RESUMO
OBJECTIVE: The aim of this study is to comprehensively evaluate both the efficacy and safety profile of integrating the Tongxin formula with optimal medical therapy (OMT) for patients experiencing acute coronary syndromes subsequent to coronary stenting, over the course of one year. METHODS: We enrolled 150 patients diagnosed with acute coronary syndromes who had received stent placement within one month and exhibited a TCM syndrome characterized by Qi deficiency and blood stasis. This group comprised patients with unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. The participants were divided equally, allocating 75 to the Tongxin formula group and 75 to a placebo-controlled group. After undergoing percutaneous coronary intervention (PCI) surgery, both groups received conventional Western medical care, including dual antiplatelet therapy and lipid-lowering medications. The placebo-controlled group received a placebo, while the Tongxin formula group were administered Tongxin formula granules orally. Both study cohorts were monitored for a duration of 6 months. The primary endpoints included the occurrence of major adverse cardiovascular events and the rate of lumen diameter reduction post-treatment in both groups, with the Seattle Angina Scale serving as a secondary assessment tool. Safety evaluations encompassed the measurement of liver and kidney function, coagulation parameters, and other relevant indicators. RESULTS: The rate of adverse cardiovascular events in the placebo-controlled group was 42.46 % within a year of surgery, whereas it was 16.90 % in the Tongxin formula group (P < 0.05). Comparing the Tongxin formula group to the placebo-controlled group, there was a decrease in the frequency of unstable angina and readmission due to cardiovascular events (P < 0.05). Coronary angiography performed 6 months after surgery revealed that the Tongxin formula group had considerably less lumen loss than the placebo-controlled group in a number of segments, including the entire segment, within the stent, at the proximal end, and at the distal end (P < 0.05). Six months after surgery, the Seattle angina score was higher in the Tongxin formula group than in the placebo-controlled group (P < 0.05). There were no significant changes in indicators such as liver and renal function as well as coagulation indexes in both groups within the first 12 months after surgery (P > 0.05). CONCLUSION: Tongxin formula has been shown to lower the occurrence of major adverse cardiovascular events, minimize narrowing of blood vessel lumen, enhance clinical symptoms, and enhance the quality of life of patients following PCI surgery, all while maintaining a good safety profile.
RESUMO
OBJECTIVE: To investigate the function of activator protein-1 (AP-1) in proliferation and collagen synthesis of cardiac fibroblasts (CFs) in neonatal rats induced by tumor necrosis factor-alpha (TNF-alpha), and to explore the mechanism of Qiangxin Decoction (QXD), a compound traditional Chinese herbal medicine, in reversing cardiac fibrosis. METHODS: CFs derived from neonatal rats were cultured with enzymatic dissociation, and fibrosis of the CFs was induced by TNF-alpha. The CFs were divided into normal control group, untreated group, 5% QXD-containing serum group, 10% QXD-containing serum group and 20% QXD-containing serum group. After 24-hour culture of QXD-containing serum, AP-1 mRNA was detected by real-time fluorescent quantitative polymerase chain reaction; proliferation and collagen synthesis of CFs were assayed by thiazolyl blue assay (MTT) and measured by hydroxyproline respectively, in order to determine the effect of different dosage decoction on the proliferation and collagen synthesis of CFs. RESULTS: After 24-hour stimulation of TNF-alpha in CFs, compared with those in normal control group, the expression of AP-1 mRNA and cardiac fibroblast proliferation and collagen synthesis increased significantly (P<0.05). However, Qiangxin Decoction could reduce the expression of AP-1 mRNA and decreased the proliferation and collagen synthesis of CFs significantly (P<0.05). CONCLUSION: Qiangxin Decoction can inhibit proliferation and collagen synthesis of CFs induced by TNF-alpha, and reverse cardiac fibrosis, which may be related to its down-regulation of the expression of AP-1.
Assuntos
Proliferação de Células/efeitos dos fármacos , Colágeno/biossíntese , Medicamentos de Ervas Chinesas/farmacologia , Fibroblastos/efeitos dos fármacos , Fator de Transcrição AP-1/metabolismo , Fator de Necrose Tumoral alfa/farmacologia , Animais , Animais Recém-Nascidos , Células Cultivadas , Feminino , Fibroblastos/citologia , Fibroblastos/metabolismo , Masculino , Miocárdio/citologia , Miocárdio/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Fator de Transcrição AP-1/genéticaRESUMO
Harmony, an inherent value concept and a lofty ideal of the Chinese nation as well as the final aim of well-being in TCM, is a quite characteristic philosophical thought in Chinese ancient culture, which infiltrated different aspects of people's life and penetrated various aspects of TCM well-being. Harmony in the TCM concept of well-being concept reflected relations between nature and human, mind and physique, diet as well as body. By the methods of recuperation and maintenance aiming at harmony, including building up health to improve the ability of adaption and body resistance to the external environment, one can reduce or avoid the occurrence of disease in order to maintain the body in the optimum condition with harmony between internal and external, Yin and Yang, body and function as well as physical and mental health.