3 Clinical examples of Chinese medicines and formulae treating
atherosclerotic disease
In addition to the mechanism of action of the chemical components of
Chinese herbal medicine described in the previous chapter, there have
been many research results on the application of Chinese herbal medicine
to clinical aspects in recent years. In a recent study, 1212 patients
with focal carotid intima-media thickness (IMT)≥1.2 mm received the
traditional Chinese medicine Tongxinluo(TXL) or placebo capsules in
addition to usual care. Studies have found that Tongxinluo can delay the
progression of carotid IMT, plaque area and vascular remodeling with
good safety(Zhang M et al.,2019). Percutaneous coronary intervention
(PCI) is the main method for the treatment of coronary atherosclerotic
heart disease (CHD). However, many patients develop restenosis within 6
months after PCI. According to the existing research evidence, a total
of 1383 patients after PCI clinical treatment study found that Chinese
herbal medicine can prevent restenosis. Traditional Chinese medicine can
reduce the rate of restenosis and angina recurrence after PCI, even if
the evidence is limited(Wu J et al., 2019). Of the 574 potential
atherosclerotic targets identified in the latest study, cassia had 99
overlapping targets. Topological analysis of Cytoscape revealed that
cassia seed has positive regulatory effects on smooth muscle cell
proliferation, inflammatory response, tumor necrosis factor (TNF)
signaling pathway, vascular endothelial growth factor (VEGF) signaling
pathway and arachidonic acid (ARA) metabolism. These results indicate
that the anti-atherosclerosis mechanism of cassia seed has
multi-component, multi-target and multi-pathway mechanism(Zhang, Sen MDa
et al., 2019). A 2022 study investigated the effect of traditional
Chinese medicine Dengzhanshengmai capsule(DZSM) and aspirin on carotid
intima-media thickness (IMT), involving 150 patients. Analysis of the
treatment results showed that DZSM was no less effective than aspirin in
the treatment of carotid atherosclerotic plaque, and its safety was
better than aspirin. This study offers new avenues for treating carotid
plaque, particularly in patients with aspirin intolerance(Shen X et al.,
2022). Qing-Xin-Jie-Yu Granule (QXJYG) is an integrated traditional
Chinese medicine formula used to treat atherosclerotic (AS)
cardiovascular diseases. Clinical studies have shown that QXJYG inhibits
ferroptosis in vulnerable AS plaques partially via the GPX4/xCT
signaling pathway.(Zhang J et al., 2023). In addition, PADMA 28, a
Tibetan medicinal preparation used in China, has been shown to be
effective in reducing atherosclerosis symptoms in patients with mild
hypercholesterolemia by reducing lipid oxidation capacity(Brunner-La
Rocca HP et al., 2005).