化合物丹申滴液药与异索胺单酸结合治疗胸痛:一个系统性审查和一个元分析
Ru Wang1, Jing Hu1, Yuanyuan Li1
1Department of Pharmacy, Medical Supplies Center, PLA General Hospital, Beijing 100853, China.
Chinese herbal medicines
|November 28, 2024
概括
相比单独使用ISMN,复合剂丹申滴剂 (CDDP) 与异索胺单酸盐 (ISMN) 相结合显著改善了胸痛症状和心电图疗效. 这种组合还降低了脂质水平和心痛发作的频率,而不会增加不良事件.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 综合医学是一个整体医学.
背景情况:
- 胸痛仍然是一个重要的心血管疾病.
- 目前的治疗方法,如异索化单酸盐 (ISMN),提供症状缓解,但可能有局限性.
- 探索组合疗法可以提高治疗效率和患者的治疗结果.
研究的目的:
- 评估复合丹申滴液药 (CDDP) 与ISMN结合的疗效与单独使用ISMN治疗胸痛的疗效.
- 评估CDDP加ISMN对胸痛症状和心电图 (ECG) 结果的影响.
- 确定组合治疗的安全性概况.
主要方法:
- 随机对照试验 (RCT) 和队列研究的系统审查和元分析.
- 搜索了多个数据库 (PubMed,科学网等) 从开始到2022年11月.
- 包括7245名患者,分析了心肌痛症状和心电图疗效的初级结果,以及脂质水平和发作频率等二级结果.
主要成果:
- 与单独使用ISMN相比,CDDP和ISMN的组合在改善心痛症状和心电图发现方面表现出明显更高的疗效 (OR=4.824,P=0.000).
- 这种组合还导致甘油三 (MD = -35.176,P=0.000) 和总胆固醇 (MD = -24.296,P=0.000) 的显著降低.
- 此外,CDDP加ISMN减少了心痛发作的持续时间和频率,但没有显著增加不良事件 (OR=0.513,P=0.000).
结论:
- 化合物丹申滴滴药与异索胺单酸盐相结合,为胸痛提供了更好的治疗疗效.
- 组合疗法耐受性良好,并呈现出一种潜在的有价值的替代治疗选择.
- 个体患者的病情和临床背景应指导治疗决策.
相关概念视频
01:16Antianginal Drugs: Nitrates and β-Blockers
522
In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
522
01:25Antianginal Drugs: Calcium Channel Blockers and Ranolazine
455
Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
455
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
386
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
386
01:23Antihypertensive Drugs: Vasodilators
479
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
479
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
479
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
479
01:25Antihypertensive Drugs: Direct Renin Inhibitors
493
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
493