Inflammation, which plays a critical role in atherosclerosis and the occurrence of acute cardiovascular events, may be a new target for treatment of coronary artery disease(CAD) to reduce residual cardiovascular risk....Inflammation, which plays a critical role in atherosclerosis and the occurrence of acute cardiovascular events, may be a new target for treatment of coronary artery disease(CAD) to reduce residual cardiovascular risk. Recently, Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease(CANTOS), the largest scale clinical trial that targeted inflammation but not lipids, has affirmed for the first time the inflammatory hypothesis of artherosclerosis and marked the advent of an exciting era of targeting inflammation for the prevention and treatment of cardiovascular diseases. Chinese medicine(CM) is a promising adjuvant therapy for CAD in light of its safety and pleiotropic effect of anti-inflammation, anti-platelet, lipid-regulating, endothelium-protection, microcirculation-improving, etc. In recent years, exploration of anti-inflammatory treatment of CAD with CM has been going on from theory to practice. Taking CANTOS as an example, the design strategy to combine CM and Western medicine to inhibit inflammation were discussed in this paper, which might provide a new perspective for CM intervention on CAD.展开更多
Covid-19 pandemic has caused hundreds of thousands deaths and millions of infections and continued spreading violently.Although researchers are racing to find or develop effective drugs or vaccines,no drugs from moder...Covid-19 pandemic has caused hundreds of thousands deaths and millions of infections and continued spreading violently.Although researchers are racing to find or develop effective drugs or vaccines,no drugs from modern medical system have been proven effective and the high mutant rates of the virus may lead it resistant to whatever drugs or vaccines developed following modern drug development procedure.Current evidence has demonstrated impressive healing effects of several Chinese medicines(CMs)for Covid-19,which urges us to reflect on the role of CM in the era of modern medicine.Undoubtedly,CM could be promising resources for developing drug candidates for the treatment of Covid-19 in a way similar to the development of artemisinin.But the theory that builds CM,like the emphasis of driving away exogenous pathogen(virus,etc.)by restoring self-healing capacity rather than killing the pathogen directly from the inside and the'black-box'mode of diagnosing and treating patients,is as important,yet often ignored,an treasure as CM herbs and should be incorporated into modern medicine for future advancement and innovation of medical science.展开更多
Objective:To assess whether an adjunctive therapy of Sodium Tanshinone ⅡA Sulfonate Injection(STS)is effective and safe in improving clinical outcomes in patients with coronary heart disease(CHD).Methods:A literature...Objective:To assess whether an adjunctive therapy of Sodium Tanshinone ⅡA Sulfonate Injection(STS)is effective and safe in improving clinical outcomes in patients with coronary heart disease(CHD).Methods:A literature search was conducted through PubMed,the Cochrane Library,Knowledge Infrastructure Databases(CNKI),Chinese Biomedical Literature Database(SinoMed),Chinese Science and Technology Periodical Database(VIP)and Wanfang Database up to August 2017.Randomized controlled trials(RCTs)comparing STS with placebo or no additional treatments on the basis of standard conventional medicine therapies were included.The outcomes were all-cause mortality,major acute cardiovascular events(MACEs),cardiac function and inflammatory factors.The risk of bias assessment according to the Cochrane Handbook was used to evaluate the methodological quality of the included trials.Revman 5.3 software was used for data analyses.Results:A total of 22 RCTs involving 1,873 participants were included.All of the trials used STS as adjunctive treatment to standard conventional medicine therapy.Due to the poor quality of methodologies of most trials,only limited evidence showed that a combination of STS with percutaneous coronary intervention(PCI)or thrombolytic therapy(TT)might be more effective on reduction of all cause death rate than TT alone[risk ratio(RR)0.25,95% confidence interval(CI)0.07 to 0.87]or PCI alone(RR 0.42,95%CI 0.04 to 4.36).The results of 6 trials comparing STS plus TT with TT alone showed that the addition of STS significantly reduced the incidence of cardiac shock(RR 0.35,95%CI 0.14 to 0.86),heart failure(RR 0.41,95% CI 0.20 to 0.83)and arrhythmia(RR 0.21,95%CI 0.12 to 0.46).STS combined with TT also showed a superior effect on cardiac function and inflammatory factor.No severe adverse event was reported related to STS.Conclusions:As an adjunctive therapy,STS combined with standard conventional medicine seems to be more effective on all-cause mortality or MACEs than conventional medicine treatment alone with less side effects.However,we cannot make a firm conclusion due to low quality of inclusion trials.Well-designed trials with high methodological quality are needed to validate the effect of STS for CHD patients.展开更多
基金Supported by the Beijing Municipal Science and Technology Commission(No.Z151100004015090)
文摘Inflammation, which plays a critical role in atherosclerosis and the occurrence of acute cardiovascular events, may be a new target for treatment of coronary artery disease(CAD) to reduce residual cardiovascular risk. Recently, Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease(CANTOS), the largest scale clinical trial that targeted inflammation but not lipids, has affirmed for the first time the inflammatory hypothesis of artherosclerosis and marked the advent of an exciting era of targeting inflammation for the prevention and treatment of cardiovascular diseases. Chinese medicine(CM) is a promising adjuvant therapy for CAD in light of its safety and pleiotropic effect of anti-inflammation, anti-platelet, lipid-regulating, endothelium-protection, microcirculation-improving, etc. In recent years, exploration of anti-inflammatory treatment of CAD with CM has been going on from theory to practice. Taking CANTOS as an example, the design strategy to combine CM and Western medicine to inhibit inflammation were discussed in this paper, which might provide a new perspective for CM intervention on CAD.
文摘Covid-19 pandemic has caused hundreds of thousands deaths and millions of infections and continued spreading violently.Although researchers are racing to find or develop effective drugs or vaccines,no drugs from modern medical system have been proven effective and the high mutant rates of the virus may lead it resistant to whatever drugs or vaccines developed following modern drug development procedure.Current evidence has demonstrated impressive healing effects of several Chinese medicines(CMs)for Covid-19,which urges us to reflect on the role of CM in the era of modern medicine.Undoubtedly,CM could be promising resources for developing drug candidates for the treatment of Covid-19 in a way similar to the development of artemisinin.But the theory that builds CM,like the emphasis of driving away exogenous pathogen(virus,etc.)by restoring self-healing capacity rather than killing the pathogen directly from the inside and the'black-box'mode of diagnosing and treating patients,is as important,yet often ignored,an treasure as CM herbs and should be incorporated into modern medicine for future advancement and innovation of medical science.
基金Supported by the Twelve Five-Year Plan of China(No.2013BAI02B01)the National Traditional Chinese Medicine Clinical Research Center Project(No.2015ZSC02)
文摘Objective:To assess whether an adjunctive therapy of Sodium Tanshinone ⅡA Sulfonate Injection(STS)is effective and safe in improving clinical outcomes in patients with coronary heart disease(CHD).Methods:A literature search was conducted through PubMed,the Cochrane Library,Knowledge Infrastructure Databases(CNKI),Chinese Biomedical Literature Database(SinoMed),Chinese Science and Technology Periodical Database(VIP)and Wanfang Database up to August 2017.Randomized controlled trials(RCTs)comparing STS with placebo or no additional treatments on the basis of standard conventional medicine therapies were included.The outcomes were all-cause mortality,major acute cardiovascular events(MACEs),cardiac function and inflammatory factors.The risk of bias assessment according to the Cochrane Handbook was used to evaluate the methodological quality of the included trials.Revman 5.3 software was used for data analyses.Results:A total of 22 RCTs involving 1,873 participants were included.All of the trials used STS as adjunctive treatment to standard conventional medicine therapy.Due to the poor quality of methodologies of most trials,only limited evidence showed that a combination of STS with percutaneous coronary intervention(PCI)or thrombolytic therapy(TT)might be more effective on reduction of all cause death rate than TT alone[risk ratio(RR)0.25,95% confidence interval(CI)0.07 to 0.87]or PCI alone(RR 0.42,95%CI 0.04 to 4.36).The results of 6 trials comparing STS plus TT with TT alone showed that the addition of STS significantly reduced the incidence of cardiac shock(RR 0.35,95%CI 0.14 to 0.86),heart failure(RR 0.41,95% CI 0.20 to 0.83)and arrhythmia(RR 0.21,95%CI 0.12 to 0.46).STS combined with TT also showed a superior effect on cardiac function and inflammatory factor.No severe adverse event was reported related to STS.Conclusions:As an adjunctive therapy,STS combined with standard conventional medicine seems to be more effective on all-cause mortality or MACEs than conventional medicine treatment alone with less side effects.However,we cannot make a firm conclusion due to low quality of inclusion trials.Well-designed trials with high methodological quality are needed to validate the effect of STS for CHD patients.
