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Objective To investigate the clinical curative effect of Modified Gualou Xiebai Banxia Decoction in the treatment of stable angina pectoris(SAP)with internal resistance of phlegm and turbidity and its effect on gut microbiota.Methods The clinical data of 72 cases of SAP patients with phlegm turbidity and internal resistance type in our hospital were selected for prospective study,sorted according to the order of admission,and divided into control group and observer by random number table method,with 36 cases in each group.The control group was given standardized western medicine treatment,and the observation group was given the addition of Modified Gualou Xiebai Banxia Decoction on the basis of the control group.The clinical efficacy and gut microbiota composition of the two groups of patients were compared.Results After treatment,the clinical efficacy of the observation group was better than that of the control group(P<0.05);there was no significant difference in the ECG efficacy between the two groups(P>0.05).Based on 16S rDNA technology,at the phylum and genus levels,there was no difference in the abundance of Bacteroidota,Bacteroides and Faecalibacterium(P>0.05).After treatment,the abundance of Bacteroidota in the observation group increased more significantly than that in the control group(P<0.05).Conclusion Modified Gualou Xiebai Banxia Decoction can effectively improve the clinical efficacy of SAP patients with phlegm-turbid internal resistance by regulating gut microbiota,which provides new inspiration for the further development of Gualou Xiebai Banxia Decoction.
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OBJECTIVE：To systematically evaluate the efficacy and safety of Kuanxiong aerosol in the treatment of coronary heart disease angina ，and to provide evidence-based reference for climical drug use . METHODS ：Retrieved from Cochrane Library，PubMed，Embase，CKNI，Wanfang data ，VIP，and CBM ，randomized controlled trials （RCTs）about Kuanxiong aerosol （trial group ）versus nitroglycerin （control group ）in the treatment of coronary heart disease angina were collected during the inception to Mar. 20th，2020. After literature screening and data extraction ，quality assessment was performed using the bias risk assessment tool recommended by the Cochrane System Evaluator Manual 5.1.0. Meta-analysis was performed by using Rev Man 5.3 statistical software. Sensitivity analysis was conducted for the stability of the result ，and trial sequential analysis （TSA）was performed by using TSA 0.9 software. RESULTS ：A total of 11 RCTs were included ，with a total of 1 847 cases. Meta-analysis showed that improvement rate of angina pectoris （within 3 min）[RR＝1.11，95％CI（1.02，1.22），P＝0.02] and total response rate of angina pectoris （within 5 min）[RR＝1.04，95％ CI（1.01，1.07），P＝0.01] in trial group were significantly higher than control group；the incidence of ADR [RR＝0.44，95％CI（0.35，0.57），P＜0.000 01] in trial group was significantly lower than control group. There was no statistical significance in total response rate of ECG [RR＝1.02，95％CI（0.97，1.09），P＝0.42] or the level of NO after treatment [SMD ＝－0.08，95％CI（－0.61，0.45），P＝0.76] between 2 groups. The results of sensitiv ity analysis and TSA showed that the efficacy evidence of Kuanxiong aerosol in the treatment of coronary heart disease pectoris was not accurate ，but the evidence of safety was accurate. CONCLUSIONS ：Kuanxiong aerosol can improve the efficacy in patients with coronary heart disease angina ，and the safety is better ，but the conclusions of efficacy needs to be further confirmed by enlarging sample size.