A systematic review of the effect of compound <i>Danshen</i> dripping pills combined with conventional Western medicine treatment on inflammatory factors and cardiac function after percutaneous coronary intervention for acute myocardial infarction_Chinese Journal of Evidence-Based Medicine

Authors：

ZHONG Changming ¹ , SHI Zhaofeng ¹ , DAI Qianqian ¹ , ZHAO Chen ³ ,  SHANG Hongcai ^1,2

1. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, P.R. China;
2. International Evidence-based Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, P.R. China;
3. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, P.R. China;

Corresponding author：

SHANG Hongcai, Email: shanghongcai@foxmail.com

Keywords：

Acute myocardial infarction; Percutaneous coronary intervention (PCI); Cardiac function; Inflammatory cytokine; Randomized controlled trial; Systematic review

DOI：

10.7507/1672-2531.202101083

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the effect of compound Danshen dripping pills combined with Western medicine on inflammatory factors and cardiac function after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, EMbase and The Cochrane Library were searched for randomized controlled trials of compound Danshen dripping pills combined with Western medicine in the treatment of acute myocardial infarction after PCI. The retrieval time was from the establishment of the databases to June 11^th, 2020. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. RevMan 5.3 software was used for meta-analysis.Results A total of 16 studies were included, involving 2 069 patients. The results of the meta-analysis showed that the combination of compound Danshen dripping pills could increase the left ventricular ejection fraction (MD =−4.74, 95%CI 4.07 to 5.42, P<0.01), decrease the B-type natriuretic peptide (SMD=−3.81, 95%CI −5.06 to −2.57, P<0.01), the level of interleukin-6 (SMD=−3.20, 95%CI −4.54 to −1.86, P<0.01) and level of tumor necrosis factor-a (SMD=−4.96, 95%CI −7.03 to −2.89, P<0.01).Conclusions Current evidence suggests that the combination of compound Danshen dropping pills has potential benefits in inhibiting inflammation and improving cardiac function after PCI. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.

Citation： ZHONG Changming, SHI Zhaofeng, DAI Qianqian, ZHAO Chen, SHANG Hongcai. A systematic review of the effect of compound Danshen dripping pills combined with conventional Western medicine treatment on inflammatory factors and cardiac function after percutaneous coronary intervention for acute myocardial infarction. Chinese Journal of Evidence-Based Medicine, 2021, 21(6): 662-668. doi: 10.7507/1672-2531.202101083 Copy

1.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会, 中国循环杂志编辑委员会. 急性心肌梗死诊断和治疗指南. 中华心血管病杂志, 2001, 29(12): 710-725.
2.	Hamasaki S, Tei C. Effect of coronary endothelial function on outcomes in patients undergoing percutaneous coronary intervention. J Cardiol, 2011, 57(3): 231-238.
3.	Chang SM, Yazbek N, Lakkis NM. Use of statins prior to percutaneous coronary intervention reduces myonecrosis and improves clinical outcome. Catheter Cardiovasc Interv, 2004, 62(2): 193-197.
4.	陆勇良. 阿托伐他汀钙片对行 PCI 术 ACS 患者炎症反应及血管内皮功能的影响分析. 中国现代药物应用, 2018, 12(11): 119-20.
5.	寻玉君, 单鹏. 他汀类药物的不良反应评价. 国际医药卫生导报, 2019, (16): 2764-2766.
6.	Luo J, Xu H, Chen K. Systematic review of compound danshen dropping pill: a Chinese patent medicine for acute myocardial infarction. Evid Based Complement Alternat Med, 2013, 2013: 808076.
7.	马世堂, 戴国梁, 程小桂, 等. 基于系统虚拟药理学复方丹参滴丸抗血小板聚集药效物质基础研究. 中药材, 2018, 41(1): 189-194.
8.	梁茜, 李炜杰, 杨希立, 等. 复方丹参滴丸改善心肌缺血再灌注损伤研究进展. 中国现代药物应用, 2020, 14(7): 236-238.
9.	中华医学会心血管病学分会. 心血管疾病防治指南和共识. 北京: 人民卫生出版社, 2010,.
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12.	陈宏, 魏冬梅, 于丽, 等. 复方丹参滴丸对老年急性心肌梗死患者 PCI 术后血清炎症因子及T细胞亚群的影响. 中国老年学杂志, 2018, 38(11): 2586-2588.
13.	陈俭. 复方丹参滴丸对急性经皮冠状动脉介入术后心功能改善的影响. 航空航天医学杂志, 2020, 31(1): 75-77.
14.	方芳, 甘受益, 冯光瑞, 等. 长期服用复方丹参滴丸对老年急性心肌梗死患者 PCI 术后左室重构及炎症因子水平的影响. 现代生物医学进展, 2017, 17(3): 544-546, 566.
15.	付文辉. 复方丹参滴丸对急性心梗患者 PCI 术后 BNP 水平及心室重塑的影响研究. 山西职工医学院学报, 2019, 29(4): 54-56.
16.	戢艳琼, 李梓香, 左金梅. 经皮冠状动脉介入术后应用复方丹参滴丸辅助治疗急性心肌梗死的疗效观察. 内科急危重症杂志, 2019, 25(3): 243-245.
17.	李丹芳. 复方丹参滴丸联合阿托伐他汀改善急性心肌梗死 PCI 术后炎性反应和心肌灌注的临床疗效. 心脑血管病防治, 2018, 18(6): 500-502.
18.	李广平, 郑心田, 王怀祯, 等. 复方丹参滴丸对急性 ST 段抬高心肌梗死介入治疗的临床作用. 中国介入心脏病学杂志, 2011, 19(1): 24-28.
19.	李红宇. 丹参滴丸对急性心肌梗死患者血浆 BNP 及 TNF-a 水平和心功能的影响研究. 中国医药指南, 2013, 11(25): 17-18.
20.	牛瑞刚. 复方丹参滴丸联合瑞舒伐他汀对 PCI 术后老年急性心肌梗死病人心功能及炎性因子的影响. 中西医结合心脑血管病杂志, 2020, 18(7): 1110-1113.
21.	欧更, 姜明燕, 郜琪臻, 等. 老年心肌梗死患者 PCI 术后心率变异性的变化及丹参滴丸的临床疗效研究. 现代生物医学进展, 2017, 17(1): 59-61, 47.
22.	石新景. 丹参滴丸联合氯吡格雷治疗急性心肌梗死的研究. 实用中西医结合临床, 2020, 20(3): 63-64.
23.	苏新生. 复方丹参滴丸对急性心肌梗死患者经皮冠状动脉介入治疗术后脑钠肽水平及心室重塑的影响. 中国实用医刊, 2019, 46(12): 110-114.
24.	许小进, 张一炎, 张苏洁, 等. 复方丹参滴丸联合瑞舒伐他汀对急性心肌梗死经皮冠状动脉介入术后左心室重构及心肌纤维化的影响. 中国医药导报, 2019, 16(35): 61-64, 77.
25.	张亚运. 复方丹参滴丸对急性 ST 段抬高型心肌梗死患者直接 PCI 疗效的影响. 太原: 山西医科大学, 2017.
26.	张怡, 伏晓琳, 刘博, 等. 丹参滴丸对急性 ST 段抬高型心肌梗死 PCI 术后心肌保护作用. 中国医药导报, 2018, 15(34): 153-156, 60.
27.	周祥群, 陈海金, 刘尚军, 等. 丹参滴丸联合强化降脂治疗对急性心肌梗死 PCI 术后再梗死的预防作用研究. 中华中医药学刊, 2017, 35(10): 2699-2702.
28.	Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation, 1979, 59(3): 607-609.
29.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性 ST 段抬高型心肌梗死诊断和治疗指南. 中华心血管病杂志, 2015, 43(5): 380-393.
30.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性 ST 段抬高型心肌梗死诊断和治疗指南. 中华心血管病杂志, 2010, 38(8): 675-690.
31.	Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Can J Cardiol, 2004, 20(10): 977-1025.
32.	沈卫峰, 张奇, 张瑞岩, 等. 2015 年急性 ST 段抬高型心肌梗死诊断和治疗指南解析. 国际心血管病杂志, 2015, 42(4): 217-9.
33.	Frangogiannis NG. Regulation of the inflammatory response in cardiac repair. Circ Res, 2012, 110(1): 159-173.
34.	Yokoyama T, Vaca L, Rossen RD, et al. Cellular basis for the negative inotropic effects of tumor necrosis factor-alpha in the adult mammalian heart. J Clin Invest, 1993, 92(5): 2303-2312.
35.	Goldhaber J I. Free radicals enhance Na+/Ca2+ exchange in ventricular myocytes. Am J Physiol, 1996, 271(3 Pt 2): H823-833.
36.	曹珊, 许梅, 张湘燕, 等. 丹参减轻炎性因子-炎症反应作用探讨. 现代中西医结合杂志, 2019, 28(11): 1251-1254.
37.	黄家林, 田代雄. 三七总皂苷抗炎免疫药理研究进展. 中华中医药杂志, 2016, 31(11): 4657-4660.
38.	孙淑萍, 杜云艳, 锁孝国, 等. 冰片对脂多糖诱导的 RAW264.7 巨噬细胞炎症模型的影响. 通化师范学院学报, 2019, 40(4): 61-68.
39.	潘洁丽, 郏国炯, 王萌. 中药制剂复方丹参滴丸对急性心肌梗死患者体内核因子-κB p65 介导的炎症反应的影响. 药物生物技术, 2017, 24(2): 120-123.

1. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会, 中国循环杂志编辑委员会. 急性心肌梗死诊断和治疗指南. 中华心血管病杂志, 2001, 29(12): 710-725.
2. Hamasaki S, Tei C. Effect of coronary endothelial function on outcomes in patients undergoing percutaneous coronary intervention. J Cardiol, 2011, 57(3): 231-238.
3. Chang SM, Yazbek N, Lakkis NM. Use of statins prior to percutaneous coronary intervention reduces myonecrosis and improves clinical outcome. Catheter Cardiovasc Interv, 2004, 62(2): 193-197.
4. 陆勇良. 阿托伐他汀钙片对行 PCI 术 ACS 患者炎症反应及血管内皮功能的影响分析. 中国现代药物应用, 2018, 12(11): 119-20.
5. 寻玉君, 单鹏. 他汀类药物的不良反应评价. 国际医药卫生导报, 2019, (16): 2764-2766.
6. Luo J, Xu H, Chen K. Systematic review of compound danshen dropping pill: a Chinese patent medicine for acute myocardial infarction. Evid Based Complement Alternat Med, 2013, 2013: 808076.
7. 马世堂, 戴国梁, 程小桂, 等. 基于系统虚拟药理学复方丹参滴丸抗血小板聚集药效物质基础研究. 中药材, 2018, 41(1): 189-194.
8. 梁茜, 李炜杰, 杨希立, 等. 复方丹参滴丸改善心肌缺血再灌注损伤研究进展. 中国现代药物应用, 2020, 14(7): 236-238.
9. 中华医学会心血管病学分会. 心血管疾病防治指南和共识. 北京: 人民卫生出版社, 2010,.
10. Higgins J, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). Cochrane, 2021. Available from: www.training.cochrane.org/handbook.
11. 张天嵩. 经典 Meta 分析统计模型的合理选择. 中国循证医学杂志, 2020, 20(12): 1477-1481.
12. 陈宏, 魏冬梅, 于丽, 等. 复方丹参滴丸对老年急性心肌梗死患者 PCI 术后血清炎症因子及T细胞亚群的影响. 中国老年学杂志, 2018, 38(11): 2586-2588.
13. 陈俭. 复方丹参滴丸对急性经皮冠状动脉介入术后心功能改善的影响. 航空航天医学杂志, 2020, 31(1): 75-77.
14. 方芳, 甘受益, 冯光瑞, 等. 长期服用复方丹参滴丸对老年急性心肌梗死患者 PCI 术后左室重构及炎症因子水平的影响. 现代生物医学进展, 2017, 17(3): 544-546, 566.
15. 付文辉. 复方丹参滴丸对急性心梗患者 PCI 术后 BNP 水平及心室重塑的影响研究. 山西职工医学院学报, 2019, 29(4): 54-56.
16. 戢艳琼, 李梓香, 左金梅. 经皮冠状动脉介入术后应用复方丹参滴丸辅助治疗急性心肌梗死的疗效观察. 内科急危重症杂志, 2019, 25(3): 243-245.
17. 李丹芳. 复方丹参滴丸联合阿托伐他汀改善急性心肌梗死 PCI 术后炎性反应和心肌灌注的临床疗效. 心脑血管病防治, 2018, 18(6): 500-502.
18. 李广平, 郑心田, 王怀祯, 等. 复方丹参滴丸对急性 ST 段抬高心肌梗死介入治疗的临床作用. 中国介入心脏病学杂志, 2011, 19(1): 24-28.
19. 李红宇. 丹参滴丸对急性心肌梗死患者血浆 BNP 及 TNF-a 水平和心功能的影响研究. 中国医药指南, 2013, 11(25): 17-18.
20. 牛瑞刚. 复方丹参滴丸联合瑞舒伐他汀对 PCI 术后老年急性心肌梗死病人心功能及炎性因子的影响. 中西医结合心脑血管病杂志, 2020, 18(7): 1110-1113.
21. 欧更, 姜明燕, 郜琪臻, 等. 老年心肌梗死患者 PCI 术后心率变异性的变化及丹参滴丸的临床疗效研究. 现代生物医学进展, 2017, 17(1): 59-61, 47.
22. 石新景. 丹参滴丸联合氯吡格雷治疗急性心肌梗死的研究. 实用中西医结合临床, 2020, 20(3): 63-64.
23. 苏新生. 复方丹参滴丸对急性心肌梗死患者经皮冠状动脉介入治疗术后脑钠肽水平及心室重塑的影响. 中国实用医刊, 2019, 46(12): 110-114.
24. 许小进, 张一炎, 张苏洁, 等. 复方丹参滴丸联合瑞舒伐他汀对急性心肌梗死经皮冠状动脉介入术后左心室重构及心肌纤维化的影响. 中国医药导报, 2019, 16(35): 61-64, 77.
25. 张亚运. 复方丹参滴丸对急性 ST 段抬高型心肌梗死患者直接 PCI 疗效的影响. 太原: 山西医科大学, 2017.
26. 张怡, 伏晓琳, 刘博, 等. 丹参滴丸对急性 ST 段抬高型心肌梗死 PCI 术后心肌保护作用. 中国医药导报, 2018, 15(34): 153-156, 60.
27. 周祥群, 陈海金, 刘尚军, 等. 丹参滴丸联合强化降脂治疗对急性心肌梗死 PCI 术后再梗死的预防作用研究. 中华中医药学刊, 2017, 35(10): 2699-2702.
28. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation, 1979, 59(3): 607-609.
29. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性 ST 段抬高型心肌梗死诊断和治疗指南. 中华心血管病杂志, 2015, 43(5): 380-393.
30. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性 ST 段抬高型心肌梗死诊断和治疗指南. 中华心血管病杂志, 2010, 38(8): 675-690.
31. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Can J Cardiol, 2004, 20(10): 977-1025.
32. 沈卫峰, 张奇, 张瑞岩, 等. 2015 年急性 ST 段抬高型心肌梗死诊断和治疗指南解析. 国际心血管病杂志, 2015, 42(4): 217-9.
33. Frangogiannis NG. Regulation of the inflammatory response in cardiac repair. Circ Res, 2012, 110(1): 159-173.
34. Yokoyama T, Vaca L, Rossen RD, et al. Cellular basis for the negative inotropic effects of tumor necrosis factor-alpha in the adult mammalian heart. J Clin Invest, 1993, 92(5): 2303-2312.
35. Goldhaber J I. Free radicals enhance Na+/Ca2+ exchange in ventricular myocytes. Am J Physiol, 1996, 271(3 Pt 2): H823-833.
36. 曹珊, 许梅, 张湘燕, 等. 丹参减轻炎性因子-炎症反应作用探讨. 现代中西医结合杂志, 2019, 28(11): 1251-1254.
37. 黄家林, 田代雄. 三七总皂苷抗炎免疫药理研究进展. 中华中医药杂志, 2016, 31(11): 4657-4660.
38. 孙淑萍, 杜云艳, 锁孝国, 等. 冰片对脂多糖诱导的 RAW264.7 巨噬细胞炎症模型的影响. 通化师范学院学报, 2019, 40(4): 61-68.
39. 潘洁丽, 郏国炯, 王萌. 中药制剂复方丹参滴丸对急性心肌梗死患者体内核因子-κB p65 介导的炎症反应的影响. 药物生物技术, 2017, 24(2): 120-123.

Chinese Journal of Evidence-Based Medicine

A systematic review of the effect of compound Danshen dripping pills combined with conventional Western medicine treatment on inflammatory factors and cardiac function after percutaneous coronary intervention for acute myocardial infarction

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