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).