Objective:To evaluate the immediate effect of Kuanxiong Aerosol(KXA)on perioperative coronary microcirculation in patients with unstable angina(UA)suffering from elective percutaneous coronary intervention(PCI).Method...Objective:To evaluate the immediate effect of Kuanxiong Aerosol(KXA)on perioperative coronary microcirculation in patients with unstable angina(UA)suffering from elective percutaneous coronary intervention(PCI).Methods:From February 2021 to July 2023,UA inpatients who underwent PCI alone in the left anterior descending(LAD)branch were included.Random numbers were generated to divide patients into the trial group and the control group at a ratio of 1:1.The index of coronary microcirculation resistance(IMR)was measured before PCI,and the trial group was given two sprays of KXA,while the control group was not given.IMR was measured again after PCI,cardiac troponin I(cTnI)and creatine kinase isoenzyme-MB(CK-MB)were detected before and 24 h after surgery,and major cardiovascular adverse events(MACEs)were recorded for 30 days.The data statistics and analysis personnel were blinded.Results:Totally 859 patients were screened,and 62 of them were involved into this study.Finally,1 patient in the trial group failed to complete the post-PCI IMR and was excluded,30 patients were included for data analysis,while 31 patients in the control group were enrolled in data analysis.There was no significant difference in baseline data(age,gender,risk factors,previous history,biochemical index,and drug therapy,etc.)between the two groups.In addition,differences in IMR,cTnI and CK-MB were not statistically significant between the two groups before surgery.After PCI,the IMR level of the trial group was significantly lower than that of the control group(19.56±14.37 vs.27.15±15.03,P=0.048).Besides,the incidence of perioperative myocardial injury(PMI)was lower in the trial group,but the difference was not statistically significant(6.67%vs.16.13%,P=0.425).No MACEs were reported in either group.Conclusions:KXA has the potential of improving coronary microvascular dysfunction.This study provides reference for the application of KXA in UA patients undergoing elective PCI.展开更多
Objective： To evaluate the effect and safety of Kuanxiong Aerosol （宽胸气雾剂, KA） on patients with angina pectoris. Methods： Block randomization was performed to randomly allocate 750 patients into KA （376 cases...Objective： To evaluate the effect and safety of Kuanxiong Aerosol （宽胸气雾剂, KA） on patients with angina pectoris. Methods： Block randomization was performed to randomly allocate 750 patients into KA （376 cases） and control groups （374 cases）. During an angina attack, the KA group received 3 consecutive sublingual sprays of KA （0.6 mL per spray）. The control group received 1 sublingual nitroglycerin tablet （NT, 0.5 rag/tablet）. Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment （1,2, 3, 4, 5, and 〉5 min）. Logistic regression analysis was performed to observe the factors influencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society （CCS） classes of angina. Results： The 5-min remission rates in the KA and control groups were not significantly different （94.41% vs. 90.64%, P〉0.05）. The angina CCS class significantly influenced the rate of remission （95% confidence interval = 0.483-0.740, P〈0.01）. In the CCS subgroup analysis, the 3- and 5-min remission rates for KA and NT were similar in the CCS I and IV subgroups （P〉0.05）, while they were significantly better for KA in the CCS Ⅱ and Ⅲ subgroups （P〈0.05 or P〈0.01）. Furthermore, the inciden0ce of adverse reactions was significantly lower in the KA group than in the control group for the CCS Ⅱ and Ⅲ subgroups （9.29% vs. 26.22%, 10.13% vs. 20.88%, P〈0.05 or P〈0.01）. Conclusions： KA is not inferior to NT in the remission of angina. Furthermore, in CCS Ⅱ and Ⅲ patients, KA is superior to NT, with a lower incidence of adverse reactions. （Registration No. ChiCTR- IPR-15007204）展开更多
Angina pectoris(AP)is the most common symptom of cardiovascular diseases,which seriously affects the quality of life in cardiovascular patients.Kuanxiong(KX)Aerosol(宽胸气雾剂),a compound preparation that consists of ...Angina pectoris(AP)is the most common symptom of cardiovascular diseases,which seriously affects the quality of life in cardiovascular patients.Kuanxiong(KX)Aerosol(宽胸气雾剂),a compound preparation that consists of 5 traditional Chinese medicines:Herba Asari,Rhizoma Alpiniae Officinarum,Lignum Santali Albi,Fructus Piperis Longi,and Borneolum,has been used in the treatment of AP for many years,exhibiting a significant curative effect and less side-effect.For the convenience and comprehensive understanding of KX Aerosol,this review systematically summarizes evidence on KX Aerosol in the treatment of AP including the pharmacological effects of its composition,clinical research,animal experiments,and network pharmacology prediction.Meanwhile,we highlight the research limitation of KX Aerosol at present.This review may guide the clinical application of KX Aerosol and further provide a reference for the research of AP.展开更多
Objective: To explore the effect of Kuanxiong Aerosol(KXA)on isoproterenol(ISO)-induced myocardial injury in rat models.Methods: Totally 24 rats were radomly divided into control,ISO,KXA low-dose and high-dose groups ...Objective: To explore the effect of Kuanxiong Aerosol(KXA)on isoproterenol(ISO)-induced myocardial injury in rat models.Methods: Totally 24 rats were radomly divided into control,ISO,KXA low-dose and high-dose groups according to the randomized block design method,and were administered by intragastric administration for 10 consecutive days,and on the 9th and 10th days,rats were injected with ISO for 2 consecutive days to construct an acute myocardial ischemia model to evaluate the improvement of myocardial ischemia by KXA.In addition,the diastolic effect of KXA on rat thoracic aorta and its regulation of ion channels were tested by in vitro vascular tension test.The influence of KXA on the expression of calcium-CaM-dependent protein kinase Ⅱ(CaMK Ⅱ)/extracellular regulated protein kinases(ERK)signaling pathway has also been tested.Results: KXA significantly reduced the ISO-induced increase in ST-segment,interventricular septal thickness,cardiac mass index and cardiac tissue pathological changes in rats.Moreover,the relaxation of isolated thoracic arterial rings that had been precontracted using norepinephrine(NE)or potassium chloride(KCl)was increased after KXA treatment in an endothelium-independent manner,and was attenuated by preincubation with verapamil,but not with tetraethylammonium chloride,4-aminopyridine,glibenclamide,or barium chloride.KXA pretreatment attenuated vasoconstriction induced by CaCl_(2)in Ca^(2+)-free solutions containing K^(+) or NE.In addition,KXA pretreatment inhibited accumulation of Ca^(2+)in A7r5 cells mediated by KCl and NE and significantly decreased p-CaMK Ⅱ and p-ERK levels.Conclusion: KXA may inhibit influx and release of calcium and activate the CaMK Ⅱ/ERK signaling pathway to produce vasodilatory effects,thereby improving myocardial injury.展开更多
Objective: The objective is to observe the effect of Kuanxiong aerosol(KXA) on angina and the quality of life of patients after percutaneous coronary intervention(PCI). Materials and Methods: Six hundred patients with...Objective: The objective is to observe the effect of Kuanxiong aerosol(KXA) on angina and the quality of life of patients after percutaneous coronary intervention(PCI). Materials and Methods: Six hundred patients with angina after PCI(AAP) were randomly assigned to an experimental group and a control group(n = 300 in each group) and received basic treatment with KXA or basic treatment(respectively) for 8 weeks. The Seattle Angina Questionnaire(SAQ) and visual analog scale(VAS) scores of the two groups during the screening period and five follow-up periods were compared. Results: A total of 179 patients were included in this interim report, including 85 in the experimental group and 94 in the control group. Among the five-dimensional scores of the SAQ, the improvement in the angina frequency and quality of life scores in the experimental group was better than those in the control group after treatment(P < 0.01), and the difference in scores of the remaining dimensions was not statistically significant(P > 0.01). The difference in VAS scores between the two groups was not statistically significant(P > 0.01). No obvious adverse reactions were observed between the two groups. Conclusions: KXA can reduce the frequency of AAP and improve patients’ quality of life.展开更多
目的:系统评价宽胸气雾剂干预院前胸闷痛病人的临床疗效和安全性。方法:检索中文数据库[中国生物医学文献服务系统(SinoMed)、维普(VIP)、中国知网(CNKI)和万方]和英文数据库(the Cochrane Library、EMbase、PubMed、Web of Science)从...目的:系统评价宽胸气雾剂干预院前胸闷痛病人的临床疗效和安全性。方法:检索中文数据库[中国生物医学文献服务系统(SinoMed)、维普(VIP)、中国知网(CNKI)和万方]和英文数据库(the Cochrane Library、EMbase、PubMed、Web of Science)从建库至2022年8月1日发表的宽胸气雾剂治疗胸闷痛的随机对照试验研究(RCT)。主要观察指标包括胸闷痛缓解率、心电图改善率和不良反应发生率。采用RevMan 5.3软件进行偏倚风险评价、Meta分析、敏感性分析和发表偏倚分析。结果:共纳入19项RCT,涉及2487例病人。Meta分析结果显示,宽胸气雾剂组(试验组)胸闷痛缓解率高于对照组,差异有统计学意义[RR=1.15,95%CI(1.06,1.25),P=0.001];心电图改善率与对照组相比差异无统计学意义[RR=1.04,95%CI(0.99,1.10),P=0.14];应用宽胸气雾剂不良反应发生率较应用硝酸甘油等常规药物低,差异有统计学意义[RR=0.41,95%CI(0.33,0.52),P<0.00001]。纳入的19项研究中仅有2项提及盲法(单盲),纳入文献质量偏低。结论:现有证据表明,宽胸气雾剂能提高胸闷痛缓解率,降低不良反应发生率,但心电图改善不明显。本研究纳入文献的方法学质量相对较低,仍然需要严格的、大样本的随机双盲试验加以验证宽胸气雾剂的临床疗效。展开更多
基金Supported by Capital's Funds for Health Improvement and Research(No.2022-1-2231)Beijing Science and Technology Program(No.Z221100007422127)Beijing Municipal Hospital Administration Green Seedling Talent Project(No.QML20231003)。
文摘Objective:To evaluate the immediate effect of Kuanxiong Aerosol(KXA)on perioperative coronary microcirculation in patients with unstable angina(UA)suffering from elective percutaneous coronary intervention(PCI).Methods:From February 2021 to July 2023,UA inpatients who underwent PCI alone in the left anterior descending(LAD)branch were included.Random numbers were generated to divide patients into the trial group and the control group at a ratio of 1:1.The index of coronary microcirculation resistance(IMR)was measured before PCI,and the trial group was given two sprays of KXA,while the control group was not given.IMR was measured again after PCI,cardiac troponin I(cTnI)and creatine kinase isoenzyme-MB(CK-MB)were detected before and 24 h after surgery,and major cardiovascular adverse events(MACEs)were recorded for 30 days.The data statistics and analysis personnel were blinded.Results:Totally 859 patients were screened,and 62 of them were involved into this study.Finally,1 patient in the trial group failed to complete the post-PCI IMR and was excluded,30 patients were included for data analysis,while 31 patients in the control group were enrolled in data analysis.There was no significant difference in baseline data(age,gender,risk factors,previous history,biochemical index,and drug therapy,etc.)between the two groups.In addition,differences in IMR,cTnI and CK-MB were not statistically significant between the two groups before surgery.After PCI,the IMR level of the trial group was significantly lower than that of the control group(19.56±14.37 vs.27.15±15.03,P=0.048).Besides,the incidence of perioperative myocardial injury(PMI)was lower in the trial group,but the difference was not statistically significant(6.67%vs.16.13%,P=0.425).No MACEs were reported in either group.Conclusions:KXA has the potential of improving coronary microvascular dysfunction.This study provides reference for the application of KXA in UA patients undergoing elective PCI.
基金Supported by the Traditional Chinese Medicine Public Welfare Scientific Research Project,State Administration of Traditional Chinese Medicine of China(No.201007001)
文摘Objective： To evaluate the effect and safety of Kuanxiong Aerosol （宽胸气雾剂, KA） on patients with angina pectoris. Methods： Block randomization was performed to randomly allocate 750 patients into KA （376 cases） and control groups （374 cases）. During an angina attack, the KA group received 3 consecutive sublingual sprays of KA （0.6 mL per spray）. The control group received 1 sublingual nitroglycerin tablet （NT, 0.5 rag/tablet）. Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment （1,2, 3, 4, 5, and 〉5 min）. Logistic regression analysis was performed to observe the factors influencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society （CCS） classes of angina. Results： The 5-min remission rates in the KA and control groups were not significantly different （94.41% vs. 90.64%, P〉0.05）. The angina CCS class significantly influenced the rate of remission （95% confidence interval = 0.483-0.740, P〈0.01）. In the CCS subgroup analysis, the 3- and 5-min remission rates for KA and NT were similar in the CCS I and IV subgroups （P〉0.05）, while they were significantly better for KA in the CCS Ⅱ and Ⅲ subgroups （P〈0.05 or P〈0.01）. Furthermore, the inciden0ce of adverse reactions was significantly lower in the KA group than in the control group for the CCS Ⅱ and Ⅲ subgroups （9.29% vs. 26.22%, 10.13% vs. 20.88%, P〈0.05 or P〈0.01）. Conclusions： KA is not inferior to NT in the remission of angina. Furthermore, in CCS Ⅱ and Ⅲ patients, KA is superior to NT, with a lower incidence of adverse reactions. （Registration No. ChiCTR- IPR-15007204）
基金Supported by the National Natural Science Foundation of China(No.81703848)Project of Administration of Traditional Chinese Medicine of Guangdong Province of China(No.20181126)+1 种基金the Special Clinical Research Fund for TCM Science and Technology of Guangdong Provincial Hospital of Chinese Medicine(No.YN2018QL06)Hospital TCM Preparation Development Project(No.E44939)。
文摘Angina pectoris(AP)is the most common symptom of cardiovascular diseases,which seriously affects the quality of life in cardiovascular patients.Kuanxiong(KX)Aerosol(宽胸气雾剂),a compound preparation that consists of 5 traditional Chinese medicines:Herba Asari,Rhizoma Alpiniae Officinarum,Lignum Santali Albi,Fructus Piperis Longi,and Borneolum,has been used in the treatment of AP for many years,exhibiting a significant curative effect and less side-effect.For the convenience and comprehensive understanding of KX Aerosol,this review systematically summarizes evidence on KX Aerosol in the treatment of AP including the pharmacological effects of its composition,clinical research,animal experiments,and network pharmacology prediction.Meanwhile,we highlight the research limitation of KX Aerosol at present.This review may guide the clinical application of KX Aerosol and further provide a reference for the research of AP.
基金Supported by Natural Science Foundation of Fujian Province(No.2018J01884)Science and Technology Major Project of Fujian Province(No.2019YZ014004)+1 种基金Fujian Provincial Health and Family Planning Commission(No.2018-CX-42)the National Natural Science Foundation of China(No.81774135)。
文摘Objective: To explore the effect of Kuanxiong Aerosol(KXA)on isoproterenol(ISO)-induced myocardial injury in rat models.Methods: Totally 24 rats were radomly divided into control,ISO,KXA low-dose and high-dose groups according to the randomized block design method,and were administered by intragastric administration for 10 consecutive days,and on the 9th and 10th days,rats were injected with ISO for 2 consecutive days to construct an acute myocardial ischemia model to evaluate the improvement of myocardial ischemia by KXA.In addition,the diastolic effect of KXA on rat thoracic aorta and its regulation of ion channels were tested by in vitro vascular tension test.The influence of KXA on the expression of calcium-CaM-dependent protein kinase Ⅱ(CaMK Ⅱ)/extracellular regulated protein kinases(ERK)signaling pathway has also been tested.Results: KXA significantly reduced the ISO-induced increase in ST-segment,interventricular septal thickness,cardiac mass index and cardiac tissue pathological changes in rats.Moreover,the relaxation of isolated thoracic arterial rings that had been precontracted using norepinephrine(NE)or potassium chloride(KCl)was increased after KXA treatment in an endothelium-independent manner,and was attenuated by preincubation with verapamil,but not with tetraethylammonium chloride,4-aminopyridine,glibenclamide,or barium chloride.KXA pretreatment attenuated vasoconstriction induced by CaCl_(2)in Ca^(2+)-free solutions containing K^(+) or NE.In addition,KXA pretreatment inhibited accumulation of Ca^(2+)in A7r5 cells mediated by KCl and NE and significantly decreased p-CaMK Ⅱ and p-ERK levels.Conclusion: KXA may inhibit influx and release of calcium and activate the CaMK Ⅱ/ERK signaling pathway to produce vasodilatory effects,thereby improving myocardial injury.
文摘Objective: The objective is to observe the effect of Kuanxiong aerosol(KXA) on angina and the quality of life of patients after percutaneous coronary intervention(PCI). Materials and Methods: Six hundred patients with angina after PCI(AAP) were randomly assigned to an experimental group and a control group(n = 300 in each group) and received basic treatment with KXA or basic treatment(respectively) for 8 weeks. The Seattle Angina Questionnaire(SAQ) and visual analog scale(VAS) scores of the two groups during the screening period and five follow-up periods were compared. Results: A total of 179 patients were included in this interim report, including 85 in the experimental group and 94 in the control group. Among the five-dimensional scores of the SAQ, the improvement in the angina frequency and quality of life scores in the experimental group was better than those in the control group after treatment(P < 0.01), and the difference in scores of the remaining dimensions was not statistically significant(P > 0.01). The difference in VAS scores between the two groups was not statistically significant(P > 0.01). No obvious adverse reactions were observed between the two groups. Conclusions: KXA can reduce the frequency of AAP and improve patients’ quality of life.
