| Research objectiveUsing network meta-analysis,the methods and results of direct and indirect comparisons of Chinese medicine injections for promoting blood circulation and removing blood stasis in the treatment of CCS were combined to obtain the ranking of treatment effects.In order to explore the correlation between the order of treatment effect and the difference in mechanism of action.Finally,the clinical efficacy and safety of traditional Chinese medicine injection for promoting blood circulation and removing blood stasis in the treatment of CCS are evaluated through clinical trial research.Research methodIn this study,by consulting the Chinese patent medicine part of the 2019 edition of the National Medical Insurance Catalogue and retrieving relevant domestic and foreign literature,27 clinical studies on the treatment of CCS with traditional Chinese medicine injections for promoting blood circulation and removing blood stasis were included,involving 13 kinds Chinese medicine injections.1.Search the database to find the clinical data information of randomized controlled trials in the treatment of CCS with traditional Chinese medicine injections for promoting blood circulation and removing blood stasis,comprehensively evaluate the collected literature according to Cochrane as a risk bias assessment tool,and then conduct Bayesian model network through R language and Ge MTC Meta-analysis.2.Through the network pharmacology method,the target and pathway prediction of the TCM injections screened by the network Meta was carried out.The chemical structural formulas of the 6 components were obtained through Pub Chem,and their chemical structural formulas were imported into the Swiss Target Prediction analysis platform to predict their targets,and then molecular docking and molecular dynamics simulations were performed to further verify the targets.3.Patients with stable angina pectoris of Qi deficiency and blood stasis type were collected and randomly divided into observation group and control group.The control group was treated according to the traditional western medicine standard treatment plan,and the observation group was additionally treated with salvianolate for injection.The efficacy indicators(individual/total scores of TCM syndromes,ECG efficacy,nitroglycerin cessation rate,SAQ score)and related safety indicators(vital signs,three routines,liver and kidney function,adverse reactions)of the two groups were fully evaluated.Research result1.Results of mesh meta-analysisTwenty-seven RCTs were included,involving 13 kinds traditional Chinese medicine injection,in clinical efficacy,except for the intervention of breviscapine injection,the rest are better than conventional western medicine treatment,the top three are Kudiezi injection,salvianolic acid for injection Yanhe Danhong Injection.Except for Xueshuantong and Kudiezi,the other interventions were better than the control group in terms of ECG efficacy.The top three interventions were Shuxuening injection,Xuesaitong injection,and salvianolate for injection.With regard to ejection fraction,the results showed that the intervention in the treatment group was comparable to the control group.2.Network pharmacology research resultsAfter screening,a total of 43 potential targets were obtained.Molecular docking and molecular dynamics simulations showed that the compounds were stably bound to the potential core targets.At the same time,the Metascape database found that the therapeutic pathways involved AGE-RAGE signaling pathway,serotonergic,Hypertrophic cardiomyopathy,complement and coagulation cascade,etc.3.Clinical study resultsStatistical analysis was performed on the data after receiving effective treatment.Compared with the control group,the treatment group was superior in TCM syndrome score,electrocardiogram efficacy,nitroglycerin discontinuation rate,SAQ score,etc.There were cases of dropout,and no adverse symptoms such as dizziness,hypotension,and gastrointestinal discomfort occurred in the patients participating in this study.Conclusion1.To compare the clinical efficacy of traditional Chinese medicine injections for promoting blood circulation and removing blood stasis in the treatment of CCS by means of network meta-analysis.The clinical efficacy and electrocardiographic efficacy of salvianolate for injection are superior to conventional western medicine treatment,and the intervention measures are ranked high.2.It is predicted that danshensu,salvianolic acid B,salvianolic acid G,shikonic acid,protocatechuic aldehyde and rosmarinic acid in salvianolic acid salts act on ACE through serotonergic pathway,AGE-RAGE and other signaling pathways,ALB,CASP3,EGFR,ESR1,TNF and other targets,play the role of anti-inflammatory,anti-oxidative stress,regulation of blood lipids and cardiac remodeling,and play a role in the treatment of CCS.3.Through clinical trials,salvianolate for injection showed better clinical efficacy and safety in the treatment of CCS. |
PDF Full Text Request