Sanqi panax notoginseng injection for angina pectoris

Data Mining-Based Analysis of Modern Chinese Medicine for the Treatment of Stable Angina Pectoris in Coronary Heart Disease

The aim of this study is to explore the clinical effects of Chinese medicine in the treatment of stable angina pectoris in coronary heart disease. Chinese medicine has multitarget, multilevel, and multilink effects in the treatment of coronary angina, which can significantly improve patients' symptoms. Its mechanism of action involves multiple levels such as regulating lipid metabolism, improving platelet function, antioxidant, and protecting endothelial function. The design was based on data mining to analyse the dosing pattern of modern Chinese medicine for the treatment of stable angina pectoris in coronary heart disease. The number of episodes of angina pectoris, the duration of the episodes, and the changes in the electrocardiogram before and after taking the medicine were observed and compared between the two groups. The number and duration of angina attacks ((2.23 ± 0.77) per week and (1.31 ± 0.34) min/time, respectively) in the study group were found to be significantly better than those in the control group ((3.86 ± 1.03) per week and (2.46 ± 1.21) min/time, respectively).

A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris

BACKGROUND

A growing number of studies suggest that Gualou Xiebai Banxia (GLXBBX) decoction, a well-known Chinese herbal formula, has beneficial effects on eliminating angina pectoris symptoms and improving condition of stable angina pectoris (SAP) patients. However, whether this treatment is effective and safe for SAP or not, evidence supporting the effectiveness and safety of this treatment is still incomplete. Besides, there is lack of systematic review to assess the detailed situation (including risk of bias and methodology) of current related clinical studies. This study aimed to evaluate the effectiveness and safety of GLXBBX in treating SAP.

METHODS

The major databases (MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP) Database, Chinese Biomedical Database (CBM), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Database) were searched from inception to March 2019. Randomized controlled trials (RCTs) of GLXBBX alone or combined with conventional drugs against conventional drugs for SAP were identified. Two assessors reviewed each trial independently. The methodological quality of the eligible studies was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias. Both the data extraction and the literature quality screening evaluation were conducted independently by 2 researchers.

RESULT

Totally 17 clinical RCTs were included in this study, involving 1676 patients. Due to the high probability of bias of the included studies, it was inappropriate to undertake a meta-analysis. Thus, we only conducted a systematic review and mainly discussed the methodology and limitation of the included studies.

CONCLUSION

Although the current evidence prompted that GLXBBX might benefit SAP patients in improvement of angina pectoris, ECG, and blood lipid on a certain extent, this systematic review revealed no definite conclusion about the application of GLXBBX for SAP due to the poor methodological quality, high risk of bias, and inadequate reporting on clinical data. More rigorous, multicenter, sufficient-sample, and double-blind randomized clinical trials are warranted.

A Chinese patent medicine Salvia miltiorrhiza depside salts for infusion combined with conventional treatment for patients with angina pectoris: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Currently, many trials have been conducted to investigate the beneficial and harmful effects of Salvia miltiorrhiza depside salts for infusion for treating patients with angina pectoris. It is important to systematically and criticallyevaluate the existing literature into providing a pooled effect to examine outcomes of angina pectoris with Salvia miltiorrhiza depside salts for infusion.

PURPOSE

A systematic review and meta-analysis were performed to determine the clinical curative effect and safety of Salvia miltiorrhiza depside salts for infusion for angina pectoris and provide clear evidence to inform clinical practice.

METHOD

The Cochrane Library, MEDLINE, EMBASE, and other four electronic Chinese databases were searched to identify relevant randomized controlled trials. Methodological quality and reporting quality of eligible studies was evaluated by using the Cochrane risk-of-bias tool and CONSORT for traditional Chinese medicine respectively. Meta-analysis was performed by RevMan 5.3 software.

RESULT

Fifty-six randomized controlled trials involving 5503 patients were included. Most of the trials were classified as having an unclear risk of bias because of poor reported methodology. The main outcomes are improvements in angina symptoms, ECG improvement and reduction of nitroglycerin use. CHD mortality or rate of CHD events was not reported in any trial. Meta-analysis showed that Salvia miltiorrhiza depside salts for infusion combined with conventional treatment was better than conventional treatment alone in improving angina symptoms (RR= 1.28, 95% CI 1.24 to 1.31, p < 0.00001), the frequency of angina attack (time/week)(WMD=-1.47, 95% CI -2.16 to -0.78), reducing clinical symptom scores (WMD=-0.55, 95% CI -0.57 to -0.53, p < 0.000011), increasing physical limitation scores (WMD= 7.68, 95% CI 1.48 to 13.88, p = 0.02), improving ECG (RR= 1.32,95% CI 1.27 to 1.38, p < 0.00001) and reducing dosage of nitroglycerin (RR= 1.50, 95% CI: 1.26 to 1.77, p < 0.00001). In addition, Egger's regression tests was found there was publication bias (Kendall' tau= 0.36, p < 0.01).

CONCLUSION

The current systematic review indicates relevant evidence for Salvia miltiorrhiza depside salts for infusion combined with conventional treatments treating patient with angina pectoris. However, the results should be interpreted with caution due to the low methodological quality, the risk of publication bias, lack of important clinically relevant outcomes and inadequate reporting on adverse events of the included trials. International methodological and reporting standards could help researchers conduct well designed trials and generate better evidence for Salvia miltiorrhiza depside salts for infusion.

Effects of panax notoginseng saponins on the osteogenic differentiation of rabbit bone mesenchymal stem cells through TGF-β1 signaling pathway

Background

Panax Notoginseng is a well-known Chinese medicinal herb which has been used in China for treatment of bone fracture for hundreds of years. However, the specific biological mechanisms of osteogenic effect of PNS are not well understood.

Methods

In this study, newborn rabbit BMSCs were isolated, and then identified by the positive expression rates of cell surface markers, including CD29, CD45 and HLA-DR, which were detected by flow cytometry(FCM). After the lentivirus-induced cell model of TGF-β1 gene silencing was established, the interference efficiency was tested by q-PCR and Western blot, and the growth curve of silencing cells was drawn by MTT so as to grasp the growth rhythm of silencing cells. In the alizarin red-staining experiment, the effect of 100 mg/L PNS on the activity of intracellular ALP of TGF-β1 gene silencing BMSCs was detected, so as to observe the effect of 100 mg/L PNS on the formation of calcium nodes of gene silencing BMSCs.

Results

By separating rabbit BMSCs, the lentivirus-induced cell model of TGF-β1 gene silencing was established. Both TGF-β1 mRNA and protein expression were restrained significantly, and the target gene kept silence stably via the verification of q-PCR and Western blot; there was no significant differences of the growth curve between RNAi cells and normal cells; the activity of intracellular APL in 100 mg RNAi group was obviously lower than that in 100 mg group (p < 0.05), but higher than that in the normal group; in the alizarin red-staining experiment, it focused on the effects of PNS on the formation of calcium nodes of gene silencing BMSCs, which showed that calcium nodes could be formed in 100 mg RNAi group but its quantity was lower than that of 100 mg group (p < 0.05).

Conclusions

It was shown that silencing TGF-β1 gene could interrupt the osteogenic effects of PNS. PNS may have a promoting effect on osteogenic differentiation of rabbits’ BMSCs in vitro by up-regulating the gene expression of TGF-β1.