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OBJECTIVE: This study aimed to explore the efficacy and safety of qi-invigorating blood-activating tongmai decoction combined with rosuvastatin in the treatment of senile type 2 diabetes mellitus (T2DM) complicated with atherosclerosis (AS). METHODS: The clinical data of 122 elderly patients with T2DM complicated with AS treated in Hospital of Chengdu University of Traditional Chinese Medicine from February 2020 to November 2021 were retrospectively analyzed. Among them, 57 patients treated with rosuvastatin alone were divided into a Monotherapy group, and 65 patients treated with qi-invigorating blood-activating tongmai decoction adjuvant combined with rosuvastatin were divided into a combined group. The two groups were compared in terms of efficacy after treatment, incidence of adverse reactions after 8 weeks of treatment, and carotid plaque indexes, glucose metabolism indexes and lipid metabolism indexes before and after 8 weeks of treatment. RESULTS: The Combined group showed a notably higher response rate than the Monotherapy group (P<0.05), but the two groups showed no significant difference in the incidence of adverse reactions (P>0.05). After 8 weeks of treatment, the intima-media thickness (IMT), plaque area, fasting blood glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triacylglycerol (TG) and low-density lipoprotein-cholesterol (LDL-C) in the two groups decreased significantly, and high-density lipoprotein-cholesterol (HDL-C) in them increased significantly. Furthermore, the Combined group showed significantly higher levels of IMT, plaque area, fasting blood glucose, HbA1c, TC, TG and LDL-C, and a significantly lower HDL-C level than the Monotherapy group (P<0.05). CONCLUSION: Qi-invigorating blood-activating tongmai decoction can promote the therapeutic efficacy of rosuvastatin in elderly patients with T2DM complicated with AS.
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Objective:To evaluate the clinical efficacy of Yiqi-Tongmai Decoction on isolated coronary muscle bridge angina patients with qi deficiency and blood stasis syndrome. Methods:A total of 64 patients with isolated coronary artery muscular bridge angina pectoris with qi deficiency and blood stasis syndrome in Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University from April 2016 to January 2020 who met the inclusion criteria were divided into 2 groups by random number table method, with 32 patients in each group. The control group took diltiazem hydrochloride tablets orally, and the treatment group took Yiqi-Tongmai Decoction on the basis of the control group. Both groups were treated for 8 weeks. The TCM syndrome scores were observed before and after treatment, and Seattle Angina Questionnaire was assessed for patient's quality of life and functional status. The exercise ECG test was observed before and after treatment, and the cause of angina pectoris need to be recorded, including the movement time and plate movement caused by time of ST segment in electrocardiogram (ecg) and dynamic evolution. Results:The total effective rate of angina pectoris was 84.38% (27/32) in the treatment group, and 53.13% (17/32) in the control group, and the difference between the two groups was statistically significant ( χ2=8.09, P<0.05). After treatment, the degree of physical activity limitation (69.24 ± 14.21 vs. 59.42 ± 11.71, Z=-2.61), stable state of angina (82.25 ± 21.24 vs. 69.11 ± 19.52, Z=2.64), angina (80.24 ± 18.31 vs. 69.11 ± 15.54, Z=2.63), treatment satisfaction (86.16 ± 19.23 vs. 61.19 ± 17.35, Z=2.22), degree of disease cognition (74.41 ± 21.13 vs. 60.43 ± 19.42, Z=2.40) scores in the treatment group were significantly higher than those in the control group ( P<0.05). In the treatment group, the time of exercise-induced angina pectoris [(476.15 ± 62.15)s vs. (399.38 ± 78.42)s, Z=-2.08], the time of ST segment descending 1 mm after exercise [(394.54 ± 75.61)s vs. (309.64 ± 81.62)s, Z=-2.40] in the treatment group were significantly longer than those in the control group ( P<0.05). The total effective rate of TCM syndrome was 93.8% (30/32) in the treatment group and 65.6% (21/32) in the control group, and the difference was statistically significant ( χ2=7.96, P<0.05). The TCM syndrome scores of the treatment group (25.15 ± 6.15 vs. 36.38 ± 10.42, Z=-2.56) in the treatment group were significantly lower than that of the control group ( P<0.05). There were no obvious adverse reactions in both groups during treatment. Conclusion:Yiqi-Tongmai Decoction can improve the clinical symptoms of isolated coronary artery muscle bridge angina pectoris with qi deficiency and blood stasis syndrome, reduce the onset of angina pectoris, delay the time of exercise induced angina pectoris, and improve the clinical efficacy.
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BACKGROUND: Vascular dementia (VaD) is a degenerative cerebrovascular disease that leads to progressive decline of patients' cognitive ability and memory. Yizhi Tongmai (YZTM) decoction is an empirical prescription first formulated by Professor Guomin Si. Our previous experiments proved the effectiveness of this prescription in the treatment of VaD. In this study, we aimed to use network pharmacology and molecular docking technology to systematically explain the potential anti-VaD mechanism of YZTM. METHODS: We identified the core compounds of YZTM and their potential targets through the TCMSP, BATMAN, and SwissTargetPrediction databases. Then, we identified the molecular targets of YZTM in VaD using the Online Mendelian Inheritance in Man and GeneCards databases. The common targets of YZTM and VaD were screened out, and then the pathways of these target genes were analyzed using the Database for Annotation, Visualization and Integrated Discovery v6.8. Molecular docking was used to verify the relationship between the core compounds and proteins. RESULTS: Through network pharmacology analysis, we discovered that the 5 core compounds in YZTM exert an anti-VaD effect. The potential mechanism of YZTM anti-VaD may be through inhibiting the NLRP3 inflammasome, TNF signaling pathway, and toll-like receptor signaling pathways. Subsequently, key compounds were docked with related proteins in the NLRP3 inflammasome (NLRP3, ASC, caspase-1, interleukin-18, and interleukin-1 ß) using molecular docking technology. The compounds were found to spontaneously bind to the proteins. CONCLUSIONS: YZTM may exert an anti-VaD effect through inhibition of the NLRP3 inflammasome. In addition, TNF signaling pathway and toll-like receptor signaling pathway may also be its underlying mechanism. The application of network pharmacology and molecular docking technology may provide a novel method for research of Chinese herbal medicine. YZTM may also provide a complementary treatment option for patients with VaD.
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Objective: To observe the effect of serum-containing Qingxin Tongmai decoction(QXTMD) on the apoptosis rate of mouse mononuclear macrophage cell line RAW264.7 induced by Acetylated low density lipoprotein (ac-LDL) and the expressions of type A scavenger receptor(SR-A), B-cell lymphoma-2(Bcl-2), Bcl-2-associated X protein(Bax), inositol-requiring enzyme 1α(IRE1α), exploring the possible mechanism of QXTMD in the treatment of atherosclerosis.Method: Eight New Zealand rabbits were randomly divided into the atorvastatin group (2.6 g·kg-1) low, medium and high-dose QXTMD groups (3.33, 6.66, 13.32 mg·kg-1). After 7 days of gavage, the carotid blood was collected to prepare drug-containing serum. The RAW264.7 cell line was stimulated with 2.5%, 5%, 10%, and 20% drug-containing serum culture for 6, 12, and 24 h, respectively. The cell proliferation rate was observed by cell counting kit-8 (CCK-8) method. The RAW264.7 cell line was cultured in vitro and divided into blank group, model group, atorvastatin group, and low, medium and high-dose QXTMY groups. The cells in blank group were cultured with bovine serum albumin(BSA). The model group was stimulated with BSA+50 mg·L-1 ac-LDL for 24 h. The other groups were stimulated with BSA+50 mg·L-1 ac-LDL+10% drug-containing serum for 24 h. The apoptosis rate and SR-A expression of RAW264.7 cells were detected by flow cytometry. The expressions of Bcl-2, Bax and IRE1α protein were detected by Western blot.Result: Compared with the blank group, the model group could increase the apoptosis rate of RAW264.7 cells (PPPPα (PPPPPConclusion: QXTMD can reduce the apoptosis rate of macrophages. The mechanism of atherosclerosis may be related to the expressions of Bax, IREα, SR-A and anti-apoptotic protein Bcl-2.
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AIM To investigate the effects of Tongmai Decoction on PLT,PAgR,D-D and TEG in elderly patients with intertrochanteric fracture in perioperative period.METHODS One hundred and fifteen recruited patient subjects were randomly divided into two groups.Fifty-seven cases in the control group were treated with Low Molecular Weight Heparins Calcium Injection,and 58 cases in the treatment group were intervened with both Low Molecular Weight Heparins Calcium Injection and Tongmai Decoction.The preoperative and postoperative dynamic changes of PLT,PAgR,D-D and TEG (R value,K value,alpha angle,MA),and adverse drug reactions in the two groups were detected 1,3,7 d prior to,and after the treatments,respectively.RESULTS No statistically significant difference between the two groups' PLT,PAgR and D-D contents were observed before the operation (P ＞ 0.05).The levels of PLT,PAgR and D-D in both groups increased one day after the operation with similar change degree (P ＞ 0.05).On the 3rd and 7th days after the surgery,the PLT,PAgR and D-D contents in the two groups began to drop,and the decline in the treatment group was more significant (P ＜ 0.05).No significantly different TEG (R value,K value,alpha angle,MA) between the two groups was noticed before the operation (P ＞ 0.05).Patients of both groups displayed their R value,K value decrease,and alpha Angle,MA increase (P ＞ 0.05) one day after the operation with similar change degree.Their R value,K value increased,and alpha angle,MA decreased,and as well as the statistically significant change between the two groups were discovered on the 3rd and 7th postoperative days (P ＜ 0.05).CONCLUSION Tongmai Decoction can effectively reduce blood hypercoagulability and prevent deep venous thrombosis in terms of PLT,PAgR,D-D and TEG (R value,K value,alpha angle,MA) improvement in elderly patients with intertrochanteric fracture in perioperative period.
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Objective To investigate the effect of Shenqi-Tongmai decoction in Stable Angina pectoris Patients with Qi-deficiency-blood-stasis syndrome and the influence on serum associated adhesion factors. Methods A total of 110 patients with stable angina pectoris treated in the department of cardiology of traditional Chinese medicine hospital of Xinle city from Feb. 2015 to Feb. 2017 were divided into 2 groups according to the number random table method, with 55 in each group. All the patients were given the standardized treatment with western medicine, and the treatment group were aditionally treated with the Shenqi-Tongmai decoction. All the patients were treated for a course of 4 weeks. The TCM syndrome score, Seattle angina questionnaire (SAQ) score, electrocardiographic examination index and serum soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1) level of the two groups before and after treatment were compared, and the clinical curative effect of the two groups was compared. Results The TCM syndrome score (7.1 ± 2.2 vs. 11.4 ± 3.0, t=8.590), serum sICAM-1 (227.69 ± 42.81 ng/ml vs. 275.33 ± 48.62 ng/ml, t=5.454) level, serum sVCAM-1 (272.04 ± 39.87 ng/ml vs. 296.58 ± 42.60 ng/ml, t=3.127) level and lead ecg ST segment down number (2.7 ± 0.6 vs. 3.2 ± 0.6, t=4.067), T wave of low lead numbers (1.7 ± 0.3 vs. 2.1 ± 0.3, t=6.807), numbers of T wave inversion lead (1.7 ± 0.3 vs. 2.1 ± 0.2, t=9.908) of the treatment group were significantly lower than those of the control group (P<0.01). The SAQ scores (76.8 ± 10.5 vs. 67.4 ± 10.1, t=4.805) was higher than that of the control group (P<0.01). The curative effect of angina pectoris and electrocardiogram of the treatment group were 91.0% (50/55) and 92.7%(51/55), and the control group were 76.4% (42/55) and 78.2% (43/55). The difference was statistically significant between the two groups (χ2=4.251, 4.681, P<0.05). Conclusions Traditional Chinese medicine Shenqi-Tongmai decoction can effectively improve the SAQ scores and TCM syndrome score and electrocardiogram examination index, improve the clinical curative effect in the treatment of Stable Angina pectoris based on the western medicine (Qi-deficiency-blood-stasis syndrome) and its mechanism may be related to improving of the serum levels of sICAM 1, sVCAM 1.
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Objective To explore the impact of blood-activatingand qi-nourishing therapy on the hypercoagulable state of rats after femur fracture.Methods One hundred and twenty SD rats were randomly divided into 4 groups,namely normal group,model group,low-molecular-weight heparin(LMWH) group,combination group (LMWH + Tongmai Decoction),30 rats in each group.The rat model of femur fracture was established.After successful modeling,LMWH group was given subcutaneous injection of LMWH 600 U/kg,and the combination group was given subcutaneous injection of LMWH 600 U/kg together with gastric gavage of Tongmai Decoction,the model group was given subcutaneous injection of the same volume of normal saline.The treatment lasted for 1-7 days after the surgery.The pathologic features of the left great saphenous vein were observed by HE staining method,and the relative volume,thickness and quantity of the blood vessels were also measured.The plasma D-dimer (D-D) and fibrinogen (FIB) levels were determined by biochemical analyzer,and the plasma levels of whole blood viscosity at low shear rate (WBV-lsr) and whole blood viscosity at high shear rate (WBV-hsr) were measured with hemodynamic detector.Results On day 7 after the modeling,less endothelium cells,agglomerative red cells,and large thrombi were found in the great saphenous vein tissue section of the model group under microscope.Compared with the normal group,the levels of D-D,FIB,WBV-lsr and WBV-hsr in the model group at various time points were increased,the difference being significant (P ＜ 0.05).After 7-day treatment,the levels of D-D,FIB,WBV-lsr and WBV-hsr in LMWH group and combination group were lower than those of the odel group,and the decrease in the combination group was superior to LMWH group(P ＜ 0.05).The blood vessel endothelium cells in the combination group were arranged neatly with same cellular width while without enlargement or swelling,the effect being superior to that of LMWH group.Conclusion Blood-activating and Qi-nourishing therapy can effectively relieve hypercoagulable state of rats after femur fracture.
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Objective To observe the efficacy of Huoxue Tongmai decoction in the treatment of coronary heart disease with angina pectoris.Methods 60 coronary heart disease patients with angina pectoris were randomly divided into two groups,30 cases in each group.The observation group was treated with Huoxue Tongmai decoction concomitant with routine chemical medicine therapy,and the control group was treated with only routine chemical medicine therapy.The total effective rate,reduced angina occurrences after therapy and ECG were observed in both two groups.Results After treatment,the total effective rate of the observation group was 93.3%,which was signifi-cantly higher than that of the control group(χ2 =4.32,P <0.05).Compared with the two groups of ECG efficacy,the total effective rate of the observation group was 83.3%,which was significantly higher than 66.7% of the control group (χ2 =4.22,P <0.05).After one,three treatment courses,the number of angina attack in the observation group was significantly lower than that in the control group,and the differences were statistically significant(t =6.99, 10.82,all P <0.05).Conclusion Houxue Tongmai decoction combined with routine chemistry medicine is more effective than routine chemistry medicine in treating angina.
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Objective To investigate the effect of Bushen-Tongmai decoction on plasma renin activity (PRA), plasma levels of brain natriuretic peptide (BNP) and angiotensinⅡ(AngⅡ) in patients with chronic heart failure. Methods A total of 100 patients with chronic heart failure from January 2011 to December 2013 were randomly divided into a control group and a treatment group, with 50 patients in each group. The patients in the control and treatment groups received conventional treatment and Bushen-Tongmai decoction plus conventional treatment for 8 weeks, respectively. Laboratory measurements including PRA, BNP and AngⅡwere performed before and after treatment.Cardiac function was measured before and after treatment with echocardiography. Results The PRA , plasma levels of BNP and AngⅡ after treatment in the treatment group were significantly decreased than before treatment (treatment group:t=2.990, 4.030, 4.401, all P<0.01);after treatment, there was significant difference in PRA, BNP and AngⅡbetween the treatment group and the control group(t=2.622, 2.863, 3.809, all P<0.05). Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) by echocardiography in both groups were significantly improved (treatment group:t=9.167, 11.030, 13.273, all P<0.01;control group:t=5.189, 7.626, 6.906, all P<0.01). Improvements of LVESD, LVEDD and LVEF in the treatment group were grater than those in the control group (t=4.037, 2.701, 7.458, all P<0.01). Conclusion Bushen-Tongmai decoction can effectively decrease PRA , plasma levels of BNP, AngⅡ, and improve cardiac function in patients with chronic heart failure.
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This study was aimed to evaluate the efficacy and safety of Y ixin Tongmai Decoction in prevention and treatment of diabetes mellitus complicated with coronary heart disease ( CHD ) after coronary stenting restenosis . Sixty cases were randomly divided into the conventional western medicine treatment plus Y ixin Tongmai Decoction group ( treatment group ) and conventional treatment of western medicine group ( control group ) . Observation was given on the in-stent restenosis before treatment and one-year after treatment . And the traditional Chinese medicine ( TCM ) Syndrome Scale , changes of single symptom in TCM syndrome , effect of Y ixin Tongmai Decoction on blood glucose and other adverse reactions were also observed before and one-year after treatment . The results showed that in the curative effect evaluation , the restenosis rate of treatment group was 6 . 90%, and the restenosis rate of control group was 17 . 24%. There was significant difference be-tween two groups ( P < 0 . 05 ) . According to the standard of TCM syndrome curative effect , the total effective-ness in the treatment group was 86 . 21%, and that of the control group was 31 . 03%. And there was signifi-cant difference between two groups ( P < 0 . 05 ) . In the safety evaluation , there were no obvious abnormalities during safety detection in the clinical study of two groups. There was no influence on blood sugar levels. And no drug related adverse reactions occurred . It was concluded that Y ixin Tongmai Decoction can reduce coro-nary stent restenosis rate in diabetes complicated with CHD (chest pain) with the syndrome of qi deficiency and blood stasis , phlegm-turbid stasis . It can significantly improve the TCM syndrome and single symptom of patients with good safety .
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OBJECTIVE:To observe the clinical efficacy of Yiqi tongmai decoction for coronary artery disease and angina pectoris and its intervention effect on patients'serum lipid level.METHODS: A total of 96 patients with coronary artery disease and angina pectoris were randomly assigned to two groups: 48(trial group) were treated with Yiqi tongmai decoction one dose daily for 4 weeks,and another 48(control group) with Guan-Xin-Ⅱ Decoction one dose daily for 4 weeks.RESULTS:The efficacy in angina pectoris and EKG in the trial group showed a significantly better improvement than in control group(P
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Objective To observe the clinical effects of Yixin Tongmai Decoction in treating angina pectoris in CHD (blood stasis syndrome) and explore its mechanism. Methods Sixty patients were randomized into two groups. The treatment group (30 cases) and the contrastive group (30 cases) were respectively given Yixin Tongmai Decoction and Danshen Injection. The clinical and ECG effect, the indexes of hemorrheology were observed. Result Effective rate of treatment group was 90.00%, significantly higher than 70.00% of contrastive group (P
