Efficacy and safety of the Shexiang Baoxin Pill for the treatment of coronary artery disease not amenable to revascularisation: study protocol for a randomised, placebo-controlled, double-blinded trial

Pan-Pan Tian, Jun Li, Jian Gao, Ying Li, Pan-Pan Tian, Jun Li, Jian Gao, Ying Li

Abstract

Introduction: Coronary artery disease (CAD) not amenable to revascularisation indicates that the coronary arteries have severe diffuse lesions or calcifications, or that CAD is complicated with severe multiple-organ disease. Currently, Western medicines available for the treatment of CAD not amenable to revascularisation are limited. Shexiang Baoxin Pill (SBP), a type of Chinese patent medicine, has been widely used to treat CAD in China for many years. Previous studies have shown that long-term administration of SBP (1-2 pills three times daily, for at least 6 months) for treatment of CAD is effective and safe, with a significant, long-term effect. This study aims to evaluate the efficacy and safety of SBP in patients with CAD not amenable to revascularisation.

Methods and analysis: This is a multicentre, randomised, double-blinded, placebo-controlled clinical trial. A total of 440 participants will be randomly allocated to two groups: the intervention group and the placebo group. Based on conventional treatment with Western medicine, the intervention group will be treated with SBP and the placebo group will be treated with SBP placebo. The primary outcomes include major adverse cardiovascular events (including angina, acute myocardial infarction, pulmonary embolism and aortic dissection). The secondary outcomes include C reactive protein, B-type natriuretic peptide, ECG, echocardiographic parameters (ejection fraction percentage and the E/A ratio) and hospital readmission rates due to CAD. Assessments will be performed at baseline (before randomisation) and at 24 weeks after randomisation.

Ethics and dissemination: The protocol has been approved by the Research Ethics Committee of Guang'anmen Hospital, China Academy of Chinese Medical Sciences in Beijing, China (reference: 2016-129-KY-01). The results of this study will be published in a peer-reviewed journal and will be used as a basis for a multisite trial.

Trial registration number: NCT03072121; Pre-results.

Keywords: coronary artery disease; randomised controlled trial; revascularization; shexiang baoxin Pill.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Flow chart. BNP, B-type natriuretic peptide; CAD, coronary artery disease; CRP, C reactive protein; SBP, Shexiang Baoxin Pill.

References

    1. Zhao D. Why dentists need to learn the epidemiological status and prevention strategy of coronary heart disease in China. Chin J Stomatol 2016;51:385–6.
    1. Mannheimer C, Camici P, Chester MR, et al. . The problem of chronic refractory angina; report from the ESC Joint Study Group on the Treatment of Refractory Angina. Eur Heart J 2002;23:355–70. 10.1053/euhj.2001.2706
    1. Gupta S, Pressman GS, Morris DL, et al. . Distribution of left ventricular ejection fraction in angina patients with severe coronary artery disease not amenable to revascularization. Coron Artery Dis 2010;21:278–80. 10.1097/MCA.0b013e32833bdf53
    1. Luo L. The research progress of treatment methods for coronary heart disease. Pub Med Forum Mag 2013;17:3363–6.
    1. Zhang Y, Tang HQ, Li J. Meta-analysis on curative effect and safety of Shexiang Baoxin Wan in treatment of coronary heart diseaseChinese. Chin J Evid Based Cardiovasc Med 2012;4:13–17.
    1. Sun H, Cui L. Optimal treatment of multivessel complex coronary artery disease. Exp Ther Med 2014;7:1563–7. 10.3892/etm.2014.1630
    1. Williams B, Menon M, Satran D, et al. . Patients with coronary artery disease not amenable to traditional revascularization: Prevalence and 3-year mortality. Catheter Cardiovasc Interv 2010;119:881–91. 10.1002/ccd.22431
    1. Lozano I, Capin E, de la Hera JM, et al. . Diffuse Coronary Artery Disease Not Amenable to Revascularization: Long-term Prognosis. Rev Esp Cardiol 2015;68:631–3. 10.1016/j.rec.2015.02.013
    1. Jiang M, Zhang C, Zheng G, et al. . Traditional chinese medicine zheng in the era of evidence-based medicine: a literature analysis. Evid Based Complement Alternat Med 2012;2012:1–9. 10.1155/2012/409568
    1. Bi YF, Mao JY, Wang XL, et al. . Clinical epidemiology survey of the traditional Chinese medicine etiology and syndrome differentiation of coronary artery disease: study protocol of a multicenter trial. Zhong Xi Yi Jie He Xue Bao 2012;10:619–27.
    1. Wy L, Shen JP. Research on mechanism of Shexiang Baoxin Pill in the treatment of coronary heart disease. J Emerg Trad Chin Med 2011;20:114–5.
    1. Liu Q, Lv C, Zhang WD, et al. . Research progress of Shexiang Baoxin Pill. Chin Trad Herb Drugs 2016;47:1409–17.
    1. Zhang XZ, Hou YM, Ou ZH. [Effect of Shexiang Baoxin pill on coronary vasodilation by analysis of coronary angiography]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2014;34:1432–5.
    1. Zl C, Gu N. Mechanism research of Shexiang Baoxin pill on treating coronary artery disease. Jilin J Trad Chin Med 2011;31:262–3.
    1. Liu Q, Lv C, Zhang WD, et al. . Advance in Modern Studies on Shexiang Baoxin Pill. China Tradit Herb Drugs 2016;47:1409–17.
    1. Zhu H, Luo XP, Wang LJ, et al. . Evalution on Clinical Effect of Long Term Shexiang Baoxin Pill Administration for Treatment of Coronary Heart Disease. Chin J Integr Med 2010;30:474–7.
    1. Jw L, Wang JL, Qi H. Curative effect observation of Shexiang Baoxin Pill on multi-vessel lesions in CAD without revascularization. Chin J Integr Med 2015;13:1015–516.
    1. Yq D. Long-term effect analysis of long term Shexiang Baoxin Pill administration for treatment of coronary heart disease. Guid Chin Med 2016;14:184–5.
    1. Zhu H, Luo XP, Wang LJ, et al. . Observation on adverse reaction and safety of long term shexiang baoxin pill administration in patients with coronary heart disease. Chin Trad Pat Med 2010;32:2027–8.
    1. Zhang YW. Discussion on Adverse Reaction and Safety of Long Term Shexiang Baoxin Pill Administration in Patients with Coronary Heart Disease. Chin J Integr Tradit West Med Cardiovasc Dis 2016;4:163–4.
    1. Cardiology Branch of Chinese Medical Association. Editor committee of Chinese journal of cardiology. Chinese guidelines for the prevention and management of chronic stable angina. Chin J Cardio 2007;35:195–204.
    1. Cardiology Branch of Chinese Medical Association. Editor committee of Chinese journal of cardiology. Guidelines for the diagnosis and management of non-ST-segment elevation myocardial infarction Acute Coronary Syndromes. Chin J Cardio 2012;40:353–67.
    1. Cardiology Branch of Chinese Medical Association. Editor committee of Chinese journal of cardiology. Guidelines for the diagnosis and management of acute ST-segment elevation myocardial infarction. Chin J Cardio 2010;38:675–90.
    1. Zheng XY. Guideline of clinical research of new drugs of traditional Chinese medicine: chest obstruction. Chin Med Sci & Tech Press 2002:68–73.
    1. Xie H. Heart of musk pill combined western medicine therapy of coronary heart disease unstable angina random parallel control study. Chin J Pract Int Med 2014;28:105–6.
    1. Ly G, Sun ZX. Progress of studies on aspirin resistance and clopidogrel resistance. Chin Hosp Pharm J 2016:866–9.
    1. Ma H J YM, Chen CH. Determinants of the medication adherence behavior among elderly patients with coronary heart diseases. J Nurs Educ Pract 2015;5:38–44. 10.5430/jnep.v5n7p38
    1. Xiong X. Integrating traditional Chinese medicine into Western cardiovascular medicine: an evidence-based approach. Nat Rev Cardiol 2015;12:374 10.1038/nrcardio.2014.177-c1
    1. Xiong XJ, Wang Z, Wang J. Innovative strategy in treating angina pectoris with Chinese patent medicines by promoting blood circulation and removing blood stasis: experience from combination therapy in Chinese medicine. Curr Vasc Pharmacol 2015;13:540–53. 10.2174/1570161112666141014153735
    1. Xiong X, Borrelli F, de Sá Ferreira A, et al. . Herbal medicines for cardiovascular diseases. Evid Based Complement Alternat Med 2014;2014:1–2. 10.1155/2014/809741
    1. Qian W, Xiong X, Fang Z, et al. . Protective effect of tetramethylpyrazine on myocardial ischemia-reperfusion injury. Evid Based Complement Alternat Med 2014;2014:1–9. 10.1155/2014/107501
    1. Zhang H, Zhu HY. New interpretation of the advantages of traditional Chinese medicine in the treatment of cardiovascular disease. Chin Arch Tradit Chin Med 2001(03):214–22.
    1. Liu HX, Liu P. Clinical characteristic advantage of traditional Chinese medicine in prevention and treatment of cardiovascular disease. Beijing J Tradit Chin Med 2007(07):396–9.
    1. Wang J. Current situation and re-understanding of syndrome and formula syndrome in Chinese medicine. Internal Medicine: Open Access 2012;02:e1000113 10.4172/2165-8048.1000113
    1. Wang J, Xiong X. Current Situation and Perspectives of Clinical Study in Integrative Medicine in China. Evidence-Based Complementary and Alternative Medicine 2012;2012:1–11. 10.1155/2012/268542
    1. YL X, WX D. Research summary and consideration of Chinese medicine for the treatment of coronary disease. Heart disease branch of China association of Chinese medicine annual meeting and Beijing Chinese medicine academic society of professional committee on cardiovascular disease 2012:143–5.
    1. Chan AW, Tetzlaff JM, Altman DG, et al. . SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med 2013;158:200–7. 10.7326/0003-4819-158-3-201302050-00583
    1. Linde K, Brinkhaus B. Randomized Trials of Chinese Herbal Medicine: A New Extension of the CONSORT Statement. Ann Intern Med 2017;167:133–4. 10.7326/M17-1067

Source: PubMed

3
Předplatit