The Ameliorating Effect Of Kuanxiong Aerosol On Coronary Microvascular Dysfunction

Objective:To explore the effect of kuanxiong aerosol on coronary microvascular dysfunction(CMD).Methods:1.Animal experimentIn rats,32 male Sprague-Dawley(SD)rats were randomly divided into sham group(blank control group),model group(model control group),kuanxiong aerosol group(experimental group)and nicorandil group(positive control group).After 3 weeks of intervention with kuanxiong aerosol and nicorandil respectively in the experimental group and positive control group,laurate was injected into the left ventricle of rats to build CMD model.Serum samples were collected to detect myocardial injury indicators,oxidative stress,inflammatory factors and endothelial function-related indicators.At the same time,the heart was extracted for histopathological staining to observe the pathological changes of myocardial tissue in rats.Immunohistochemical staining was conducted to detect the expression of inflammatory factors in rat myocardium.The expression of apoptosis factors in rat myocardium was detected by Western blot.2.Clinical research system evaluationBased on Pubmed,Web of Science,Cochrane library,CNKI,WIP,Wanfang Medicine,Chinese Biomedical Literature and other databases,we collected the(random or non-random)clinical researches of kuanxiong aerosol as the treatment of CMD,involving patients with coronary microvascular dysfunction treated by kuanxiong aerosol.With or without control group,we both evaluated the safety and efficacy of the research findings.There is no time limit for retrieval.The study features and main results in the study were fully described.Results:1.Animal experimentIt was found that compared with the model group,the levels of serum myocardial ischemia markers,endothelin-1,inflammatory factors and malondialdehyde decreased in rats pretreated with broad-chest aerosol(P < 0.01).The concentration of nitric oxide and superoxide dismutase increased(P < 0.01).The pathological staining showed that compared with the model group,the progress of microvascular microthrombosis was suppressed,and the microvascular stenosis was improved.Also,the deposition of collagen fibers around the blood vessels was reduced in the kuanxiong aerosol group.Immunohistochemical results showed that the expression of inflammatory factors in the kuanxiong aerosol group was lower than that in the model group(P < 0.01).The protein immunoelectrophoresis showed that compared with the model group,the degree of the rat myocardial tissue apoptosis of the kuanxiong aerosol group was slighter(P < 0.01).2.Clinical research system evaluation:266 articles were retrieved,and 5 prospective clinical studies were included in the end,3 of which were randomized controlled studies.According to these studies,kuanxiong aerosol is a safe therapy.Also,after treated with kuanxiong aerosol,angina pectoris can be quickly relieved,Corrected TIMI frame count(CTFC)and ET-1decrease,and the level of nitric oxide increases.Due to the lack of homogeneity between studies,no meta-analysis was included.In terms of the safety of kuanxiong aerosol,3 studies that reported adverse reactions of kuanxiong aerosol indicated that the incidence of adverse reactions was low and the symptoms were mild.Conclusion:Pretreatment with kuanxiong aerosol can improve CMD by resisting inflammatory reaction,vascular endothelial injury,oxidative stress and cell apoptosis,thus improving endothelial function and microvascular structure of cardiac tissue.In addition,kuanxiong aerosol may improve CTFC of CMD patients and relieve clinical symptoms in time.However,due to some certain limitations,this study can’t make conclusive statements on the clinical curative effect of kuanxiong aerosol.