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Park J, Bak S, Chu H, Kang S, Youn I, Jun H, Sim D, Leem J. Current Research Status and Implication for Further Study of Real-World Data on East Asian Traditional Medicine for Heart Failure: A Scoping Review. Healthcare (Basel) 2023; 12:61. [PMID: 38200969 PMCID: PMC10779411 DOI: 10.3390/healthcare12010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
This study used real-world data (RWD) to explore the long-term effects of East Asian traditional medicine (EATM) on heart failure (HF). A comprehensive search was conducted across five databases to identify relevant studies, which were then reviewed using the Arksey and O'Malley scoping review framework. The analysis focused on a descriptive examination of the long-term outcomes associated with EATM intervention. Methodologically, the study explored various aspects, including study subjects, interventions, applied clinical outcomes, and statistical methods. Out of 258 studies, 12 were selected. Eight studies involved patients with HF, while the others used HF as an outcome. Datasets from the National Health Insurance Research Database were used in Taiwan, while electronic medical record data were used in China and Japan. EATM interventions have been found to be associated with lower mortality and readmission rates. One study indicated that an increased dose of Fuzi, a botanical drug, or prompt use of Fuzi after diagnosis led to a decreased mortality hazard ratio. In two studies examining readmission rates, a significant increase was observed in the non-exposed group, with odds ratios of 1.28 and 1.18. Additionally, in patients with breast cancer, the subdistribution hazard ratio for the occurrence of doxorubicin-induced HF was reduced to 0.69. Although cohort studies with survival analysis were common, methodological flaws, such as issues with statistical methods and HF diagnosis, were identified. Despite these challenges, the study observed an association between EATM and improved clinical outcomes in patients with HF, emphasizing the potential of RWD studies to complement randomized controlled trials, especially for longer-term follow-ups. These results provide foundational data for future RWD research.
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Affiliation(s)
- Jeongsu Park
- Wonkwang University Gwangju Korean Medicine Hospital, Gwangju 61729, Republic of Korea;
| | - Seongjun Bak
- College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea; (S.B.); (H.C.)
| | - Hongmin Chu
- College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea; (S.B.); (H.C.)
- Wollong Public Health Subcenter, Paju Public Health Center, Paju 10924, Republic of Korea
| | - Sukjong Kang
- Department of Convergence Technology for Food Industry, Graduate School, Wonkwang University, Iksan 54538, Republic of Korea;
| | - Inae Youn
- Department of Acupuncture & Moxibustion, National Medical Center, Seoul 06591, Republic of Korea;
| | - Hyungsun Jun
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Daeun Sim
- College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea; (S.B.); (H.C.)
| | - Jungtae Leem
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea
- Research Center of Traditional Korean Medicine, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea
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Hu M, Li H, Ni S, Wang S. The protective effects of Zhi-Gan-Cao-Tang against diabetic myocardial infarction injury and identification of its effective constituents. JOURNAL OF ETHNOPHARMACOLOGY 2023; 309:116320. [PMID: 36828197 DOI: 10.1016/j.jep.2023.116320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cardiovascular complications are highly prevalent in patients with diabetes. Zhi-Gan-Cao-Tang (ZGCT), a famous traditional Chinese medicine (TCM) prescription, can be used for the treatment of diabetes with cardiovascular disease complications. ZGCT is composed of nine Chinese herbs: the radix and rhizoma of Glycyrrhiza uralensis Fisch. (Gancao in Chinese, 12 g), the radix of Rehmannia glutinosa Libosch. (Dihuang in Chinese, 50 g), the radix and rhizoma of Panax ginseng C. A. Mey. (Renshen in Chinese, 6 g), the radix of Ophiopogon japonicus (L. f.) Ker-Gawl. (Maidong in Chinese, 10 g), the fructus of Ziziphus jujuba Mill. (Dazao in Chinese, 18 g), the fructus of Cannabis sativa L. (Maren in Chinese, 10 g), Donkey-hide gelatine (Ejiao in Chinese, 6 g), the ramulus of Cinnamomum cassia Presl (Guizhi in Chinese, 9 g), and the fresh rhizoma of Zingiber officinale Rosc. (Shengjiang in Chinese, 9 g). Many of these Chinese herbs are also used in other systems of medicine (Japan, India, European, etc.). However, the effects and effective constituents of ZGCT against diabetic cardiovascular disease remain unclear. AIM OF THE STUDY This study aimed to investigate the protective effect of ZGCT against diabetic myocardial infarction (DMI) injury in vivo and in vitro and to identify the effective constituents of ZGCT. MATERIALS AND METHODS The in vivo effect on DMI injury was evaluated in a DMI mouse model. The in vitro effect and effective constituent screening experiments were conducted in an H9c2 cardiomyocyte injury model induced by high glucose and hypoxia. RESULTS It was found that ZGCT significantly reduced myocardial infarction size and serum lactate dehydrogenase (LDH) levels in DMI mice. Myocardial histopathological experiments showed that ZGCT alleviated the disordered arrangement and fracture of muscle fibers and cell disappearance and reduced inflammatory cell infiltration. Cellular experiments showed that ZGCT inhibited cardiomyocyte apoptosis by decreasing the expression of the proapoptotic factor Bax. In addition, it inhibited inflammatory reactions by suppressing the activation of the IκBα/NF-κB pathway and the expression of iNOS. Eight constituents from six Chinese herbs in the recipe of ZGCT were found to enhance the viability of injured cardiomyocytes, and six effective constituents played protective roles through anti-apoptotic and/or anti-inflammatory activities. In addition, one of the effective constituents, glycyrrhizic acid, was verified in vivo to have cardioprotective effect on DMI mice. CONCLUSIONS The TCM prescription ZGCT protects against DMI by inhibiting cardiomyocyte apoptosis and reducing inflammatory reactions. Eight effective constituents of ZGCT were identified. This study provides a scientific basis for the clinical application of ZGCT and is valuable for quality marker research on this prescription.
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Affiliation(s)
- Mengting Hu
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Haoran Li
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Shengkun Ni
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Shufang Wang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China; Innovation Center of Translational Pharmacy, Jinhua Institute of Zhejiang University, Jinhua, 321000, China.
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Liu CT, Hung IL, Hsu CY, Hu KC, Chen YH, Tsai MY. Chinese Herbal Medicine Reduces the Risk of Heart Failure in Hypertensive Patients: A Nationwide, Retrospective, Cohort Study. Front Cardiovasc Med 2022; 9:922728. [PMID: 35898268 PMCID: PMC9313033 DOI: 10.3389/fcvm.2022.922728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Hypertension (HTN) is the leading preventable risk factor for cardiovascular disease worldwide. Patients with HTN are at higher risk for heart failure (HF). The currently available therapeutic approaches for HTN do not always optimally control blood pressure or are not suitable for hypertensive patients who have a higher number of comorbidities. This study aimed to determine whether Chinese herbal medicine (CMH)-based interventions could reduce the risk of HF in hypertensive patients. Methods This retrospective study randomly selected 2 million enrollees from the National Health Insurance Research Database and identified 507,608 patients who were newly diagnosed with HTN in 2000–2017. After 1:1 frequency-matching by age, sex, index year, income, urbanization, duration of HTN, comorbidities and antihypertensive medications, we selected 8,912 eligible patients in each group. During 16 years of follow-up, 380 CHM users and 426 CHM non-users developed HF, representing incidence rates of 6.29 and 7.43 per 1,000 person-years, respectively. Results CHM users had significantly lower HF risk compared with CHM non-users (adjusted HR = 0.85, 95% CI 0.74–0.98). The markedly predominant effect was observed in those receiving CHM products for more than 180 days (adjusted HR = 0.65). The frequently prescribed formula, Jia-Wei-Xiao-Yao-San, and the single herbs Ge Gen, Huang Qi, Du Zhong, Huang Qin, and Chuan Xiong were significantly associated with lower risk of HF. Conclusions This population-based study revealed decreased HF risk in hypertensive patients with CHM use. These findings may provide a reference for HF prevention strategies and support the integration of CHM into clinical intervention programs that provide a favorable prognosis for hypertensive patients.
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Affiliation(s)
- Chun-Ting Liu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, Dali Branch, Jen-Ai Hospital, Taichung, Taiwan
| | - I-Ling Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Chinese Medicine, Dali Branch, Jen-Ai Hospital, Taichung, Taiwan
| | - Chung Y. Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Kai-Chieh Hu
- Management Office for Health Data, College of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Ming-Yen Tsai ;
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Wang LS, Yen PT, Weng SF, Hsu JH, Yeh JL. Clinical Patterns of Traditional Chinese Medicine for Ischemic Heart Disease Treatment: A Population-Based Cohort Study. Medicina (B Aires) 2022; 58:medicina58070879. [PMID: 35888597 PMCID: PMC9320598 DOI: 10.3390/medicina58070879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives: Traditional Chinese medicines (TCMs) are widely prescribed to relieve ischemic heart disease (IHD); however, no cohort studies have been conducted on the use of TCMs for patients with IHD. The aim of the study was to analyze TCM prescription patterns for patients with IHD. Materials and Methods: The retrospective population-based study employed a randomly sampled cohort of 4317 subjects who visited TCM clinics. Data were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan for the period covering 2000 to 2017. Data analysis focused on the top ten most commonly prescribed formulae and single TCMs. We also examined the most common two- and three-drug combinations of TCM in single prescriptions. Demographic characteristics included age and sex distributions. Analysis was performed on 22,441 prescriptions. Results: The majority of TCM patients were male (53.6%) and over 50 years of age (65.1%). Zhi-Gan-Cao-Tang (24.76%) was the most frequently prescribed formulae, and Danshen (28.89%) was the most frequently prescribed single TCM for the treatment of IHD. The most common two- and three-drug TCM combinations were Xue-Fu-Zhu-Yu-Tang and Danshen” (7.51%) and “Zhi-Gan-Cao-Tang, Yang-Xin-Tang, and Gua-Lou-Xie-Bai-Ban-Xia-Tang” (2.79%). Conclusions: Our results suggest that most of the frequently prescribed TCMs for IHD were Qi toning agents that deal with cardiovascular disease through the promotion of blood circulation. The widespread use of these drugs warrants large-scale, randomized clinical trials to investigate their effectiveness and safety.
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Affiliation(s)
- Lung-Shuo Wang
- Department of Chinese Medicine, Sin-Lau Hospital, Tainan 70142, Taiwan; (L.-S.W.); (P.-T.Y.)
- The School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung 82445, Taiwan
| | - Pei-Tzu Yen
- Department of Chinese Medicine, Sin-Lau Hospital, Tainan 70142, Taiwan; (L.-S.W.); (P.-T.Y.)
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Jong-Hau Hsu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Pediatrics, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: (J.-H.H.); (J.-L.Y.)
| | - Jwu-Lai Yeh
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (J.-H.H.); (J.-L.Y.)
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Zhang N, Zhao Y, Liu Y, Tang N, Zheng W, Mao M, Liu Q, Shen L, Deng B. A double-blinded, placebo-controlled randomized trial evaluating the efficacy and safety of Zhigancao Tang granules for treating HFpEF: study protocol for a randomized controlled trial. Trials 2021; 22:293. [PMID: 33879223 PMCID: PMC8056488 DOI: 10.1186/s13063-021-05232-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 03/29/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by diastolic dysfunction. Despite the increasing incidence of HFpEF, there is no available therapy that reduces the mortality rate of HFpEF. Zhigancao Tang has been used traditionally for the treatment of cardiovascular diseases in China. The use of traditional Chinese medicine (TCM) is associated with improvements in clinical syndromes and quality of life of patients. A randomized clinical trial should be conducted to provide clear evidence regarding the efficacy and safety of Zhigancao Tang granules for the treatment of HFpEF. METHODS A randomized, double-blinded, placebo-controlled clinical trial was proposed. A total of 122 patients with HFpEF will be randomly assigned to receive Zhigancao Tang granules or placebo for 12 weeks. The primary outcome measure is cardiac function. The secondary outcomes include measurement of the integral TCM syndrome score, echocardiography, 6-min walk test, N-terminal-pro hormone B-type natriuretic peptide level, atrial natriuretic peptide level, Minnesota Living with Heart Failure scale, and Lee's scale. The outcome measures will be evaluated at baseline, 4 weeks, and 12 weeks. Adverse events will be evaluated from baseline till the 12-week follow-up period. DISCUSSION The results of this trial will demonstrate whether Zhigancao Tang granules are effective and safe for treating HFpEF. TRIAL REGISTRATION ClinicalTrials.gov NCT04317339 . Registered on 23 March 2020.
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Affiliation(s)
- Na Zhang
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Yingli Zhao
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Yu Liu
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Nuo Tang
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Wang Zheng
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Meijiao Mao
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Qingcheng Liu
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Lin Shen
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Bing Deng
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
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Cheng YC, Lu CN, Hu WL, Hsu CY, Su YC, Hung YC. Decreased stroke risk with combined traditional Chinese and western medicine in patients with ischemic heart disease: A real-world evidence. Medicine (Baltimore) 2020; 99:e22654. [PMID: 33080705 PMCID: PMC7571976 DOI: 10.1097/md.0000000000022654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Both ischemic heart disease (IHD) and stroke are major causes of death worldwide. We investigated the effects of combined Traditional Chinese medicine (TCM) and western medicine (WM) on stroke risk in IHD patients.Taiwanese patients with IHD were enrolled in the TCM study during their outpatient visit. Stroke events after TCM or non-TCM treatment were examined. Chi-square tests and Student t-tests were used to examine differences between patients using and not using TCM. The Cox proportional hazards regression model was used to estimate hazard ratios (HRs). Sex, age, and comorbidities were included in a multivariable Cox model to estimate the adjusted HR (aHR). The survival probability and the probability free of stroke were calculated by the Kaplan-Meier method.There were 733 IHD patients using TCM and 733 using non-TCM treatment, with the same proportion of sex and age within each cohort. Using single Chinese herb such as Dan Shen, San Qi, or Chuan Xiong would have lower stroke events and lower aHR than non-TCM in IHD patients. There was 0.3-fold lower stroke risk in IHD patients with combination TCM and non-TCM treatment (95% CI = 0.11-0.84, P = .02). Moreover, the survival rate was higher (P < .001) and the incidence of hemorrhagic stroke was significantly lower (P = .04) in IHD patients with TCM treatment.IHD patients using combined TCM and WM had a higher survival rate and lower risk of new onset stroke, especially hemorrhagic stroke than those who did not use TCM treatment.
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Affiliation(s)
- Yu-Chen Cheng
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Cheng-Nan Lu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
- Fooyin University College of Nursing
- Kaohsiung Medical University College of Medicine, Kaohsiung
| | - Chung Y. Hsu
- Graduate Institute of Biomedical Sciences, China Medical University
| | - Yuan-Chih Su
- Management Office for Health Data, Clinical Trial Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
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Functional Redox Proteomics Reveal That Salvia miltiorrhiza Aqueous Extract Alleviates Adriamycin-Induced Cardiomyopathy via Inhibiting ROS-Dependent Apoptosis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:5136934. [PMID: 32963697 PMCID: PMC7501560 DOI: 10.1155/2020/5136934] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 01/03/2023]
Abstract
The anticancer agent adriamycin (ADR) has long been recognized to induce a dose-limiting cardiotoxicity, while Salvia miltiorrhiza (SM) is a Chinese herb widely used for the treatment of cardiovascular disorders and its aqueous extract (SMAE) has shown anticancer as well as antioxidant effects. In the current study, we aimed at investigating the synergistic effect and potent molecular mechanisms of SMAE with a focus on the cardioprotective benefit observed under ADR adoption. Histopathological analysis indicated that SMAE could substantially alleviate cardiomyopathy and cell apoptosis caused by ADR. Meanwhile, the two-dimensional electrophoresis (2-DE) oxyblots demonstrated that SMAE treatment could effectively reduce carbonylation of specific proteins associated with oxidative stress response and various metabolic pathways in the presence of ADR. SMAE application also showed protective efficacy against ADR-mediated H9c2 cell death in a dose-dependent manner without causing any cytotoxicity and significantly attenuated the reactive oxygen species production. Particularly, the simultaneous administration of ADR and SMAE could remarkably suppress the growth of breast cancer cells. We also noticed that there was a marked upregulation of detoxifying enzyme system in the presence of SMAE, and its exposure also contributed to an increase in Nrf2 and HO-1 content as well. SMAE also amended the ERK/p53/Bcl-xL/caspase-3 signaling pathways and the mitochondrial dysfunction, which eventually attribute to apoptotic cathepsin B/AIF cascades. Correspondingly, both the ERK1/2 inhibitor (U0126) and pan-caspase inhibitor (Z-VAD-FMK) could at least partially abolish the ADR-associated cytotoxicity in H9c2 cells. Collectively, these results support that ROS apoptosis-inducing molecule release is closely involved in ADR-induced cardiotoxicity while SMAE could prevent or mitigate the causative cardiomyopathy through controlling multiple targets without compromising the efficacy of chemotherapy.
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Cross-Talk between Gut Microbiota and the Heart: A New Target for the Herbal Medicine Treatment of Heart Failure? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9097821. [PMID: 32328141 PMCID: PMC7165350 DOI: 10.1155/2020/9097821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/19/2020] [Accepted: 02/05/2020] [Indexed: 02/06/2023]
Abstract
Heart failure (HF) is the severe and terminal stage of various heart diseases. A growing number of studies have suggested the potential clinical significance of gut microbiota in the pathophysiology of HF. Herbal medicine (HM) plays a role in rebalancing the composition of gut microbiota and is widely used in the prevention and treatment of HF. There are many similarities between intestinal microecology and the traditional Chinese medicine (TCM) theory, such as the holistic concept and the theory of the “heart's connection with the small intestine.” These similarities provide a theoretical basis for HM to prevent and treat diseases by regulating the intestinal flora and its metabolites. In this work, the cross-talk between gut microbiota and the heart is reviewed, and the relationship between TCM and gut microbiota is discussed. Based on the current literature and research, we hypothesize that the cross-talk between gut microbiota and the heart may offer a new therapeutic target for HF intervention.
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Liu J, Yang S, Wang W, Zhang Y, Wang Q, Sun X, Tan N, Du K, Wang Y, Zhao H. Use of Qishen granule for the treatment of heart failure: A systematic review and meta-analysis of animal studies. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2020. [DOI: 10.1016/j.jtcms.2020.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Han L, Wang C, Yao D, Wang B, Zhang Z, Liu J. Clinical efficacy and safety of Danhong injection for the treatment of chronic heart failure: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e19526. [PMID: 32243368 PMCID: PMC7220450 DOI: 10.1097/md.0000000000019526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Danhong injection (DHI) has been widely in the treatment of chronic heart failure (CHF) in China; however, there is not enough clinical evidence DHI for treating CHF. METHODS Two researchers will search literatures of DHI for CHF in databases. Extracted data are analyzed with Review Manager 5.3 software. The selected studies should be conducted quality evaluation, forest plots and funnel plots will be run by RevMan5.3. RESULTS This systematic review validates the clinical efficacy and safety of DHI in the treatment of CHF through the analysis of New York Heart Association functional classification, left ventricular ejection fraction, left ventricular end-diastolic dimension, cardiac output, brain natriuretic peptide, adverse events. CONCLUSIONS This systematic review will be provided a rational clinical evidence to evaluate the effectiveness and safety of DHI for the treatment of CHF. REGISTRATION NUMBER PROSPERO CRD42019144686.
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Affiliation(s)
- Lihua Han
- Department of Pharmacology, College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang
| | - Chuan Wang
- Department of Pharmacology, College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang
- Key Laboratory of Pharmacodynamics and Material Basis of Chinese Medicine of Shaanxi Administration of Traditional Chinese Medicine
- Subject Innovation Team of Shaanxi University of Chinese Medicine
| | - Dongfeng Yao
- Department of Pharmacology, College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang
| | - Bin Wang
- Department of Pharmacology, College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang
- Key Laboratory of Pharmacodynamics and Material Basis of Chinese Medicine of Shaanxi Administration of Traditional Chinese Medicine
- Subject Innovation Team of Shaanxi University of Chinese Medicine
| | - Zhen Zhang
- Shaanxi Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Shaanxi University of Chinese Medicine, China
| | - Jiping Liu
- Department of Pharmacology, College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang
- Key Laboratory of Pharmacodynamics and Material Basis of Chinese Medicine of Shaanxi Administration of Traditional Chinese Medicine
- Subject Innovation Team of Shaanxi University of Chinese Medicine
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Li J, Gao Z, Zhang L, Li S, Yang Q, Shang Q, Gao X, Qu H, Gao J, Shi L, Liu Y, Du J, Xu H, Shi D. Qing-Xin-Jie-Yu Granule for patients with stable coronary artery disease (QUEST Trial): A multicenter, double-blinded, randomized trial. Complement Ther Med 2019; 47:102209. [PMID: 31780034 DOI: 10.1016/j.ctim.2019.102209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/25/2019] [Accepted: 10/03/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND AIM Despite optimal secondary preventive treatment, patients with stable coronary artery disease (SCAD) remain at high risk of cardiovascular events. This multicenter, double-blinded, randomized trial sought to determine whether the addition of Qing-Xin-Jie-Yu Granule (QXJYG), a traditional Chinese medicine prescription, to standard therapy would further reduce risk of cardiovascular events in patients with SCAD. METHODS A total of 1500 patients with documented SCAD were randomly assigned in a 1:1 ratio to QXJYG or placebo for 6 months, and followed up for another 6 months. The primary outcome was a composite of cardiovascular death, nonfatal myocardial infarction (MI) and coronary revascularization. Near the end of the trial, but before unblinding, a commonly used composite 'hard' endpoint composed of cardiovascular death, nonfatal myocardial infarction and ischemic stroke was additionally analyzed. RESULTS During a median follow-up of 12 months, no significant difference of the primary outcome between the two groups was observed (1.59% vs. 1.62%; hazard ratio, 0.41; 95% CI, 0.13-1.28). However, absolute risk of the composite 'hard' endpoint was reduced by 0.99% (0.31% vs. 1.30%; hazard ratio, 0.06; 95%CI, 0.01 to 0.53). No difference of adverse events between the two groups was observed. CONCLUSION In patients with SCAD, the addition of QXJYG to standard therapy was associated with reduced risk of nonfatal MI and the composite 'hard' endpoint of cardiovascular death, nonfatal MI and stroke. (http://www.chictr.org.cn/showproj.aspx?proj=5200, ChiCTR-TRC-13004370).
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Affiliation(s)
- Jingen Li
- Department of Cardiology, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China; Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhuye Gao
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lijing Zhang
- Department of Cardiology, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Shengyao Li
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiaoning Yang
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qinghua Shang
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiang Gao
- Internal Medicine Division, Tieying Hospital of Fengtai District, Beijing, China
| | - Hua Qu
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Gao
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lixiao Shi
- Department of Cardiovasology, Beijing Chinese Medicine Hospital, Capital Medical University, Beijing, China
| | - Yue Liu
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianpeng Du
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hao Xu
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Dazhuo Shi
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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12
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Lu CY, Lu PC, Chen PC. Utilization trends in traditional Chinese medicine for acute myocardial infarction. JOURNAL OF ETHNOPHARMACOLOGY 2019; 241:112010. [PMID: 31175928 DOI: 10.1016/j.jep.2019.112010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/09/2019] [Accepted: 06/01/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Among heart diseases, acute myocardial infarction (AMI) is the most serious and life-threatening emergency. In Taiwan, heart disease has consistently ranked second among the top 10 leading causes of death since 2007, second only to malignant tumors; however, population-based studies on the use of traditional Chinese medicine (TCM) in AMI cases are limited. AIM OF THE STUDY This study investigated the characteristics of TCM users and prescriptions of TCM, and their differences between two cohorts of patients with AMI, identified 10 years apart. MATERIALS AND METHODS A cross-sectional study was conducted using the Taiwan National Health Insurance claims database. From among two random sample of 1 million beneficiaries selected from the claims database, we identified two cohorts of patients with first hospitalization for AMI in between 2000-2001 and 2010-2011. Patients who had received TCM therapy within one year after hospital discharge were defined as TCM users, whereas, all the other patients with AMI were considered non-users of TCM. We compared the characteristics of TCM use and the patterns of prescriptions between the two cohorts. RESULTS The proportion of patients receiving TCM care was similar between the two AMI cohorts; 20% (85/418) of the patients were diagnosed in 2000-2001 and 21% (169/817) in 2010-2011. In the 2010-2011 AMI cohort, the proportion of men was smaller among TCM users than non-users, and TCM users were less likely to have hyperlipidemia. Among TCM users, the most frequently prescribed herb was Dan-shen (Salvia miltiorrhiza Bunge, Salvia root) in both cohorts. The most commonly used Chinese herbal formulations were Xue-Fu-Zhu-Yu-Tang (Blood Mansion Dispel Stasis) for the 2000-2001 cohort and Zhi-Gan-Cao-Tang (Honey-Fried Licorice Decoction) for the 2010-2011 cohort. CONCLUSIONS This study revealed the differences in the prescription frequency of Chinese herbal formulation among the two cohort of patients with AMI, suggesting that the practice of prescribing TCM has evolved from post-antique formula to classical remedies during the 10 years evaluated. Further investigations are needed to evaluate if the change in the utilization of Chinese herbal formulations impacts the effectiveness of the treatment.
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Affiliation(s)
- Chung-Yen Lu
- Department of Sport and Health Management, Da-Yeh University, Changhua, 515, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taipei Branch, Taipei, 114, Taiwan.
| | - Pei-Chin Lu
- Department of Chinese Medicine, China Medical University Hospital, Taichung, 404, Taiwan.
| | - Pei-Chun Chen
- Department of Public Health, China Medical University, Taichung, 404, Taiwan.
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13
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Yu Y, Spatz ES, Tan Q, Liu S, Lu Y, Masoudi FA, Schulz WL, Krumholz HM, Li J. Traditional Chinese Medicine Use in the Treatment of Acute Heart Failure in Western Medicine Hospitals in China: Analysis From the China PEACE Retrospective Heart Failure Study. J Am Heart Assoc 2019; 8:e012776. [PMID: 31364457 PMCID: PMC6761625 DOI: 10.1161/jaha.119.012776] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Traditional Chinese medicine (TCM) is used in the treatment of many conditions, including heart failure (HF), although it is not well characterized. Methods and Results We conducted a retrospective analysis of TCM use in a random sample of hospitalizations for HF within a random sample of Western medicine hospitals in China in 2015 using data from the China PEACE 5r‐HF (China Patient‐Centered Evaluative Assessment of Cardiac Events 5 Retrospective Heart Failure Study). We describe the frequency of TCM use and its association with patient characteristics, in‐hospital use of evidence‐based therapies, and hospital characteristics using hierarchical logistic regression models. Finally, we assessed risk‐adjusted in‐hospital bleeding and mortality. Among 10 004 patients hospitalized with HF (median age, 73 years; 48.9% women) from 189 hospitals, 74.7% received TCM (83.3% administered intravenously). The most commonly used agent was Salvia miltiorrhiza (51.2%). Patients with coronary artery disease (odds ratio [OR], 1.73; 95% CI, 1.53–1.95) or stroke (OR, 1.32; 95% CI, 1.15–1.51) were more likely to receive TCM; there was no correlation with evidence‐based therapy use. Nearly all hospitals (99.4%) used TCM, with substantial variation across hospitals (median OR, 3.29; 95% CI, 2.82–3.76). In‐patient bleeding (OR, 1.39; 95% CI, 1.03–1.88) and mortality (OR, 1.36; 95% CI, 1.04–1.79) were higher with Salvia miltiorrhiza, although not with other TCMs. Conclusions In a nationally representative sample of patients hospitalized with acute HF in China, three fourths received TCM. Nearly all hospitals used TCM, although use varied substantially by hospital. Although TCM was not used in lieu of evidence‐based therapies for HF, we found a signal for harm with the most commonly used TCM. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02877914.
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Affiliation(s)
- Yuan Yu
- The China PEACE Collaborative Group: NHC Key Laboratory of Clinical Research for Cardiovascular Medications National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.,Central China Subcenter of the National Center for Cardiovascular Diseases Henan People's Republic of China
| | - Erica S Spatz
- Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.,Section of Cardiovascular Medicine Yale School of Medicine New Haven CT
| | - Qi Tan
- Department of Internal Medicine Yale School of Medicine New Haven CT.,Department of Health Policy and Management Yale School of Public Health Yale University New Haven CT
| | - Shuling Liu
- Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT
| | - Yuan Lu
- Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT
| | - Frederick A Masoudi
- Division of Cardiology University of Colorado Anschutz Medical Campus Aurora CO
| | - Wade L Schulz
- Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.,Department of Laboratory Medicine Yale School of Medicine New Haven CT
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.,Section of Cardiovascular Medicine Yale School of Medicine New Haven CT.,Department of Biostatistics Yale School of Public Health Yale University New Haven CT
| | - Jing Li
- The China PEACE Collaborative Group: NHC Key Laboratory of Clinical Research for Cardiovascular Medications National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.,Central China Subcenter of the National Center for Cardiovascular Diseases Henan People's Republic of China
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14
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Zhang M, Liu Y, Liu M, Liu B, Li N, Dong X, Hong Z, Chai Y. UHPLC-QTOF/MS-based metabolomics investigation for the protective mechanism of Danshen in Alzheimer's disease cell model induced by Aβ 1-42. Metabolomics 2019; 15:13. [PMID: 30830431 DOI: 10.1007/s11306-019-1473-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/09/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Alzheimer's disease (AD) is a chronic neurodegenerative disorder with neither definitive pathogenesis nor effective therapy so far. Danshen, the dried root and rhizome of Salvia miltiorrhiza Bunge, is used extensively in Alzheimer's disease treatment to ameliorate the symptoms, but the underlying mechanism remains to be clarified. OBJECTIVES To investigate potential biomarkers for AD and elucidate the protective mechanism of Danshen on AD cell model. METHODS An ultra high performance liquid chromatography-quadrupole time of flight mass spectrometry (UHPLC-QTOF/MS)-based approach combined with partial least squares discriminant analysis (PLS-DA) has been developed to discriminate the metabolic modifications between human brain microvascular endothelial cell (hBMEC) and AD cell model induced by amyloid-β protein (Aβ1-42). To further elucidate the pathophysiology of AD, related metabolic pathways have been studied. RESULTS Thirty-three distinct potential biomarkers were screened out and considered as potential biomarkers corresponding to AD, which were mostly improved and partially restored back to normalcy in Danshen pre-protection group. It was found that AD was closely related to disturbed arginine and proline metabolism, glutathione metabolism, alanine aspartate and glutamate metabolism, histidine metabolism, pantothenate and CoA biosynthesis, phenylalanine tyrosine and tryptophan biosynthesis, citrate cycle and glycerophospholipid metabolism, and the protective mechanism of Danshen in AD cell model may be related to partially regulating the perturbed pathways. CONCLUSIONS These outcomes provide valuable evidences for therapeutic mechanism investigation of Danshen in AD treatment, and such an approach could be transferred to unravel the mechanism of other traditional Chinese medicine (TCM) and diseases.
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Affiliation(s)
- Mingyong Zhang
- School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai, 200433, China
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai, 200433, China
| | - Yue Liu
- School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai, 200433, China
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai, 200433, China
| | - Min Liu
- Department of Pharmacy, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
| | - Biying Liu
- School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai, 200433, China
| | - Na Li
- School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai, 200433, China
| | - Xin Dong
- School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai, 200433, China
| | - Zhanying Hong
- School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai, 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai, 200433, China.
| | - Yifeng Chai
- School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai, 200433, China
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15
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Chen WD, Huang HS, Su YC, Chou SC, Ho WC, Kao MC, Lin HJ, Huang ST. The characteristics and prescription patterns of Chinese herbal medicine in clinical practice for the treatment of anemia. Taiwan J Obstet Gynecol 2018; 57:570-577. [PMID: 30122581 DOI: 10.1016/j.tjog.2018.06.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Chinese herbal medicine (CHM) is frequently applied to patients to improve the symptoms and signs associated with anemia. The aim of this study is to use the claims data from the National Health Insurance Research Database (NHIRD) in Taiwan to analyze CHM prescription patterns and to identify the frequency and combinations of CHM commonly used to treat anemia. MATERIALS AND METHODS A total of 41,028 patients were diagnosed with anemia in Taiwan within the defined study period. After randomly equal matching for age and sex, data from 7682 patients characterized as CHM users and non-users were analyzed. Network analyses of the 30 most frequently applied herbs and formulas were used to indicate CHM combinations in patients with anemia. RESULTS Those patients with anemia who were older, office workers, and lived in central areas of Taiwan had higher tendencies toward CHM usage. Based on considerations of comorbidities, anemia patients associated with chronic kidney diseases, diabetes mellitus, and hypertensive diseases preferred Western medical management and demonstrated a lesser likelihood of combining treatment with CHM; by contrast, those with coronary artery disease demonstrated a higher tendency for CHM use. Notably, Astragalus membranaceus (AM) and Gui-Pi-Tang (GPT) were the most commonly prescribed CHM single herb and formula, respectively. The core prescription pattern consisted of AM, Salvia miltiorrhiza (SM), Angelica sinensis (AS), GPT, and Si-Wu-Tang (SWT), as indicated by the associations and frequency of CHM utilization by traditional Chinese medicine (TCM) physicians. CONCLUSION This study demonstrates that CHM may be applied as an integral element of treatment for patients with anemia. It also provides insight regarding individual therapy and common clinical practices of TCM physicians in the treatment of anemia. Further research is required to explore potential interactions and possible mechanisms at play with CHM management of anemia.
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Affiliation(s)
- Wei-Di Chen
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Sen Huang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung 40447, Taiwan; Cancer Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Yuan-Chih Su
- School of Chinese Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung 40447, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Shen-Chieh Chou
- Department of Pharmacy School of Pharmacy, China Medical University, Taichung, Taiwan
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Ming-Ching Kao
- Department of Biological Science and Technology, College of Biopharmaceutical and Food Science, China Medical University, Taichung, Taiwan
| | - Hung-Jen Lin
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung 40447, Taiwan
| | - Sheng-Teng Huang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung 40447, Taiwan; Cancer Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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16
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Shexiang Baoxin Pills as an Adjuvant Treatment for Chronic Heart Failure: A System Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:6949348. [PMID: 29849724 PMCID: PMC5941719 DOI: 10.1155/2018/6949348] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 02/05/2018] [Indexed: 12/23/2022]
Abstract
Background Shexiang Baoxin pills (SXBXP), as a Traditional Chinese Medicine, are widely used for chronic heart failure in China. It is essential to systematically assess the efficacy and safety of SXBXP as an adjuvant treatment for chronic heart failure. Methods Seven English and Chinese electronic databases (PubMed, Embase, Cochrane Library, CBM, Wanfang, VMIS, and CNKI) were searched from inception to July 2017. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of eligible studies. Meta-analysis was performed by Review Manager 5.3. Results A total of 27 RCTs with 2637 participants were included in this review. Compared to conventional treatment, SXBXP combined with conventional treatment showed potent efficacy when it came to the total efficacy rate (OR, 3.88; 95% CI, 2.87, 5.26; P < 0.00001), B-type natriuretic peptide (BNP) (MD = -66.95; 95% CI, -108.57, -25.34; P = 0.002), N-terminal pro-brain natriuretic peptide (NT-ProBNP) (MD = -0.15; 95% CI, -0.21, -0.09; P < 0.00001), six-minute walking distance (6-MWD) (MD = 38.57; 95% CI, 28.47, 48.67; P < 0.00001), cardiac output (CO) (MD = 0.84; 95% CI, 0.68, 0.99; P < 0.00001), and Stroke Volume (SV) (MD = 7.43; 95% CI, 4.42, 10.44, P < 0.00001). The pooled subgroup analysis indicated that there was a significant difference between SXBXP plus conventional treatment and conventional treatment alone in short term course (OR = 3.51; 95% CI, 2.28, 5.40; P < 0.00001), in middle period of treatment (OR = 5.01; 95% CI, 2.61, 9.60; P < 0.00001), and in long-term course (OR = 3.77; 95% CI, 2.13, 6.67; P < 0.00001). No serious adverse events or reactions were mentioned in these RCTs. Conclusions As an adjuvant drug, this study suggested that SXBXP provide an obvious efficacy for the treatment of CHF. However, due to small samples and generally low quality studies being applied in this study, more rigorous and well-designed RCTs are needed to confirm these findings.
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17
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Tsai MY, Hu WL, Chiang JH, Huang YC, Chen SY, Hung YC, Chen YH. Improved medical expenditure and survival with integration of traditional Chinese medicine treatment in patients with heart failure: A nationwide population-based cohort study. Oncotarget 2017; 8:90465-90476. [PMID: 29163845 PMCID: PMC5685766 DOI: 10.18632/oncotarget.20063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/29/2017] [Indexed: 12/27/2022] Open
Abstract
Background No previous studies have evaluated the effects of traditional Chinese medicine (TCM) treatment on patients with heart failure (HF). Hence, in this study, we determined whether TCM treatment affects the healthcare burden and survival of HF patients. Methods Samples were retrieved from the registry of catastrophic illness patients of the Taiwan National Health Insurance Research Database (NHIRD). Based on a frequency (1:1) matched case-control design, patients with HF between 2000 and 2010 were designated as cases (TCM users) and controls (non-TCM users). TCM treatment for patients with HF was analyzed. Results Among these patients, 312 used TCM for HF treatment and exhibited significantly increased 5-year survival (p < .0001), with multivariate adjustment, compared with those without TCM use. Mean outpatient clinic visits at 1 year and 5 years after HF diagnosis were higher in TCM users, and accumulated medical costs were lower than in non-TCM users at 1 year. The hospitalization cost at 1-year follow-up was lower for TCM users than for non-TCM users. We found that, compared with non-TCM users, TCM users had an 86% reduction in risk of mortality in the compensated group, and a 68% reduction in the decompensated group receiving TCM treatment (aHR 0.32, 95% CI 0.20–0.52). The hazard ratio (HR) of Chinese herbal medicine (CHM) users with HF was significantly lower than that of non-users (aHR 0.24, 95% CI 0.16–0.35). We also analyzed the most commonly used herbal products as well as the HRs associated with their use, thus providing future research avenues. Conclusions This nationwide retrospective cohort study finds that combined therapy with TCM may improve survival in HF patients. This study also suggests that TCM may be used as an integral element of HF interventions on health care costs.
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Affiliation(s)
- Ming-Yen Tsai
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jen-Huai Chiang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital and School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Yu Chen
- School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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