.97,3.87),P＜0.001] of trial group were significantly higher than those of control group,while serum TC [WMD=-1.14,95％CI(-1.46,-0.82),P＜0.001],TG [WMD=-0.53,95％CI(-0.84,-0.22),P＜0.001] and CRP [WMD =-0.91,95 ％ CI (-1.14,-0.69),P＜ 0.001] levels of trial group were significantly lower than those of control group,with statistical significance.CONCLUSIONS:Therapeutic efficacy of Xuefu zhuyu decoction in adjuvant treatment have good therapeutic efficacy and can significantly improve the blood lipid and inflammatory factors level.
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BACKGROUND: The change of the axial angle of the lower limb is related to the occurrence and development of osteoarthritis.OBJECTIVE: To analyze the correlation between the change of lower limb power line and pain area in the knee osteoarthritis patients.METHODS: Totally 65 knee osteoarthritis patients were selected as pain group and 30 healthy people were selected as control group. All the participants took anteroposterior and lateral knee radiographs through PACS imaging systems to collect six imaging indexes, including install index, the degree of tibiofemoral joint subluxation, tibiofemoral inside and outside joint clearance ratio, femoral angle, tibial angle and tibiofemoral angle. Knee osteoarthritis patients in pain group were divided into two common clinical pain areas which were proparea and medial area.RESULTS AND CONCLUSION: (1) The insall index, the degree of tibiofemoral joint subluxation, tibiofemoral inside andoutside joint clearance ratio between knee osteoarthritis patients in pain group and people in healthy control group hadsignificant differences. There was no statistical significance in the femoral angle, tibial angle and tibiofemoral angle. (2) In terms of the comparison between proparea and medial area in knee osteoarthritis patients in pain group, tibiofemoral joint subluxation degree was statistically different. (3) These findings suggest that there was a higher patella in knee osteoarthritis patients who were in pain, more severe in the degree of tibiofemoral joint subluxation, and more limited in tibiofemoral inside and outside joint clearance ratio. The degree of tibiofemoral joint subluxation of proparea was more severe than medial area in pain group.
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BACKGROUND:Nickel-titanium memory-shape compression anastomosis clip (Ni-Ti CAC) has been used in gastrointestinal anastomosis, but its efficacy and safety still remain controversial.OBJECTIVE:To evaluate the efficacy and safety of Ni-Ti CAC in gastrointestinal anastomosis.METHODS:A computer-based online research of PubMed, EMbase, Cochrane Library, CBM, CNKI, and VIP databases was performed for articles published before January 15th, 2017 using the keywords of nickel-titanium, compression anastomosis clip, anastomosis, gastric, jejunum, ileum, small intestine, colon, rectum, and large intestine in English and Chinese, respectively. The randomized controled trials about Ni-Ti CACversus conventional methods for gastrointestinal anastomosis were included. Meta-analysis of the anastomosis time, time of exsufflation, and hospitalization time was performed, and sequential analysis was conducted on TSA v0.9 software.RESULTS AND CONCLUSION:A total of 18 eligible randomized controlled trials were enroled, involving 1860 patients. Ni-Ti CAC could reduce the anastomosis time [MD=-3.83, 95%CI(-6.48,-1.19),P=0.004] and time of exsufflation [MD=-0.14, 95%CI(-0.22,-0.05),P=0.002], but there was no significant difference in the hospitalization time [MD=-0.83, 95%CI(-1.82, 0.16), P=0.10]. The quality was ranked as low level based on GRADE system. The time of exsufflation of Ni-Ti CAC was superior to that of conventional method, which was confirmed by sequential analysis. One case of death was reported and incision infection was the most common adverse effects; additionaly, pulmonary embolism and abdominal pain occurred. To conclude, Ni-Ti CAC can facilitate gastrointestinal anastomosis, accelerate the time of exsufflation, and holds a good safety. However, more multicenter and high-quality randomized controlled trials are needed.