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This study was designed to assess the clinical efficacy of oral blood-activating and stasis-removing Chinese patent medicines in treating hypertensive left ventricular hypertrophy(LVH) based on network Meta-analysis. The clinical randomized controlled trials(RCTs) concerning the treatment of hypertensive LVH with oral blood-activating and stasis-removing Chinese patent medicines were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, and Cochrane Library from their inception to September 2021. Two researchers independently completed the literature screening, data extraction, and quality evaluation. The data were then analyzed by RevMan 5.3, Stata 15.1, and ADDIS 1.16.8. Finally, a total of 31 RCTs were included, involving 3 001 patients and four oral blood-activating and stasis-removing Chinese patent medicines. In terms of the alleviation of heart damage, the Chinese patent medicines combined with conventional western medicine groups were superior to the conventional western medicine groups in lo-wering the left ventricular mass index(LVMI). There was no significant difference in LVMI, left ventricular ejection fraction(LVEF), or the ratio of early diastolic peak flow velocity to late diastolic peak flow velocity(E/A) between different Chinese patent medicines combined with conventional western medicine groups. Xinnao Shutong Capsules/Tablets combined with conventional western medicine had the best efficacy in reducing LVMI and elevating LVEF, while Xinkeshu Capsules/Tablets combined with conventional western medicine had the best effect in improving E/A. In the control of blood pressure, when all Chinese patent medicines except for Xinnao Shutong Capsules/Tablets were combined with conventional western medicine, the resulting systolic blood pressure(SBP) and diastolic blood pressure(DBP) were significantly lower than those in the conventional western medicine group. Xinkeshu Capsules/Tablets combined with conventional western medicine produced the best effect in reducing SBP and DBP, followed by Xinnao Shutong Capsules/Tablets. In terms of safety, no serious adverse reactions occurred in all trials. The four oral blood-activating and stasis-removing Chinese patent medicines included in this study exhibited obvious advantages in the treatment of hypertensive LVH when they were combined with conventional western medicine, with the best effects observed in the Xinnao Shutong Capsules/Tablets combined with conventional western medicine group. However, due to the limitation of the quantity and quality of the included articles, the conclusion of this study still needs to be verified by more high-quality, multi-center, and large-sample RCTs.
Assuntos
Humanos , China , Hipertrofia Ventricular Esquerda/tratamento farmacológico , Medicina Tradicional Chinesa , Metanálise em Rede , Medicamentos sem Prescrição , Volume Sistólico , Função Ventricular EsquerdaRESUMO
By reviewing the 2015 edition of Chinese Pharmacopoeia, the author collected 37 neutral blood-activating and stasis-removing traditional Chinese medicines. And by retrieving literatures on relevant material basis and pharmacological effects on CNKI, the author organized and summarized their chemical composition and pharmacological effects. Neutral blood-activating and stasis-removing traditional Chinese medicines are rich in chemical components, such as flavonoids, steroids and sugars. At the same time, it has a variety of pharmacological effects, including anti-platelet aggregation and anti-thrombotic mechanism, anti-atherosclerosis, inhibition of ischemia-perfusion injury, anti-tumor, anti-fibrosis, liver protection, anti-inflammatory analgesia, blood pressure reduction and immune regulation. It is widely used in the treatment of liver fibrosis, cardiovascular disease, liver cancer, uterine cancer, hypertension, hyperlipidemia and other diseases. Nowadays, as people has paid increasing attention to neutral herbs, studies on traditional Chinese medicines for activating blood circulation and removing blood stasis have been further deepened, which provides a better development prospect for neutral blood-activating and stasis-removing traditional Chinese medicines. From the perspective of medicinal properties, the authors systematically collected and summarized the pharmacological effects and material basis of neutral blood-activating and stasis-removing traditional Chinese medicines. This article provides theoretical guidance for the clinical application of neutral blood-activating and stasis-removing traditional Chinese medicines and new medicine research ideas for neutral blood-activating and stasis-removing traditional Chinese medicines.
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Objective To investigate the clinical effect of Guizhi Fuling Capsule Combined with activating blood circulation to remove stasis to treat uterine fibroids.Methods 84 patients with uterine fibroids from June 2015 to October 2016 in our hospital were randomly selected and divided into experimental group and control group, 42 cases in each group.The control group was treated with Guizhi Fuling Capsule,and the experimental group was treated with blood activating and Stasis Removing Therapy on this basis of treatment.The patients were followed up for three months, and the clinical treatment effects of the two groups were compared and analyzed.Results The total effective rate of the experimental group was 97.6%,which was significantly better than the control group(76.1%), the difference was statistically significant(P<0.05);through the change of single symptom in two groups, it was found that there was no significant difference between the experimental group and the control group;The improvement rate of anemia, vaginal bleeding, abdominal pain, dysmenorrhea, menorrhagia in the experimental group was significantly higher than the control group, the difference between the two groups was statistically significant(P<0.05);The average volume of uterine fibroids in the experimental group was significantly lower than that in the control group, the difference was statistically significant(P<0.05).Conclusion Guizhi Fuling Capsule Combined with promoting blood circulation and removing blood stasis therapy has obvious effect and less adverse reaction.It can be used and popularized in clinic.
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Objective To provide references for rational clinical usage and purchase of TCM decoction pieces for blood-activating and stasis-removing. Methods Excel 2013 software was used to conduct statistical analysis on categories, consumption quantity, consumption sum and annual average growth rate of TCM decoction pieces for blood-activating and stasis-removing during 2011-2015 in TCM Hospital of Jiangsu Province (hereinafter refered to as our hospital). Results The consumption quantity and consumption sum of TCM decoction pieces for blood-activating and stasis-removing in our hospital increased year by year. Among all types of TCM decoction pieces for blood-activating and stasis-removing, TCM decoction pieces for activating blood and adjusting maridians occupied the largest amount, followed by TCM decoction pieces for activating blood and relieving pains, breaking up the static blood and eliminating masses, and blood-activating and wound - curing. The TCM decoction pieces with the biggest annual consumption quantity were Salviae Miltiorrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Curcumae Radix, and the TCM decoction pieces with the biggest annual consumption sum were Notoginseng Radix et Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, and Carthami Flos. Conclusion Both the consumption quantity and the consumption sum of the TCM decoction pieces for blood-activating and stasis-removing in our hospital have been increasing year by year. However, the proportion consumption quantity and the consumption sum of TCM decoction pieces and medicine utilization structure have kept stable, and in basically rational use.
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[Objective] To investigate the effect of external application of osmosis-improving herbal medicine and enema with blood-activating and stasis-removing herbal medicine for chronic pelvic inflammation. [Methods] Single-blind and randomized trial was performed on 120 cases of chronic pelvic inflammation. The cases were randomized to two groups: group A ( n = 57) was treated by enema with blood-activating and stasis-removing herbal medicine and group B ( n = 63) by the combination of enema and external application of osmosis-improving herbal medicine. Fourteen days constituted one course of treatment and the therapeutic effect was evaluated after two courses. [Results] In group A, 30 cases were cured, 21 effective, 6 ineffective and the total effective rate was 89.5%; 43 were cured, 18 effective, 2 ineffective and the total effective rate was 96.8% in group B. The result of Ridit analysis showed that the effect of group B was better than that of group A ( t = 3.08, P