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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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Coronary heart disease (CHD) and stroke are the most well-known cardiovascular diseases, which share many common pathological basis. Yindan Xinnaotong soft capsule (YDXNT) is a commonly used Chinese patent medicine in the treatment of stroke and CHD. However, its action of mechanism of co-treatment for stroke and CHD is still unclear. The aim of this study was to explore the common mechanism of YDXNT in co-treatment of CHD and stroke using network pharmacology, experimental verification and molecular docking. An integrated literature mining and databases of IPA, ETCM, HERB, Swiss Target Prediction, OMIM and GeneCards were used to screen and predict active ingredients and potential targets of YDXNT in co-treatment of CHD and stroke. The protein-protein interaction network, GO analysis and pathway analysis were analyzed by IPA software. The effect of YDXNT on core targets was verified by immunofluorescence. UPLC-QTOF/MS and molecular docking were used to screen and predict the main active constituents of YDXNT and their interactions with core targets. A total of 151 potential targets are predicted for YDXNT in co-treatment of CHD and stroke. Hypoxia-inducible factor-1α (HIF1α)-matrix metalloproteinase-9 (MMP9)-mediated HIF1α signaling pathway serves as one of the common mechanisms. YDXNT could reduce the increase of mitochondrial fluorescence intensity and the protein expression of HIF1α and MMP9 in HL-1 and HA induced by oxygen and glucose deprivation/reperfusion (OGD/R) in a dose-dependent manner. Baicalin may be the material basis for treating stroke and CHD with YDXNT. In conclusion, the HIF1α signaling pathway is one of the common key mechanisms of YDXNT in the co-treatment of stroke and CHD. The study provides support and basis for the in-depth scientific connotation of the traditional Chinese medicine theory of "same treatment to different diseases".
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To estabish ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for simultaneous determination of quercetin(QCT), isorhamnetin(ISR), kaempferol(KMF), ginkgolide A(GA), ginkgolide B(GB), ginkgolide C(GC) and bilobalide(BB) in rat plasma and investigate the pharmacokinetic process of seven compounds after oral administration of Yindan Xinnaotong Ruanjiaonang, The results indicated that all calibrations curves showed good linearity (r≥0.997 1). RSD of intra-day and inter-day precisions were all within 11%. The matrix effects and extraction recovery were in the range of 93.28%-103.6% and 72.43%-95.77% respectively. The peak concentration (Cmax) of QCT, ISR, KMF, GA, GB, GC and BB were (45.02±11.28), (49.90±13.82), (27.85±8.38), (76.31±18.19), (76.54±15.43), (35.35±10.28), (48.70±12.34) μg•L⁻¹, respectively. The peak time (tmax) of seven constituents were (0.33±0.11), (0.50±0.23), (0.33±0.14), (0.75±0.29), (1.0±0.35), (1.5±0.23), (0.75±0.50) h, respectively. UPLC-MS/MS method established in this research was proved to be so rapid and sensitive that it can be applied to the pharmacokinetic study of seven bioactive constituents in Yindan Xinnaotong Ruanjiaonang.
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Objective To investigate the effects of Yindan Xinnaotong Soft Capsule on oxidative stress and vascular endothe‐lial function in the patients with type 2 diabetes mellitus(T2DM ) .Methods A total of 86 patients with T2DM were randomly di‐vided into the routine glucose‐reducing group(routine group ,40 cases) and the Yindan Xinnaotong Soft Capsule group(Yindan Xin‐naotong group ,46 cases) .On the basis of diet control and exercise ,the routine group was given the glucose‐reducing therapy for blood glucose reaching the standard for 12 successive weeks ,while on the basis of blood glucose reaching the standard by the rou‐tine therapy ,the Yindan Xinnaotong group was added with Yindan Xinnaotong Soft Capsule ,1 .2 g per time ,3 times daily for 12 successive weeks .The changes of blood lipids ,MDA ,SOD ,NO and ET were determined before treatment and after 12‐week treat‐ment .The flow mediated endothelium‐dependent diastolic function (FMD) and non‐flow mediated endothelium‐dependent diastolic function (NMD) in brachial artery were simultaneously detected using ultrasonography .Results After 12 weeks of treatment ,the levels of TC ,TG ,LDL‐C ,MDA and ET in the two group were obviously decreased compared with before treatment ,the levels of HDL‐C ,SOD ,NO and FMD in both groups were increased (P<0 .05);moreover the above indexes after treatment in the Yindan Xinnaotong group had significant changes compared with the routine group (P<0 .05) .Conclusion Yindan Xinnaotong Soft Cap‐sule can down‐regulate oxidative stress and regulate the lipid metabolic abnormality and obviously improve the injured vascular en‐dothelial function in T2DM .
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Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.
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This article was aimed to assess the effectiveness and safety of Y in-Dan Xin-Nao-Tong (YDXNT) Cap-sule combined with routine modern therapies for treatment of type-2 diabetes mellitus (T2MD) complicated with coronary heart disease (CHD). Databases including CBMDisc, CMAC, CNKI, VIP, Wanfang Data, PubMed, EMbase, and Web of Science were electronically searched from inception to December 2013. Randomized controlled trials (RCTs) on YDXNT capsule combined with routine modern therapies for treatment of T2MD complicated with CHD were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, ex-tracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.1.0 software. The results showed that a total of 9 RCTs with 667 T2MD with CHD cases were included. The results of meta-analysis indicated that the total effective rate of YDXNT capsule combined with routine modern therapies was significant higher than the routine treatment for T2MD complicated with CHD treatment with statistical significance (OR = 4.01, 95%CI [2.37-6.79], P< 0.000 01). It showed that YDXNT capsule combined with routine modern therapies can control angina pectoris. Due to limitation of included data, controlling of the duration of angina pectoris, the attack frequency of angina pectoris, and fasting blood glucose, may be better than the routine treatment group with significant differences. YDXNT capsule can improve hemorheology indices and reduce high condensation state among CHD with T2DM patients in order to relieve angina pectoris. It was concluded that on the basis of current clinical evidences, YDXNT capsule had better treatment effect than the routine treatment group in the treatment of CHD with T2DM. However, the results have certain limitations. It still required double-blind multi-center RCTs with high quality, large samples for further verification.
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Objective To investigate the effects of Yindan Xinnaotong Capsule on the osteoponin(OPN)expression in myocardium tissue of the rats after acute myocardial infarction(AMI)and to clarify the mechanism of Yindan Xinnaotong Capsule in alienating rat AMI.Methods 90 Wistar rats were used to establish AMI models by ligating of the left anterior descending coronary artery.The AMI model rats were randomly divided into AMI model group, highdoseofYindan(16g·kg-1·d-1)group,lowdoseofYindan(0.08g·kg-1·d-1)group,positivedrug control captopril(5 mg·kg-1 ·d-1 )group(n=12);at the same time sham operation group(n=10)was set up, the rats in sham operation group was treated with wearing without ligation. All the rats were administrated for 4 weeks,then the myocardium tissue samples were obtained.The histological changes of myocardium tissue were observed by HE and Masson staining;the DNA fragments of apoptotic cells were detected by TUNEL staining and the apoptotic index(AI)was calculated.The expression of OPN mRNA in non-infarction area was measured by RT-PCR.Results Compared with sham operation group,the AI of the rats in model group was significantly increased (P<0.05);compared with model group,the AI of the rats in Yindan groups and captopril group were markedly decreased(P<0.01 );compared with captopril group, the AI of the rats in high dose of Yindan group was significantly decreased(P<0.05).Compared with sham operation group,the expression level of OPN mRNA in non-infarction area of the rats in model group was significantly increased(P<0.01);compared with model group, the expression levels of OPN mRNA in non-infarction area of the rats in Yindan groups and captopril group were also decreased significantly(P<0.01);compared with captopril group,the expression level of OPN mRNA non-infarction area of the rats in high dose of Yindan group was significantly decreased(P<0.05).Conclusion Yindan Xinnaotong Capsule could obviously alleviate the apoptosis of myocardium tissue of the rats after acute myocardial infarction and decrease the expression of OPN mRNA in non-infarction area of left ventricle, which indicates that Yindan Xinnaotong Capsule may protect myocardium tissue through decreasing the OPN mRNA expression.
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Objective:To study the action of Xinnaotong on adhesion molecule expression by cultured endothelial cells and platelets. Methods: Tumor necrosis factor ?(TNF ?) stimulated ICAM I expression on the cell surface was studied with human umbilical vein endothelial cells(HUVEC).Thrombin stimulated expression of platelet P selectin was studied with human blood platelets. Adhesion molecule expression was measured by flow cytometry. Results: ICAM I molecule expression on HUVEC was significantly stimulated by TNF ?. The stimulatory effect of TNF ? on HUVEC was inhibited by Xinnaotong(0.25～2g/L) in a concentration dependent manner. The same dose of Xinnaotong can inhibit the p selectin expression on human blood platelets stimulated by thrombin. Conclusion: Xinnaotong inhibites expression of adhesion molecues(ICAM I, p selectin) in HUVEC and in human blood platelets.