Li Yuan, Wang Lian-Xin, Xie Yan-Ming
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2016 Dec;41(24):4488-4493. doi: 10.4268/cjcmm20162403.
In recent years, Chinese patent medicines such as smiltiorrhizadepsidesal(SMDS) injection are combined with western medicine to achieve good clinical efficacy for stable angina pectoris(SAP). SMDS is prepared by the water-soluble active ingredients extracted from Salvia miltiorrhiza, with the functions of promoting blood circulation, removing blood stasis and activating blood vessels, and it is used to treat type ⅠSAP and type ⅡSAP. The efficacy and safety of SMDS combined with simple routine western medicine for SAP were investigated by searching PubMed, EMbase, the Cochrane Library, CNKI, VIP, WanFang Data and CBM Database. SMDS combined with conventional western medicine treatment showed better efficacy for SAP as compared with western medicine alone, and better than other traditional Chinese medicines(such as Danshen injection and compound Danshen injection) combined with conventional western medicine. It was found that SMDS had a positive role in reducing blood viscosity, atherosclerosis, and improving microcirculation. The reported adverse drug reactions (ADRs) of SMDS combined with conventional western medicine therapy in clinical research were basically the same with ADRs reported by spontaneous reporting system(SRS) warning signals. Overall, SMDS combined with conventional western medicine had low incidence of ADR and no serious ADR occurred for SAP treatment in clinical trials. Currently, some drugs related to cardiovascular diseases such as ascinepazidemaleate injection, sodium succinate, propafenone hydrochloride and papaverine hydrochloride injection combined with SMDS have incompatibility, which should be highly emphasized in clinical use.
近年来,丹参总酚酸(SMDS)注射液等中成药与西药联合应用于稳定型心绞痛(SAP)取得了良好的临床疗效。SMDS由丹参中提取的水溶性活性成分制备而成,具有活血化瘀、疏通血管的作用,用于治疗Ⅰ型SAP和Ⅱ型SAP。通过检索PubMed、EMbase、Cochrane图书馆、中国知网(CNKI)、维普资讯(VIP)、万方数据和中国生物医学文献数据库(CBM),研究SMDS联合单纯常规西药治疗SAP的疗效和安全性。结果显示,与单纯西药相比,SMDS联合常规西药治疗SAP疗效更佳,且优于其他中药(如丹参注射液和复方丹参注射液)联合常规西药。研究发现,SMDS在降低血液黏稠度、动脉粥样硬化及改善微循环方面具有积极作用。临床研究中报道的SMDS联合常规西药治疗的药物不良反应(ADR)与自发报告系统(SRS)警示信号报告的ADR基本一致。总体而言,SMDS联合常规西药治疗SAP的ADR发生率较低,临床试验中未出现严重ADR。目前,一些心血管疾病相关药物如马来酸氯苯那敏注射液、琥珀酸钠、盐酸普罗帕酮和盐酸罂粟碱注射液与SMDS联合应用存在配伍禁忌,临床使用时应高度重视。