Observation of Curative Effect of Trimetazidine Combined with Metoprolol in Elderly Patients with Coronary Heart Disease Complicated with Heart Failure and the Effect of Myocardial Remodeling by Integrated Traditional Chinese and Western Medicine

Efficacy and safety of oral Chinese patent medicines in the treatment of coronary heart disease combined with hyperlipidemia: a systematic review and network meta-analysis of 78 trials

AIM OF THE STUDY

To evaluate the clinical efficacy and safety of commonly used oral Chinese patent medicines for the treatment of coronary heart disease combined with hyperlipidemia in clinical practice through a network meta-analysis.

MATERIALS AND METHODS

PubMed, Embase, Cochrane Library, Web of Science, Wanfang, VIP, SinoMed, and CNKI databases were searched for all published randomized controlled trials (RCTs) on the treatment of coronary heart disease combined with hyperlipidemia using Chinese patent medicines. NoteExpress software was used to screen the literature obtained from the databases according to the inclusion and exclusion criteria. The Cochrane risk of bias assessment tool was used to evaluate the quality of the included studies. A network meta-analysis was performed using R 4.2.1. Subgroup analyses of outcome indicators were made based on conventional treatment (CT) methods. The incidence of adverse events in the included RCTs was statistically analyzed. A funnel plot was drawn using RevMan 5.4.1 software for the assessment of bias in the total clinical effectiveness rate. Finally, the quality of evidence for interventions with statistically significant differences was evaluated using the GRADE system.

RESULTS

A total of 78 RCTs were included, involving 7,955 cases and 8 types of Chinese patent medicines, which were Tongxinluo Capsule, Naoxintong Capsule, Compound Danshen Dripping Pill, Shexiangbaoxin Pill, Songling Xuemaikang Capsule, Xuezhikang Capsule, Yindan Xinnaotong Capsule, and Zhibitai Capsule. A total of 24 RCTs reported the incidence of adverse events, but no statistically significant difference in the incidence of adverse events was found between the experimental and control groups in each study (P > 0.05). There was no obvious publication bias in all studies, but the overall quality of evidence in the included RCTs was low. Comparison of different intervention measures showed that Naoxintong Capsule + CT improved the cardiac index and cardiac output, and lowered the low-density lipoprotein cholesterol and total cholesterol levels. Tongxinluo Capsule + CT raised high-density lipoprotein cholesterol levels and reduced triglyceride levels. Xuezhikang Capsule + CT improved the total clinical effectiveness rate. Subgroup analyses showed that differences in CT did not cause heterogeneity in the results.

CONCLUSION

Compared with the use of CT alone, the combined use of Chinese patent medicines with CT can effectively improve the symptoms in patients with both coronary heart disease and hyperlipidemia.

Identification of key genes associated with heart failure based on bioinformatics analysis and screening of traditional Chinese medicines for the prevention and treatment of heart failure

Heart failure (HF) is the final stage of heart disease. An increasing number of experiments and clinical reports have shown that traditional Chinese medicine (TCM) has many therapeutic effects and advantages in treating HF. In this study, we used bioinformatics methods to screen key genes and predict the components of Chinese herbal medicines with preventive and therapeutic effects on HF. GSE120895 and GSE21610 HF chips were downloaded from the Gene Expression Omnibus database. We screened differentially expressed genes (DEGs). Weighted gene coexpression network analysis was performed to determine key modules. Genes in key modules were used for Gene Ontology and Kyoto Encyclopedia of Genes Genomes analysis to determine the biological functions. Finally, receiver operating characteristic curve analysis was used to screen out key genes, and single-sample GSEA was conducted to screen TCM compounds and effective ingredients of TCM compounds related to HF. We have selected a key module (MeTerquoise) and identified 489 DEGs, of which 357 are up regulated and 132 are down regulated. Gene Ontology and Kyoto Encyclopedia of Genes Genomes analyses indicated that the DEGs were associated with the extracellular matrix, fat metabolism and inflammatory response. We identified IL2, CXCR4, CCL5, THY1, CCN2, and IL7R as key genes. Single-sample GSEA showed that key genes were mainly related to energy metabolism, mitochondrial oxidative phosphorylation, extracellular matrix, and immunity. Finally, a total of 70 TCM compounds and 30 active ingredients of TCM compounds were identified. Bioinformatics methods were applied to preliminarily predict the key genes and TCM compounds involved in HF. These results provide theoretical support for the treatment of HF with TCM compounds and provide targets and research strategies for the development of related new Chinese medicines.

Retracted: Observation of Curative Effect of Trimetazidine Combined with Metoprolol in Elderly Patients with Coronary Heart Disease Complicated with Heart Failure and the Effect of Myocardial Remodeling by Integrated Traditional Chinese and Western Medicine

[This retracts the article DOI: 10.1155/2022/6098799.].