Myocardial fibrosis (MF) is a common pathological process in various cardiac diseases, including myocardial infarction (MI), hypertensive heart disease, and dilated cardiomyopathy. MF is characterized by excessive deposition of extracellular matrix (ECM), reduced myocardial compliance, and impaired cardiac function. This process can lead to arrhythmias and sudden cardiac death. Currently, effective and safe therapies for MF are limited. This review summarizes recent advances in the use of natural compounds to treat MF by regulating signaling pathways. Representative compounds, such as Salvianolic acid B (Sal B), Astragaloside IV (AS-IV), Pachymic acid, Resveratrol, Curcumin, Matrine, Artemisinin, and Artesunate, among others, can modulate multiple profibrotic signaling pathways. These compounds reduce profibrotic cytokines, inhibit collagen deposition, reverse myofibroblast differentiation, enhance ECM degradation, and alleviate inflammation and oxidative stress. As a result, they improve MF and regulate systemic inflammatory responses. However, comprehensive data on the pharmacokinetics, bioavailability, long-term safety, and clinical efficacy of these natural compounds are still lacking. Future studies should focus on optimizing delivery strategies and conducting rigorously designed clinical trials to support the clinical translation of these compounds for MF treatment.

Neutrophil extracellular traps (NETs) are positively correlated with the severity of calcific aortic valve disease (CAVD). This study aims to elucidate the mechanism by which NETs contribute to CAVD. The CAVD mice model was established by calcification-promoting diets, and NETs formation was modulated via intraperitoneal injection of Cl-amidine. We observed the effect of NETs on Raw264.7 cells by regulating NETs and TLR9 in vitro. Concentrations of TNF-α, MPO-DNA complex, and IL-10 were measured using ELISA. NETs formation was assessed through immunofluorescence assay citrullinated histone H3 (citH3). Expression levels of BMP2, RUNX2, IL-1β, TNF-α, IL-10, and TLR 9 were analyzed by qRT-PCR and Western blotting, while flow cytometry was used to assess the expression of CD86 and CD206 on Raw264.7 cells. Results indicated that compared to the vehicle group, the CAVD group exhibited significant valve thickening and increased calcium deposition, as well as elevated levels of inflammatory factors TNF-α and IL-1β, NET-related markers MPO-DNA complexes and citH3, ossification factors BMP2 and RUNX2, and TLR9. Conversely, IL-10 levels were significantly reduced. Cl-amidine intervention in early CAVD mice significantly improved valve thickness and reduced calcium deposition, inflammatory factors, NETs-related markers, ossification factors, and TLR9 levels, while increasing IL-10 levels. Cl-amidine may delay CAVD progression in mice by reducing NETs. In vitro studies confirmed that serum from CAVD mice induced NETs, promoting the polarization of Raw264.7 cells to the M1 phenotype via TLR9 signaling pathway, thereby releasing pro-inflammatory factors (TNF-α, IL-1β, and IL-6), and inhibiting M2 polarization and IL-10 expression. In summary, our findings suggest that NETs promote Raw264.7 cell polarization to M1 through the TLR9 signaling pathway, contributing to the inflammatory response in CAVD. This study proposes a novel therapeutic strategy targeting NETs to delay CAVD progression.

BackgroundThe global and regional burden of lower extremity peripheral artery disease (LEPAD) and its trends have not been systematically studied. Utilizing data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study analyses the global burden and associated risk factors for LEPAD from 1990 to 2021 and predicts its incidence trends to 2050.MethodsLEPAD-related data including the number of morbidity, mortality, disability-adjusted life years (DALYs), age-standardized rate (ASR), were extracted from the GBD 2021 database. The analysis assesses the burden stratified by social demographic index (SDI), age, and sex. Bayesian age-period-cohort (BAPC) models were used to predict the future age-standardized incidence.FindingsThe global incidence, death, and DALY of LEPAD increased significantly between 1990 and 2021; however, age-standardized incidence rate (ASIR), age-standardized rates of death (ASMR), and age-standardized disability-adjusted life years (ASDR) have shown an overall decline. In addition, ASIR and SDI were positively correlated. Age-specific analyses revealed that ASMR increased with age. The predictions from the BAPC model indicate a slight increase in ASIR over the next 29 years. While high fasting glucose dominated LEPAD DALYs, summary exposure value (SEV) metrics exposed high Low-Density Lipoprotein Cholesterol (LDL-C) as the primary metabolic exposure burden, highlighting a critical prevention gap.InterpretationThe burden of LEPAD increases progressively with age, and its prevalence is influenced mainly by the SDI. Despite the increased incidence of LEPAD in women, mortality and DALYs were substantially higher in men. The global burden of LEPAD is projected to increase progressively by 2050, representing a major health concern.

This study systematically evaluated the efficacy and safety of Wenxin Granules in treating chronic pulmonary heart disease complicated by arrhythmia, aiming to provide more reliable evidence-based support for clinical practice. Randomized controlled trials(RCTs) investigating Wenxin Granules for this indication were retrieved from CNKI, VIP, Wanfang, PubMed, Cochrane Library, and EMbase. According to pre-defined inclusion and exclusion criteria, two researchers independently performed literature screening and data extraction. The methodological quality of the included studies was assessed via the Cochrane risk of bias tool 2.0(RoB 2.0), and RevMan 5.4 was used for Meta-analysis. A total of 10 RCTs were finally included. Meta-analysis showed that compared with conventional treatment alone, Wenxin Granules combined with conventional treatment increased the clinical response rate(OR=4.82, 95%CI[3.19, 7.29], P<0.000 01) and the effective rate of electrocardiogram(ECG)(OR=4.34, 95%CI[2.69, 7.01], P<0.000 01). However, regarding the specific indicator of premature ventricular contractions, there was no statistically significant difference between the two groups(SMD=1.24, 95%CI[-1.46, 3.94], P=0.37). Safety assessment indicated that the difference in the incidence of adverse reactions between the combined therapy group and the conventional treatment group was not statistically significant(OR=2.17, 95%CI[0.76, 6.17], P=0.15). In conclusion, Wenxin Granules as a supplement to conventional treatment significantly increases the clinical response rate and effective rate of ECG in patients with chronic pulmonary heart disease complicated by arrhythmia, without significantly increasing the risk of adverse reactions. The findings of this study provide supportive evidence for the clinical application of Wenxin Granules for this indication.

The ratio of triglycerides to high-density-lipoprotein cholesterol (TG/HDL-C) is increasingly recognized as a practical marker for insulin resistance and cardiovascular risk assessment. This retrospective study investigates the potential of the TG/HDL-C ratio to predict the development of calcific aortic valve disease (CAVD), thereby extending its applicability in cardiovascular diagnostics. Data from 400 individuals, comprising 200 patients with diagnosed CAVD and 200 matched healthy controls, were analyzed. Clinical parameters were compared between groups, and logistic regression was utilized to explore the association of the TG/HDL-C ratio with CAVD. The diagnostic performance of the TG/HDL-C ratio was assessed using receiver operating characteristic (ROC) curves. The TG/HDL-C ratio was notably higher in the CAVD group than in the controls (Z = -7.98, P < 0.001). Multivariable logistic regression analysis indicated that the TG/HDL-C ratio is an independent predictor of CAVD after adjusting for confounders including gender. The ROC curve analysis revealed that the TG/HDL-C ratio achieved a sensitivity of 80.5

OBJECTIVE: To systematically evaluate the antihypertensive effect of dietary patterns of blood pressure management. METHODS: The researchers searched the following databases: PubMed, Embase, the Cochrane Library, Web of Science, Scopus, China Knowledge Network, China Biomedical Literature Service, Wanfang Database, and Wipu.com by computer. Search for randomized controlled trials (RCTs) on the effects of Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH), and Chinese Heart-Healthy (CHH) diet on blood pressure in English and Chinese. RCTs, which were published from the time of the study until 02/2023. The investigators assessed and screened the literature before conducting a systematic evaluation and meta-analysis using Stata 15 software. RESULTS: This study included 27 publications containing 7,409 study subjects, including 3,677 in the trial group and 3,732 in the control group. Dietary models for blood pressure management were effective in reducing systolic blood pressure [weighted mean difference (WMD) = -3.94, 95% confidence interval (CI): (-5.10, -2.77), P < 0.001] and diastolic blood pressure [WMD = -2.32, 95% CI: (-3.01, -1.63), P < 0.001]. CONCLUSIONS: Dietary models for blood pressure management have a clear positive impact on blood pressure management in patients, and more high-quality studies with standardized design and long intervention period are needed in the future to provide strong evidence for healthy diet-based blood pressure management.

经穴体外反搏是特色中医外治技术,可从血流动力学、穴位、经络等多维度治疗冠心病,该疗法将传统中医经络穴位理论应用于体外反搏,具有多途径、多靶点、多效应等特点.本研究综述经穴体外反搏改善血管内皮功能、抗炎、提高剪切应力、改善心肌重塑、促进血管生成及侧支循环开放等的作用,以期抑制动脉粥样硬化的发展,为冠心病的康复治疗提供循证依据.

Intervention based on "digital therapeutics" (DTs) to aid smoking cessation (SC) has developed in recent years. This systematic review and meta-analysis aimed to explore the efficacy of DTs in SC. Databases (PubMed, Embase, Scopus, Institute of Electrical and Electronics Engineers Xplore, ClinicalTrials, Science Direct, Web of Science, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wanfang, Cochrane Central Register of Controlled Trials) from inception to June 27, 2022 were searched to collect randomized controlled trials focusing on use of DTs for SC. Revman 5.3 and Stata16 were used for meta-analysis. After literature screening, data extraction, and quality assessment by two researchers. 33 studies (19,749 participants) were included. Compared with the control group, DTs significantly increased the prevalence of abstinence of smokers [OR ​= ​1.77, 95% CI [1.39,2.26], p ​= ​0], significantly increased the point prevalence abstinence (PPA) [OR ​= ​1.45,95% CI [1.18,1.78], p ​= ​0], and improved participation in SC programs [OR ​= ​1.12,95% CI [1.01,1.24], p ​= ​0.038]. Subgroup analysis showed that, among different intervention groups, the prevalence of DTs-assisted SC in chronic obstructive pulmonary disease (COPD) smokers was higher than that in other groups [OR ​= ​5.18,95% CI [1.49,18.05], p ​= ​0.001], the prevalence of WeChat-assisted SC in smokers was higher than that in other groups [OR ​= ​4.37,95% CI [2.21,8.67], p ​= ​0]. This meta-analysis showed that DTs-assisted SC improved the prevalence of abstinence, PPA, and increased the participation of smokers in SC programs.

目的:分析血清半乳糖凝集素-3(Gal-3)及炎症反应与慢性心力衰竭病人心功能和心脏主要不良心脏事件(MACE)的相关性.方法:选取2019年4月—2020年6月在上海中医药大学附属曙光医院心血管内科诊断为慢性心力衰竭病人138例为试验组,选取同时期健康体检者62名为对照组.观察血清Gal-3及炎症反应因子超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平变化,分析其与心功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及左室射血分数(LVEF)]及3个月内发生MACE的相关性.结果:试验组血清Gal-3、hs-CRP、TNF-α及IL-6水平高于对照组(P<0.01).慢性心力衰竭病人心功能分级越高,Gal-3、hs-CRP、TNF-α及IL-6水平越高(P<0.05).试验组血清Gal-3和炎症反应因子与LVESD、LVEDD呈正相关(P<0.01),与LVEF呈负相关(P<0.01).发生MACE病人血清Gal-3和炎症反应因子高于未发生MACE病人(P<0.05).结论:慢性心力衰竭病人血清Gal-3及炎症反应因子水平升高,对心功能及MACE发生情况有影响,提示Gal-3及炎症反应可辅助判断慢性心力衰竭病情严重程度及预后.

目的:探究中医不同证型胸痹病人低密度脂蛋白胆固醇(LDL-C)水平及降脂达标情况.方法:回顾性选取2021年6月—2022年6月在我院心血管内科住院期间诊断为胸痹的病人80例,参照《中药新药临床研究指导原则(试行)》,将冠心病心绞痛按照中医辨证进行分型,本研究主要纳入心血瘀阻证、痰阻心脉证、气滞血瘀证、气虚血瘀证、气阴两虚证.结果:①痰阻心脉证最常见,其次,分别为心血瘀阻证、气虚血瘀证、气滞血瘀证、气阴两虚证;②不同分型中LDL-C水平由高到低依次为痰阻心脉证>气滞血瘀证>心血瘀阻证>气虚血瘀证>气阴两虚证,差异有统计学意义(P<0.05);③不同证型LDL-C达标率均较低,差异无统计学意义(P>0.05);尽早联合应用降脂药、较低动脉粥样硬化性心血管疾病(ASCVD)危险分层的病人LDL-C达标率偏高,差异有统计学意义(P<0.001).结论:胸痹中医证型以痰阻心脉证和心血瘀阻证常见,痰阻心脉证LDL-C水平最高,各分型达标率均较低,存在极高的心血管疾病风险,降低LDL-C应尽早联合用药,积极控制危险因素,中医可从化痰通络着手研究以期降低ASCVD风险,提高生活质量.

目的 系统评价免疫球蛋白辅助治疗扩张型心肌病(DCM)的疗效与安全性.方法 检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普生物医学数据库(VIP)、万方数据库(Wanfang Deta)、PubMed、Embase、Cochrane Librery等数据库,收集从建库至2022年1月发表的免疫球蛋白治疗DCM的临床随机对照试验(RCTs).由2名研究员独立筛选文献、提取数据及质量评价后,采用RevMan 5.3和R 4.1.0软件进行Meta分析.结果 共纳入21篇RCTs,1691例患者,其中试验组(常规治疗联合免疫球蛋白)患者851例、对照组(常规治疗)患者840例.Meta分析结果显示:与对照组比较,试验组患者的临床疗效更好[RR=1.35,95％CI(1.25,1.45),P＜0.000 01],左心室射血分数显著增加[MD=7.35,95％CI(6.13,8.57),P＜0.000 01];显著降低左心室舒张末期内径[MD=-6.23,95％CI(-7.41,-5.05),P＜0.000 01]、免疫球蛋白 G 水平[MD=-1.37,95％CI(-1.96,-0.78),P＜0.000 01]及脑钠肽水平[MD=-474.79,95％CI(-609.29,-340.28),P＜0.000 01].结论 免疫球蛋白辅助治疗进一步改善DCM患者的临床疗效、左心室射血分数、左心室舒张末期内径、免疫球蛋白G及脑钠肽水平.但是纳入文献数目和样本量较少,该结论还需更多高质量、多中心的RCTs来验证.

目的 对通心络胶囊治疗冠心病心绞痛的系统评价/Meta分析进行再评价.方法 检索建库至2022年5月1日中国知网(CNKI)、万方(WanFang Data)、维普(VIP)、PubMed、EMbase、the Cochrane Library数据库发表的通心络胶囊治疗冠心病心绞痛的系统评价/Meta分析,由2位研究员筛选符合纳入与排除标准的系统评价,提取资料,交叉核对.采用AMSTAR2量表进行方法学质量评价,采用GRADE工具行证据等级评价.结果 共纳入9篇系统评价/Meta分析.AMSTARE2评价结果显示所有报告均为极低级质量.GEADE分级结果显示,57个结局指标中,证据质量为中级的指标3个,证据质量为低级的指标12个,证据质量为极低级的指标42个,研究的局限性和发表偏倚为主要降级原因.结论 通心络胶囊治疗冠心病心绞痛的相关系统评价/Meta分析的方法学质量总体不高,结论的证据水平普遍较低,未来需要严格遵循循证医学科研设计要求的临床试验和系统评价以提供更高质量的证据.

目的 观察鹿红方对心肌梗死后心力衰竭大鼠心肌纤维化的影响,从TGF-β1/Smads通路探讨其作用机制.方法 采用左冠状动脉结扎法制各心肌梗死后心力衰竭大鼠模型.60只Wistar大鼠随机分为假手术组、模型组、培哚普利组和鹿红方低、中、高剂量组,鹿红方低、中、高剂量组分别予鹿红方0.625、1.25、2.5 g/kg灌胃,培哚普利组予培哚普利2 mg/kg灌胃,模型组及假手术组予等体积生理盐水,每日1次.灌胃8周后,超声心动图检测大鼠左室射血分数(LVEF)和缩短分数(FS);HE和Masson染色检测心脏组织病理变化,计算心肌胶原容积分数(CVF);PCR和Western blot分别检测心肌组织TGF-β1、Smad2、Smad3、Smad7 mRNA和蛋白表达.结果 与假手术组比较,模型组大鼠LVEF、FS明显降低(P＜0.01),心肌组织局部出现细胞消失,结缔组织内部有大量淋巴细胞浸润,细胞发生肿胀,呈纤维化改变,CVF明显升高(P＜0.01),心肌组织TGF-β1、Smad2、Smad3 mRNA和蛋白表达升高,Smad7 mRNA和蛋白表达明显降低(P＜0.01);与模型组比较,鹿红方低、中、高剂量组及培哚普利组大鼠LVEF、FS明显升高(P＜0.01),结缔组织增生、淋巴细胞浸润减少,心肌纤维化改善,CVF明显降低(P＜0.05,P＜0.01),鹿红方中、高剂量组及培哚普利组大鼠心肌组织TGF-β1、Smad2、Smad3 mRNA和蛋白表达明显降低,Smad7 mRNA和蛋白表达明显升高(P＜0.01).结论 鹿红方对心肌梗死后心力衰竭大鼠心肌纤维化有良好的抑制作用,其机制可能与调节TGF-β1/Smads通路有关.

BACKGROUND:Excessive activation of the nod-like receptor family pyrin domain containing 3(NLRP3) inflammasome plays a significant role in the progression of cardiac injury. In China, it has been well recognized that Chinese herbal medicine is markedly effective in treating cardiovascular diseases (CVDs). LuQi Formula (LQF) has been used clinically for more than 10 years and confirmed to be effective in improving cardiac function and inhibiting apoptosis. However, the specific mechanisms underlying its efficacy are mostly unknown. This study aimed to evaluate whether LQF could alleviate cardiac injury and apoptosis by regulating the NLRP3 inflammasome and the caspase-3/Bax pathway.PURPOSE:In this study, we investigated the effects of LQF on cardiac remodeling in a mouse model of myocardial infarction (MI) in vivo.METHODS:Forty male C57BL/6 mice were randomly divided into four groups: the sham group, the model group, the LQF group, and the perindopril group, with a sample size (n) of 10 mice in each group. Except the sham group, the other groups received left anterior descending (LAD) coronary artery ligation to induce MI and then treated with LQF, perindopril, or saline. Six weeks after MI, echocardiography was used to evaluate cardiac structure and function. Myocardial tissue morphology was observed by haematoxylin and eosin (H&E) staining, and heart samples were stained with Masson's trichrome to analyse myocardial fibrosis. Myocardial hypertrophy was observed by fluorescent wheat germ agglutinin (WGA) staining. The expressions of NLRP3, ASC, Cle-caspase-1, IL-1β, TXNIP, Cle-caspase-3, Bcl-2, and Bax in heart tissues were assessed by western blot analysis. mRNA expressions of ANP and BNP in heart tissues were measured by RT-PCR. The expression of reactive oxygen species in myocardial tissue was detected by using a DCFH-DA probe.RESULTS:Echocardiographic analysis showed that compared with the model group, the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) in the LQF and perindopril group were increased (P < 0.05), left ventricular internal diameter end diastole (LVIDd) and left ventricular internal diameter end-systole (LVIDs) were reduced (P < 0.05), and H&E and Masson's trichrome staining of cardiac tissues showed that LQF and perindopril could partially reverse ventricular remodeling and alleviate myocardial fibrosis (P < 0.05). WGA fluorescence results showed that compared with the model group, myocardial hypertrophy was significantly reduced in the LQF and perindopril group. We also found that LQF and perindopril reduce the oxidative stress response in the heart of MI mice. The protein expression of NLRP3, ASC, Cle-caspase-1, IL-1β, TXNIP, Cle-caspase-3, and Bax was downregulated in the LHF and perindopril treatment group, and Bcl-2 expression was upregulated.CONCLUSION:LQF and perindopril significantly attenuated cardiac injury and apoptosis in the MI model. In addition, we found that LQF effectively inhibited the activation of the NLRP3/ASC/caspase-1/IL-1β cascade, decreased inflammatory infiltration, delayed ventricular remodeling, and downregulated caspase-3/Bax signaling, which can effectively reduce the apoptosis of cardiomyocytes. Perindopril showed the same mechanism.

自噬与心血管疾病的发生发展密切相关,同时中药单体及复方通过多靶点、多途径干预自噬,延缓心力衰竭发展.现综述中药调控自噬防治心力衰竭的研究进展,以期为研发具有心肌细胞保护作用的活性成分提供参考.

Background Tingli Dazao Xiefei decoction (TDXD) has been shown to have a therapeutic effect on heart failure (HF). Nevertheless, its molecular mechanism for treating HF is still unclear. Materials and Methods TDXD and HF targets were collected from the databases, and protein-protein interaction (PPI) analysis and enrichment analysis were performed on the overlapping targets. Then, AutoDock was employed for molecular docking. Finally, we used the left anterior descending coronary artery (LAD) ligation to induce HF model rats for in vivo experiments and verified the effect and mechanism of TDXD on HF. Results Network pharmacological analysis showed that the main active components of TDXD in treating HF were quercetin, kaempferol, beta-carotene, isorhamnetin, and beta-sitosterol, and the core targets were IL-6, VEGFA, TNF, AKT1, and MAPK1. Multiple gene functions and signaling pathways were obtained by enrichment analysis, among which inflammation-related, PI3K/Akt, and MAPK signaling pathways were closely related to HF. Furthermore, the molecular docking results showed that the core targets had good binding ability with the main active components. Animal experiments showed that TDXD could effectively improve left ventricular ejection fraction (EF) and left ventricular fractional shortening (FS), decrease left ventricular internal diastolic diameter (LVIDd) and left ventricular internal systolic diameter (LVIDs), reduce the area of myocardial fibrosis, and decrease serum BNP, LDH, CK-MB, IL-6, IL-1β, and TNF-α levels in HF rats. Meanwhile, TDXD could upregulate the expression of Bcl-2, downregulate the expression of Bax, and reduce cardiomyocyte apoptosis. At the same time, it was verified that TDXD could significantly decrease the expression of PI3K, P-Akt, and P-MAPK. Captopril showed similar effects. Conclusions Combining network pharmacological analysis and experimental validation, this study verified that TDXD could improve cardiac function and protect against cardiac injury by inhibiting the activation of PI3K/Akt and MAPK signaling pathways.

目的 观察鹿芪方对慢性心力衰竭小鼠心肌细胞焦亡的影响,从ROS/NLRP3/Caspase-1通路探讨其作用机制.方法 60只C57BL/6J小鼠随机分为假手术组、模型组、鹿芪方组、培哚普利组,采用冠状动脉前降支结扎法制备慢性心力衰竭小鼠模型.鹿芪方组和培哚普利组分别予相应药液灌胃,假手术组和模型组予等量生理盐水灌胃,连续6周.超声检测小鼠心功能,HE染色、Masson染色检测小鼠心肌组织病理变化和胶原纤维沉积,DHE荧光探针检测心肌组织活性氧(ROS)含量,Western blot检测心肌组织NLRP3、ASC、Caspase-1蛋白表达,免疫组化检测白细胞介素(IL)-1β表达,透射电镜观察心肌组织超微结构.结果 与假手术组比较,模型组小鼠左室射血分数(LVEF)和左室收缩分数(LVFS)降低,左室舒张末期内径(LVIDd)与左室收缩末期内径(LVIDs)升高;心肌细胞明显增大,排列不规则,有较多炎性细胞聚集及胶原纤维沉积;心肌组织ROS含量增加,NLRP3、ASC、Caspase-1蛋白及IL-1β表达升高,差异均有统计学意义(P<0.01).与模型组比较,鹿芪方组与培哚普利组小鼠LVEF和LVFS升高,LVIDd和LVIDs降低;心肌细胞损伤改善,胶原纤维沉积明显减少,心肌纤维化明显减轻;心肌组织ROS含量减少,NLRP3、ASC、Caspase-1蛋白及IL-1β表达降低,差异均有统计学意义(P<0.01).结论 鹿芪方能有效减轻慢性心力衰竭小鼠心肌细胞焦亡,其机制可能与抑制ROS/NLRP3/Caspase-1通路活化,减轻心肌炎症反应相关.

目的 系统评价复方丹参滴丸联合阿司匹林治疗冠心病的有效性及安全性.方法 计算机检索中国知网数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、重庆维普中的文科技期刊数据库(VIP)、PubMed、The Cochrane Library、EMbase,检索时间从建库至2020年2月15日,纳入有关复方丹参滴丸联合阿司匹林治疗冠心病的临床随机对照试验,由两名研究员按照Cochrane系统评价方法进行文献数据提取和质量评价,采用RevMan 5.3软件进行Meta分析和相应的描述性分析.结果 共纳入16项研究,涉及1 763例病人.Meta分析结果显示:复方丹参滴丸联合阿司匹林可提高冠心病病人临床疗效[OR=5.58,95％ CI (3.83,8.13),P＜0.000 01],抑制血小板聚集[WMD=-7.70,95％ CI(-8.96,-6.44),P＜0.000 01],降低血栓素B2水平[WMD=-13.15,95％ CI(-15.07,-11.23),P＜0.000 01]、二磷酸腺苷(ADP)诱导血小板聚集率[WMD=-6.17,95％CI(-11.15,-1.20),P=0.01].结论 现有证据表明:复方丹参滴丸联合阿司匹林治疗冠心痛,可提高病人临床疗效,降低血小板聚集率,抑制血小板聚集,减少血栓素形成.

目的:探讨鹿红方对急性心肌梗死经皮冠状动脉介入(PCI)术后患者冠状动脉微循环的影响.方法:纳入68例急性心肌梗死PCI术后患者,随机分为治疗组和对照组,每组各34例.对照组患者给予常规西药治疗,治疗组患者在对照组治疗基础上加用鹿红方口服,两组治疗疗程均为12周.比较两组患者的心绞痛发病例数、中医证候疗效;于治疗前后检测两组患者的左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)和左心室舒张末期容积(LVEDV),评价两组患者心肌血流灌注成像的总负荷评分(SSS);检测并比较两组患者的血清血管内皮生长因子(VEGF)水平.结果:试验过程中,治疗组脱落2例、对照组脱落4例,最终治疗组32例、对照组30例纳入统计分析.①治疗后,治疗组的心绞痛发病例数较治疗前明显减少(P＜0.05),且治疗组的心绞痛发病例数少于对照组(P＜0.05);②治疗后,治疗组患者的中医证候疗效总有效率为90.62％,对照组为63.33％,治疗组的中医证候疗效优于对照组(P＜0.05);③治疗后,两组患者的LVESV、LVEDV较治疗前均降低(P＜0.05),LVEF均升高(P＜0.05),但组间LVESV、LVEDV、LVEF比较差异均无统计学意义(P＞0.05);④治疗后,两组患者的心肌灌注成像SSS较治疗前均降低(P＜0.05),且治疗组患者的SSS低于对照组(P＜0.05);⑤治疗后,治疗组患者的血清VEGF水平较治疗前明显升高(P＜0.05),且治疗组患者的血清VEGF水平高于对照组(P＜0.05).结论:鹿红方联合西医常规疗法治疗能有效改善急性心肌梗死PCI术后患者的冠状动脉微循环障碍,增加患者的心肌血流灌注,从而改善患者的临床症状,其机制可能与上调VEGF表达有关.