Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (8): 729-735.doi: 10.3736/jcim20090805

• Original Clinical Research • Previous Articles     Next Articles

A randomized double-blinded controlled trial of Xuefu Zhuyu Capsule on short-term quality of life in unstable anginal patients with blood-stasis syndrome after percutaneous coronary intervention

 Fu-yong Chua,Jie Wanga,b,Xiao-wei Suna,Yan-wei Xinga,Kui-wu Yaoa,Shi-han Wanga,Zhi-zhong Lic   

  1. a Department 〇£ Cardiology,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China
    b Department of Clinical Basic Science of Chinese Medicine, Hubei Universtiy of Chinese Medicine, Wuhan 430065,Hubei Province,China
    c Rescue Center of Emergency» Beijing Anzhen Hospital, China Capital University of Medical Science^ Beijing 100029, China
  • Received:2009-04-13 Accepted:2009-06-04 Online:2009-08-20 Published:2009-08-15
  • Contact: Jie Wang E-mail:wangjie0103@yahoo.com

Background

With the wide application of percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD), it is a popularly concerned problem within clinical doctors to promote the patients’ early recovery and improve their health related quality of life (HR-QoL).
Objective

To evaluate the efficacy and safety of Xuefu Zhuyu (XFZY) Capsule, a compound traditional Chinese herbal medicine for activating blood circulation, in improving HR-QoL in unstable angina (UA) patients with blood-stasis syndrome after PCI, and to make a comparison with Shengmai (SM) Capsule.Design, setting, participants and interventions: The study was performed at Rescue Center of Emergency, Beijing Anzhen Hospital, China Capital University of Medical Science from March 2008 to February 2009. Using a randomized, double-blinded, double-dummy and placebo controlled study design, ninety patients diagnosed as UA and concomitant blood stasis syndrome after successful PCI therapy were enrolled and randomized into three groups: XFZY group, SM group and placebo group, and the patients were administered with the corresponding medications for 4 weeks.Main outcome measures: The Short-Form 36 (SF-36) and Seattle Angina Questionnaire (SAQ) were applied to assess the HR-QoL in each group before and after the treatment.
Results

A total of 90 patients were recruited and 4 cases of them withdrew from the study during the treatment period indicating a 4.4% of dropping rate. After the treatment, several domains of scores in SF-36 and SAQ were significantly increased in three groups (P<0.05, P<0.01). The efficacy of XFZY Capsule in improving body pain (BP), general health (GH), vitality (VT), social function (SF), role emotional (RE), angina stability (AS), angina frequency (AF), as well as treatment satisfaction (TS) was better than that of placebo (P<0.05, P<0.01). Meanwhile, the dimensions of BP, GH, SF, AS, AF, TS were improved as compared with those in the SM group (P<0.05). No obvious adverse reaction was found during and after the treatment with the exception of one case in XFZY group reporting of discomfort in the stomach.
Conclusion

Compared with SM Capsule, a short-term treatment of XFZY Capsule exhibits better efficacy in improving HR-QoL in UA patients with blood-stasis syndrome after PCI. However, its long-term efficacy and safety needs further investigation.

Key words: Xuefu Zhuyu Capsule, Unstable angina, Quality of life, Randomized controlled trial, Double-blind, Double-dummy

Figure 1

Flow diagram of this randomized trial"

Table 1

Baseline characteristics in three groups"

Characteristics Placebo group
(n=29)
SM group
(n=29)
XFZY group
(n=28)
Statistic value P
Male [Cases (%)] 20 (69.0) 15 (51.7) 18 (64.3) 1.95 0.37
Age ($\bar{x}$±s, years) 58.8±8.9 61.6±9.2 61.7±9.6 0.14 0.87
Course of disease ($\bar{x}$±s, years) 6.1±3.4 5.8±3.7 5.2±3.2 0.22 0.65
Body mass index ($\bar{x}$±s, kg/m2) 23.28±3.59 24.07±3.41 23.40±3.54 0.12 0.89
Hypertension [Cases (%)] 12 (41.3) 14 (48.2) 13 (46.4) 0.30 0.86
Hyperlipidemia [Cases (%)] 10 (34.5) 10 (34.5) 11 (39.3) 0.18 0.91
Diabetes mellitus [Cases (%)] 12 (41.4) 11 (37.9) 7 (25.0) 1.86 0.39
Smoking [Cases (%)] 19 (65.5) 15 (51.7) 17 (60.7) 1.18 0.56
Average stent number ($\bar{x}$±s) 1.7±1.2 1.2±0.8 1.9±1.1 1.21 0.31

Table 2

SF-36 scores in 3 groups before and after treatment ($\bar{x}$±s)"

Variable Placebo group (n=29) SM group (n=29) XFZY group (n=28)
Before treatment After treatment Before treatment After treatment Before treatment After treatment
PF 63.18±26.45 68.21±29.60* 64.37±28.60 80.34±18.41** 63.20±27.66 78.36±25.58**
RP 47.45±10.56 48.12±10.24 46.44±12.56 47.72±14.20 47.93±11.41 47.50±15.31
BP 45.28±14.15 49.37±12.20* 44.75±15.16 51.34±16.37* 45.31±16.24 57.40±14.28*△▲
GH 58.61±26.42 63.62±12.28 57.16±25.43 64.21±15.57 57.45±26.30 68.10±23.21*△▲
VT 49.39±14.34 54.29±14.67* 49.10±10.66 54.40±15.35* 48.71±15.73 59.43±16.30*
SF 53.61±14.38 63.78±13.41* 55.20±16.52 63.24±12.45* 55.31±15.03 69.23±15.36*△▲
RE 65.63±11.25 66.61±12.46 63.33±10.54 74.16±11.02* 64.42±19.40 77.56±13.25*
MH 57.20±12.18 59.20±15.52 61.42±14.25 59.27±10.56 55.34±15.39 57.12±16.67
HT 39.67±14.25 39.34±12.56 39.80±16.56 40.32±15.37 40.51±12.89 41.35±21.27

Table 3

SAQ scores in 3 groups before and after treatment ($\bar{x}$±s)"

Group n PL AS AF TS DP
Placebo
Before treatment 29 54.32±15.43 39.32±11.56 56.17±13.64 56.49±10.42 43.18±10.39
After treatment 29 62.70±12.54* 44.17±16.28* 64.25±12.40* 61.29±12.76* 41.80±18.30
SM
Before treatment 29 53.10±15.32 38.65±12.23 55.12±14.16 55.45±12.14 42.19±13.27
After treatment 29 64.20±11.14* 49.10±16.78* 67.43±11.20** 67.12±16.34** 48.89±12.14
XFZY
Before treatment 28 54.17±16.80 39.84±13.51 55.40±14.20 56.52±10.36 43.66±17.12
After treatment 28 64.69±13.76* 56.30±12.49*△▲ 71.31±16.58**△▲ 73.32±9.58**△△▲ 45.21±16.24
[1] Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, Pepine CJ, Schaeffer JW , Smith EE 3rd, Steward DE, Theroux P, Alpert JS, Eagle KA, Faxon DP, Fuster V, Gardner TJ, Gregoratos G, Russell RO, Smith SC Jr .ACC/AHA guidelines for the management of patients with unstable angina and non-ST segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines(Committee on the Management of Patients with Unstable Angina)[J]. J Am Coll Cardiol, 2000,36(3):970-1062
doi: 10.1016/S0735-1097(00)00889-5
[2] Braunwald E, Zipes DP, Libby P .Heart disease[M].Philadelphia: Saunders , 2001: 1232-1264
[3] Bliley AV, Ferrans CE . Quality of life after coronary angioplasty[J]. Heart Lung, 1993,22(3):193-199
doi: 10.3109/01902149309064354 pmid: 8491654
[4] Holubkov R, Laskey WK, Haviland A, Slater JC, Bourassa MG, Vlachos HA, Cohen HA, Williams DO, Kelsey SF, Detre KM; NHLBI Dynamic Registry.Registry Investigators . Angina 1 year after percutaneous coronary intervention: a report from the NHLBI Dynamic Registry[J]. Am Heart J, 2002,144(5):826-833
doi: 10.1067/mhj.2002.125505
[5] Cronin SN, Freeman LH, Ryan G, Drake DM . Recovery after percutaneous transluminal coronary angio-plasty: assessment after discharge[J]. Crit Care Nurse, 2000,20(2):70-76
pmid: 11873753
[6] Kimble LP, King KB . Perceived side effects and benefits of coronary angioplasty in the early recovery period[J]. Heart Lung, 1998,27(5):308-314
doi: 10.1016/S0147-9563(98)90051-6 pmid: 9777376
[7] Barnason SA, Zimmerman LM, Brey B, Catlin S, Nieveen JL . Patterns of recovery following percutaneous coronary intervention: a pilot study[J]. Appl Nurs Res, 2006,19(1):31-37
doi: 10.1016/j.apnr.2004.12.002 pmid: 16455439
[8] Pedersena SS, Denolleta J , Daemen J, van de Sande M, de Jaegere PT, Serruys PW, Erdman RA, van Domburg RT.Fatigue, depressive symptoms, and hopelessness as predictors of adverse clinical events following percutaneous coronary intervention with paclitaxel eluting stents[J]. J Psychosom Res, 2007,62(4):455-461
doi: 10.1016/j.jpsychores.2006.12.018
[9] Zheng GL, Wang SH . Clinical effect and mechanism of Xuefu Zhuyu Capsule in treating unstable angina pectoris[J]. Zhongguo Zhong Xi Yi Jie He Za Zhi, 2009,29(1):65-68
郑国玲, 王盛华 . 血府逐瘀胶囊治疗不稳定型心绞痛的临床疗效观察及机制探讨[J]. 中国中西医结合杂志, 2009,29(1):65-68
[10] Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, Pepine CJ, Schaeffer JW , Smith EE 3rd, Steward DE, Theroux P, Gibbons RJ, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Smith SC Jr; American College of Cardiology; American Heart Association.Committee on the Management of Patients with Unstable Angina. ACC/AHA 2002 guideline update for management of patients with unstable angina and non-ST-segment elevation myocardial infarction-summary article: a report of the American College of Cardiolog/American Heart Association task force on practice guidelines(Committee on the Management of Patients with Unstable Angina)[J]. J Am Coll Cardiol, 2002,40(7):1366-1374
doi: 10.1016/S0735-1097(02)02336-7
[11] Chinese Association of Integrative Medicine, Professional Committee of Blood Circulation. Diagnostic criteria of blood stasis[J].Zhong Xi Yi Jie He Za Zhi, 1987, 7(3):Cover 2
中国中西医结合研究会活血化瘀专业委员会 .血瘀证诊断标准[J].中西医结合杂志, 1987, 7(3):Cover 2
[12] Ware JE, Snow KK, Kosinski M, andek B .SF-36 health survey manual and interpretation guide[M].Boston, MA: The Health Institute , 1993: 2-7
[13] Jenkinson C, Wright L, Coulter A . Criterion validity and reliability of the SF-36 in a population sample[J]. Qual Life Res, 1994,3(1):7-12
doi: 10.1007/BF00647843
[14] Rao ZH, Yuan ZM . A new questionnaire for assessing the organic functional state of patients with coronary heart disease[J]. A new questionnaire for assessing the organic functional state of patients with coronary heart disease, 1996,17(1):14-16
饶中和, 袁志敏 . 一种新的估测冠心病患者机体功能状态的调查表[J]. 国外医学: 老年医学分册, 1996,17(1):14-16
[15] Xu J, Hu MY, Yang YB, Wang BH, Xie YN . Health measurement questionnaire SF-36[J]. Zhongguo Xing Wei Yi Xue Ke Xue, 1999,8(2):150-153
许军, 胡敏燕, 杨云滨, 王斌会, 解亚宁 . 健康测量量表SF-36[J]. 中国行为医学科学, 1999,8(2):150-153
[16] Chen KJ, Shi DZ . The great progress of traditional Chinese medicine in treating restenosis after percutaneous coronary intervention[J]. Zhongguo Zhong Yi Yao Xin Xi Za Zhi, 1996,3(5):35
陈可冀, 史大卓 . 中医药防治冠状动脉手术后再狭窄研究取得显著进展[J]. 中国中医药信息杂志, 1996,3(5):35
[17] Chen BJ, Pan ZQ, Su XX, Meng LQ, Li ZS . Study on changes of TCM syndrome in patients with coronary heart disease before and after intervention treatment[J]. Zhongguo Zhong Xi Yi Jie He Za Zhi, 2007,27(8):689-691
doi: 10.3321/j.issn:1003-5370.2007.08.007
陈伯钧, 潘宗奇, 苏学旭, 孟丽琴, 李志尚 . 冠心病介入治疗前后中医证型变化的研究[J]. 中国中西医结合杂志, 2007,27(8):689-691
doi: 10.3321/j.issn:1003-5370.2007.08.007
[18] Spertus JA, Winder JA, Dewhurst TA, Deyo RA, Fihn SD . Monitoring the quality of life in patients with coronary artery disease[J]. Am J Cardiol, 1994,74(12):1240-1244
doi: 10.1016/0002-9149(94)90555-X pmid: 7977097
[19] Liu TX, Kong SP, Liao ZY, Lu SK . Assessment study on physical function and the quality of life for CHD patients with SAQ[J]. Zhongguo Xing Wei Yi Xue Ke Xue, 1997,6(2):127-129
刘同想, 孔素平, 廖忠友, 卢斯科 . 西雅图心绞痛调查量表对冠心病患者机体功能及生存质量的评估研究[J]. 中国行为医学科学, 1997,6(2):127-129
[20] Weintraub WS, Spertus JA, Kolm P, Maron DJ, Zhang Z, Jurkovitz C, Zhang W, Hartigan PM, Lewis C, Veledar E, Bowen J, Dunbar SB, Deaton C, Kaufman S , O'Rourke RA, Goeree R, Barnett PG, Teo KK, Boden WE; COURAGE Trial Research Group, Mancini GB.Effect of PCI on quality of life in patients with stable coronary disease[J]. N Engl J Med, 2008,359(7):677-687
doi: 10.1016/j.jvs.2008.09.023 pmid: 18703470
[1] Chiung-Hui Huang, Mei-Ling Yeh, Fang-Pey Chen, Daphne Wu. Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial. Journal of Integrative Medicine, 2022, 20(4): 321-328.
[2] Maryam Azimi, Hanieh Niayesh, Mahboobeh Raeiszadeh, Sedigheh Khodabandeh-shahraki. Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation: A double-blind randomized controlled tria. Journal of Integrative Medicine, 2022, 20(3): 230-236.
[3] Ubiratan Cardinalli Adler, Maristela Schiabel Adler, Ana Elisa Madureira Padula, Livia Mitchiguian Hotta, Amarilysde Toledo Cesar, José Nelson Martins Diniz, Helen de Freitas Santos, Edson Zangiacomi Martinez. Homeopathy for COVID-19 in primary care: A randomized, double-blind, placebo-controlled trial (COVID-Simile study). Journal of Integrative Medicine, 2022, 20(3): 221-229.
[4] Xin Wang, Wen-juan Song, Yi Ruan, Bing-chu Li, Can Lü, Nian Huang, Fan-fu Fang, Wei Gu. Core muscle functional strength training for reducing the risk of low-back pain in military recruits: An open-label randomized controlled trial. Journal of Integrative Medicine, 2022, 20(2): 145-152.
[5] Meng-zhu Zhao, Chen Zhao, Shuang-shuang Tu, Xu-xu Wei, Hong-cai Shang. Evaluating the methodology of studies conducted during the global COVID-19 pandemic: A systematic review of randomized controlled trials. Journal of Integrative Medicine, 2021, 19(4): 317-326.
[6] Si-chun Gu, Jie Zhou, Qing Ye, Can-xing Yuan. Pingchan granule for depressive symptoms in Parkinson’s disease: A randomized, double-blind, placebo-controlled trial. Journal of Integrative Medicine, 2021, 19(2): 120-128.
[7] Jie Wu, Shu-wei Duan, Hong-tao Yang, Yue-yi Deng, Wei Li, Ya-ni He, Zhao-hui Ni, Yong-li Zhan, Shan Lin, Zhi-yong Guo, Jun Zhu, Jing-ai Fang, Xu-sheng Liu, Li-hua Wang, Rong Wang, Nian-song Wang, Xiao-hong Cheng, Li-qun He, Ping Luo, Shi-ren Sun s, Ji-feng Sun, Ai-ping Yin, Geng-ru Jiang, Hong-yu Chen, Wen-hu Liu, Hong-li Lin, Meng Liang, Lu Ma, Ming Chen, Li-qun Song, Jian Chen, Qing Zhu, Chang-ying Xing, Yun Li, Ji-ning Gao, Rong-shan Li, Ying Li, Hao Zhang, Ying Lu, Qiao-ling Zhou, Jun-zhou Fu, Qiang He, Guang-yan Cai, Xiang-mei Chen. Efficacy and safety of Shenyankangfu Tablet, a Chinese patent medicine, for primary glomerulonephritis: A multicenter randomized controlled trial. Journal of Integrative Medicine, 2021, 19(2): 111-119.
[8] Xian Wang, Xuan Yin, Xiu-tian Guo, Yan Wang, Wen-qi Jin, Ai-jun Mao, Lixing Lao, Zhang-jin Zhang, Jie Zhang, Shi-fen Xu. Effects of the pestle needle therapy, a type of acupoint stimulation, on post-hemorrhoidectomy pain: A randomized controlled trial. Journal of Integrative Medicine, 2020, 18(6): 492-498.
[9] Sherman Gu, Arthur Yin Fan. Controversial conclusions from two randomized controlled trials for acupuncture's effects on polycystic ovary syndrome or in vitro fertilization support. Journal of Integrative Medicine, 2020, 18(2): 89-91.
[10] Gerli E.G. Herr, Fábio Goulart da Silva, Francisco José Cidral-Filho, Fabricia Petronilho, Lucinéia Gainski Danielski, Mariana Pereira de Souza Goldim, Afonso Shiguemi Inoue Salgado, Franciane Bobinski, Daniel Fernandes Martins, Eliane R. Winkelmann. Effects of the use of bioceramic wraps in patients with lower limb venous ulcers: A randomized double-blind placebo-controlled trial. Journal of Integrative Medicine, 2020, 18(1): 27-.
[11] Xin-yu Yue, Zhuo-qi Feng, Xi-yi Yu, Jia-min Hu, Xiao-Jing He, Shi Shu. Fire-needle acupuncture for upper limb spastic paralysis after stroke: Study protocol for a randomized controlled trial. Journal of Integrative Medicine, 2019, 17(3): 167-172.
[12] Pádraic J.Dunne, Julie Lynch, Lucia Prihodova, Caoimhe O'Leary, Atiyeh Ghoreyshi, Sharee A. Basdeo, Donal J.Cox, Rachel Breen, Ali Sheikhi, Áine Carroll, Cathal Walsh, Geraldine McMahon, Barry White. Burnout in the emergency department: Randomized controlled trial of an attention-based training program. Journal of Integrative Medicine, 2019, 17(3): 173-180.
[13] Ya-ru Huangfu, Wei Peng, Bao-jun Guo, Zhi-fu Shen, Li Li, Shi-wei, Liu, Hui Zheng, You-ping Hu. Effects of acupuncture in treating insomnia due to spleen-stomach disharmony syndrome and its influence on intestinal microbiome: Study protocol for a randomized controlled trial. Journal of Integrative Medicine, 2019, 17(3): 161-167.
[14] Goulnar Kasymjanova, Anh-Thi Tran, Victor Cohen, Carmela Pepe, Lama Sakr, David Small, Jason Scott Agulnik, Robert Thomas Jagoe. The use of a standardized Chinese herbal formula in patients with advanced lung cancer: A feasibility study. Journal of Integrative Medicine, 2018, 16(6): 390-395.
[15] J.M. Oliver-Baxter, H.S. Whitford, D.A. Turnbull, M.J. Bond. Effects of vitamin supplementation on inflammatory markers and psychological wellbeing among distressed women: A randomized controlled trial. Journal of Integrative Medicine, 2018, 16(5): 322-328.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[4] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
[5] . Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication (Chinese version, part two). Journal of Chinese Integrative Medicine, 2010, 8(11): 1001-1005
[6] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[7] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[8] Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[9] Rui Jin, Bing Zhang. A complexity analysis of Chinese herbal property theory: the multiple formations of herbal property (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(11): 1198-1205
[10] Hui-min Liu, Xian-bo Wang, Yu-juan Chang, Li-li Gu. Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis. Journal of Chinese Integrative Medicine, 2012, 10(11): 1211-1228