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In recent years， coronary microvascular disease （CMVD）， a main type of ischemic heart disease with high incidence and low diagnosis rate， has become a new research hotspot and received much clinical attention. The etiology of CMVD is complex and the symptoms are various. Traditional Chinese and Western medicine have different opinions on its pathogenesis and treatment plan. Western medicine believes that CMVD is related to structural abnormalities （such as microvascular remodeling， vascular invasion， lumen obstruction， sparse vascular vessel and perivascular fibrosis） and functional abnormalities （such as endothelial dysfunction， smooth muscle cell dysfunction， microvascular constriction， microvascular spasm， inflammation and autonomic nervous dysfunction） of coronary microvascular vessels as well as the extravascular factors （such as heart rate and blood pressure）. In clinics， conventional western medicines are usually used for empirical treatment， but with undesirable effects. Traditional Chinese medicine （TCM） believes that CMVD belongs to the category of "chest impediment"， "heart pain" and "collateral disease"， and the common syndromes include Qi deficiency and blood stasis， Qi stagnation and blood stasis， Qi and Yin deficiency， congealing cold in heart vessel， heart and spleen deficiency， blood stasis obstructing collaterals， combined phlegm and blood stasis， and liver and kidney deficiency， with a variety of treatment methods. Specifically， Chinese patent medicines， self-designed prescriptions， modified classical prescriptions and TCM characteristic therapies have achieved certain effects. This review discussed the risk factors， pathological mechanism， TCM etiology and pathogenesis and traditional Chinese and Western medicine treatment of CMVD， to provide reference for the study and treatment of CMVD.
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Shexiang Baoxin pills （SBP） are prescribed based on Suhexiang Pills derived from the Formulary of the Bureau of Taiping People's Welfare Pharmacy （《太平惠民和剂局方》） in the Song Dynasty. As the classic Chinese patent medicine in warming and dredging with aromatics， SBP have been widely used in clinical treatment for 30 years by virtue of their unique efficacy in coronary atherosclerotic heart disease （CHD）. Angiogenesis is a biological process in which the body activates angiogenesis-related factors in the body to act on endothelial cells under local vascular injury， tumor growth， local inflammation， and other stimuli to promote the proliferation， migration， and infiltration of endothelial cells， and form new sprouting or non-sprouting blood vessels. As a new strategy for ischemic diseases such as CHD， therapeutic angiogenesis is of great significance in the prevention and treatment of CHD in promoting angiogenesis of ischemic myocardium and establishing effective collateral circulation. However， for the atherosclerotic plaque and tumor， angiogenesis promotion is a risk factor for accelerating the disease progression. Therefore， safe and effective regulation of ischemic myocardial angiogenesis has become the focus of the current prevention and treatment of CHD. Studies in recent years have shown that SBP can intervene in angiogenesis with multiple pathways and targets， which can exert therapeutic angiogenesis effect on CHD and also inhibit atherosclerotic plaque and tumor angiogenesis to varying degrees. This study reviewed the experimental and clinical trials on the regulatory effect of SBPs on angiogenesis in CHD to provide references for the research on Chinese medicine intervention in angiogenesis of CHD.
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Objective:To evaluate the clinical efficacy and safety of compound glycyrrhizin combined with tripterygium wilfordii polyglycosides for psoriasis.Methods:Literature search was conducted in CNKI, Wanfang, VIP databases, Sinomed, PubMed, the Cochrane Library and Embase with the deadline of September 28th, 2020. The randomly controlled trials of compound glycyrrhizin combined with tripterygium wilfordii polyglycosides in treating psoriasis was included. The publication bias and methodology quality of RCTs were evaluated according to the Cochrane 5.0.1 bias risk assessment method. The RevMan 5.3 software was used for meta analysis.Results:Ten studies with 961 patients were included, with the experimental group ( n=486) and the control group ( n=475). The results of meta-analysis showed that the total effective rate [ OR=3.16, 95% CI (2.00-4.99), P<0.001], the cure rate [ OR=2.56, 95% CI (1.94-3.61), P<0.001], the recurrence rate [ OR=0.15, 95% CI (0.04-0.60), P=0.007], the total incidence of adverse reactions [ OR=0.53, 95% CI (0.34-0.82), P=0.004], the incidence of abnormal liver function [ OR=0.17, 95% CI (0.06-0.47), P=0.001] in the experimental group were better than those in the control group. There was no significant difference on the incidence of adverse reactions of digestive tract ( P>0.05) or lower extremity or facial edema ( P>0.05) between both groups. Conclusions:Compound glycyrrhizin combined with tripterygium wilfordii polyglycosides is effective in the treatment of psoriasis than tripterygium wilfordii polyglycosides alone, and can reduce the recurrence rate and the incidence of adverse reactions. However, a large number of large samples and high-quality studies are still needed.