BACKGROUND: The morbidity and mortality of coronary heart disease (CHD) has remained high, which greatly increases people's economic burden. Several studies have showed that Tiaogan formula (TGF), as a kind of Chinese herbal medicine, was of benefit to relieving angina pectoris symptoms and improving the quality of life for CHD patients. However, the intensity of evidence has been poor, limiting the further clinical application of TGF to CHD. This systematic review and meta-analysis will assess the effectiveness and safety of studies of TGF in CHD patients. METHODS: A systematic search for literature up to December 2022 will be conducted in following public electronic databases: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database Database, and Wanfang Database. Inclusion criteria are randomized controlled trials of Tiaogan formula in the treatment of coronary heart disease. The primary outcome measures will be mortality, acute cardiovascular events, total efficacy rate, and improvement of angina symptoms. The secondary outcome measures will be electrocardiogram, levels of blood lipid, and adverse events. RevMan 5.4 software Cochrane Collaboration (London, United Kingdom) will be applied for data synthesis, sensitivity analysis, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Egger tests will be used to assess funnel plot symmetries. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence. RESULTS: This study will provide a systematic review of Tiaogan formula in the treatment of CHD. CONCLUSION: This study will provide a high-quality synthesis of the effects and safety of Tiaogan formula in the treatment of CHD patients.
Coronary Disease , Drugs, Chinese Herbal , Humans , Quality of Life , Systematic Reviews as Topic , Meta-Analysis as Topic , Coronary Disease/drug therapy , Coronary Disease/complications , Angina Pectoris/drug therapy , Angina Pectoris/complications , Drugs, Chinese Herbal/adverse effects , Treatment Outcome
Objective To observe the effects of TCM preconditioning of activating blood and dissolving stasis and myocardial ischemic preconditioning on NO/serum and HSP70/myocardium of rats with ischemia reperfusion for 24 hours by ischemia reperfusion. Methods Male Wistar rats were randomly divided into 4 groups, three groups of which were fed normally, one of which was administered with suspension of Chinese medicine. 10 days later normal rats in each group were operated by coronary artery ligation to establish myocardial ischemia model. The rats of sham-operated group were performed in the same way as myocardial ischemia rats except the coronary artery was not ligated. The rats of IR group were reperfused for 24 hours after 45 min of myocardial ischemia. The rats of TCM group were treated with suspension of Chinese medicine administration of 0.32g/100g for 10 days before the same ischemia and reperfusion as IR group. And the rats of IP group were also performed the same ischemia and reperfusion as IR group after 5 min of ischemia and 5 min of reperfusion for three times. The NO/serum of rats was observed by fluorospectrophotometry and the HSP70/myocardium by immunohistochemistry. Results The results showed that the contents of NO/serum and expression of HSP70/myocardium in the IP group and TCM group of activating blood and dissolving stasis were expressed more significantly than the IP group (P<0.05) . Conclusion The group of myocardial ischemic preconditioning for ischemia reperfusion and the TCM group of activating blood and dissolving stasis have the similar effects on the contents of NO and expression of HSP70 increasing.
Objective To observe the effects of TCM preconditioning of warming Yang and supplementing heart Qi on the myocardial ultrastructure of rats with acute myocardial ischemia, and discuss its protection on the ischemia reperfusion myocardium and relation with myocardial ischemic preconditioning. Method Male Wistar rats were randomly divided into 4 groups, 3 of which were fed normally, one of which was administered with TCM, and myocardial infarction model was established after 10 days. IR group were reperfused 48 hours after 45 min of ischemia. TCM group were treated with prophylactic administration of 0.36 g/100 g body weight for 10 days before the same ischemia and reperfusion as IR group. IP group were also performed the same ischemia and reperfusion as IR group after 5 min of ischemia and 5 min of reperfusion three times. The myocardial ultrastructure of rats was observed by electron microscope. Results In IR group:sarcolemma damaged, myofilament dissolved and fragmented, arranged loosely, mitochondria arranged confused, some mitochondria looked like cavitation or partly cavitation, some also presented coacervation state, glycogen decreased. And the myocardium damaged badly, it proved that part of the myocardium damaged after the ischemia reperfusion. In TCM and IP groups:the state of the cardiocytes were improved relatively and the sarcolemmas were integrated, the cardiocytes’ nucleoli presented to be oval-shape, and the nucleoli looked obviously, the mitochondria were showed relatively obviously, myofilaments were well arranged, the bright and dark bands of the sarcomeres looked apparently, mitochondria arranged in good order between the myofibrils, but still some myofilaments were broke and part of the mitochondria presented cavitation state. Conclusion The myocardial ischemic preconditioning and TCM preconditioning of warming Yang and supplementing heart Qi both can protect the ischemic myocardium through mitigating the damages of the myocardial ultrastructure, and they have the similar protection effects on the damaged myocardial ultrastructure of the rats with ischemia reperfusion.
