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【medical-news】一些证据表明中草药可以帮助心绞痛患者

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http://www.medicalnewstoday.com/medicalnews.php?newsid=55430

Some Evidence Shows Chinese Herbal Medicine Helps Angina Patients

An herbal medicine used to treat cardiovascular diseases in China may improve symptoms of chest pain when used in conjunction with traditional treatments, according to a new systematic review.

In several studies included in the review, taking tongxinluo improved angina patients' electrocardiogram results. Overall, though, the review did not provide solid evidence that the medicine routinely benefits cardiac patients with angina.

"Tongxinluo is one of the most successful traditional Chinese medicines on the market in China," said lead author Wu Taixiang.

Tongxinluo, widely used in parts of Asia, is composed of eight herbs and insects, which are mixed together, ground to a fine powder and enclosed in capsules. Patients taking it for cardiovascular conditions typically consume three to four capsules, three to four times daily, for four weeks.

Because of the medicine's popularity, Taixiang, an associate professor at Sichuan University, West China Hospital, in Chengdu, Sichuan, and his coauthors say they felt a "social responsibility" to investigate possible clinical benefits.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

The meta-analysis compiled data from 18 randomized controlled trials, all conducted in China, comprising 1,413 patients ranging in age from 25 to 88. Most of the trials examined the effect of tongxinluo when used in conjunction with traditional angina treatments compared to traditional treatments alone.

Angina is chest pain, squeezing or discomfort that occurs when the heart fails to get enough blood. It often occurs as a symptom of coronary artery disease, the most common type of heart disease.

With stable angina, patients experience a regular pattern of chest pain. In unstable angina, patients experience unpredictable pain due to a restriction or blockage in blood flow. A third type of angina, called variant angina, occurs rarely.

"There are very clearly drawn guidelines for treating unstable angina based on numerous clinical trials," said James L. Weiss, M.D., director of the cardiology fellowship and training program at Johns Hopkins University School of Medicine. Weiss was not affiliated with the review.

Conventional pharmacological treatment for patients with angina typically includes medications such as nitrates, which relax and widen blood vessels; beta-blockers, which slow the heart rate and lower blood pressure; calcium channel blockers, which relax blood vessels and slow heart rate; and heparin, which prevents clot formation.

In seven of the studies in the review, patients with unstable angina treated with tongxinluo and conventional treatment who underwent EKGs had better results than patients treated with conventional treatment alone. An EKG measures the electrical activity of the heart and helps physicians detect cardiac problems or changes.

Evidence from ten of the studies indicated that the herbal medicine improved angina symptoms, such as chest pain and discomfort. In three of the studies, tongxinluo's results appeared as effective as those of nitrate medications.

Tongxinluo's beneficial role in treating angina did not surprise Taixiang, who called the review "an encouraging exploration."

However, more work needs to be done, according to the study authors. The studies did not show that the use of tongxinluo reduced the number of heart attacks, sudden death or the need for cardiac procedures such as bypass or angioplasty.

The review also linked the herbal medicine to uncomfortable side effects, including gastrointestinal symptoms and blood vessel breakage under the skin.

The studies offered only short-term analysis for a small number of patients. Most of the reviewed trials involved fewer than 100 participants, and all of the studies evaluated tongxinluo's effects for no longer than eight weeks.

But the main shortcoming of the studies that evaluated the medicine was their poor quality. "Some trialists selected an incorrect drug as the control in their trial, thus resulting in a wrong conclusion," Taixiang said. As a result, he said, "we cannot recommend the use of [tongxinluo] based on current evidence that resulted from poor quality trials."

Weiss agreed that the review lacked evidence that the herbal medicine benefits angina patients. "It would require a controlled randomized clinical trial with a fairly large number of patients - hundreds at least - to see whether this agent added to usual treatment would benefit patients," he said.

People with new, worsening or persistent chest pain should be treated immediately in the emergency department of a hospital.

Taixiang W, et al. Tongxinluo (Tong xin luo or Tong-xin-luo) capsule for unstable angina pectoris (Review). The Cochrane Database of Systematic Reviews 2006, Issue 4.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

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2006-11-01 01:47 浏览 : 820 回复 : 3

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本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。

2006-11-01 09:57

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现在是一边复习，并且自己复习的进度，处理相关板块的历史遗留问题。哈哈

Some Evidence Shows Chinese Herbal Medicine Helps Angina Patients
一些证据表明中药通心络有助于心绞痛病人
An herbal medicine used to treat cardiovascular diseases in China may improve symptoms of chest pain when used in conjunction with traditional treatments, according to a new systematic review.
根据系统性分析结果，中国用来治疗心血管病的一种中药如果结合传统疗法，可以缓解胸痛症状。
In several studies included in the review, taking tongxinluo improved angina patients' electrocardiogram results. Overall, though, the review did not provide solid evidence that the medicine routinely benefits cardiac patients with angina.
本分析包括的几项研究中，通心络可以改善心绞痛病人的心电图结果。不过，常规应用该药是否有助于心绞痛病人方面，本文没有找到坚实的依据。
"Tongxinluo is one of the most successful traditional Chinese medicines on the market in China," said lead author Wu Taixiang.
第一作者吴泰翔（音译）说：“通心络是目前中国市场最成功的中医药品之一。”
Tongxinluo, widely used in parts of Asia, is composed of eight herbs and insects, which are mixed together, ground to a fine powder and enclosed in capsules. Patients taking it for cardiovascular conditions typically consume three to four capsules, three to four times daily, for four weeks.
通心络在亚洲部分国家应用广泛，包括8种中药和昆虫混合在一起，磨成细磨，包装成胶囊。心血管病人每次3~4个胶囊，每日如用3~4次，连续4周。
Because of the medicine's popularity, Taixiang, an associate professor at Sichuan University, West China Hospital, in Chengdu, Sichuan, and his coauthors say they felt a "social responsibility" to investigate possible clinical benefits.
因为该药常用，四川大学华西医院吴泰翔副教授及其同事感到探讨它的临床价值是一种社会责任感。
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.
本文被收录入本期的Cochrane Library，是Cochrane协作网的刊物，该组织的任务是评价卫生各个方面的研究。系统性回顾可以根据某一专题的内容和现有研究，得出某一医疗实践的循证性结论，
The meta-analysis compiled data from 18 randomized controlled trials, all conducted in China, comprising 1,413 patients ranging in age from 25 to 88. Most of the trials examined the effect of tongxinluo when used in conjunction with traditional angina treatments compared to traditional treatments alone.
Meta分析包括了18例随机对照的研究，均在中国进行，涉及1413例病人，年龄25～88，大多数研究都是比较单独应用传统疗法和合用通心络之后的治疗效果。
Angina is chest pain, squeezing or discomfort that occurs when the heart fails to get enough blood. It often occurs as a symptom of coronary artery disease, the most common type of heart disease.
心绞痛是胸痛，是发生与心肌供血不足是的压榨样疼痛或者不适。通常是冠状动脉性心脏病的症状，是最常见的一种心脏病。
With stable angina, patients experience a regular pattern of chest pain. In unstable angina, patients experience unpredictable pain due to a restriction or blockage in blood flow. A third type of angina, called variant angina, occurs rarely.
稳定性心绞痛病人胸痛具有规律性。不稳定性心绞痛病人血流减少或者阻塞性胸痛无规律。第三种心绞痛：变异性心绞痛发病率低。
"There are very clearly drawn guidelines for treating unstable angina based on numerous clinical trials," said James L. Weiss, M.D., director of the cardiology fellowship and training program at Johns Hopkins University School of Medicine. Weiss was not affiliated with the review.
约翰斯霍普金森大学医学院心脏学会及培训项目负责人James L. Weiss，M.D.说：“根据大量的临床研究，在治疗不稳定性心绞痛方面具有非常明确的治疗原则。”，Weiss没有参与本研究。
Conventional pharmacological treatment for patients with angina typically includes medications such as nitrates, which relax and widen blood vessels; beta-blockers, which slow the heart rate and lower blood pressure; calcium channel blockers, which relax blood vessels and slow heart rate; and heparin, which prevents clot formation.
心绞痛病人常规用药包括硝酸盐类，主要是舒张血管，beta受体阻滞剂，减缓心率，降低血压，钙离子通道拮抗剂，舒张血管，降低心率，肝素，防止血栓形成。
In seven of the studies in the review, patients with unstable angina treated with tongxinluo and conventional treatment who underwent EKGs had better results than patients treated with conventional treatment alone. An EKG measures the electrical activity of the heart and helps physicians detect cardiac problems or changes.
本文涉及的7个研究种，采用通心络和传统疗法治疗不稳定性心绞痛病人，心电图显示效果优于单独应用传统疗法。心电图测量心肌的电活动，帮助医生发现心肌问题或者异常改变。
Evidence from ten of the studies indicated that the herbal medicine improved angina symptoms, such as chest pain and discomfort. In three of the studies, tongxinluo's results appeared as effective as those of nitrate medications.
其中10项研究说明该中药可以改善心绞痛症状，例如胸部疼痛和不适。其中的三项研究种，通心络的效果和硝酸酯类药物相当。
Tongxinluo's beneficial role in treating angina did not surprise Taixiang, who called the review "an encouraging exploration."
泰翔对通心络对治疗功效并不感到惊讶，说这一系统性分析非常“振奋人心”。
However, more work needs to be done, according to the study authors. The studies did not show that the use of tongxinluo reduced the number of heart attacks, sudden death or the need for cardiac procedures such as bypass or angioplasty.
但是根据本研究人说意见，需要进一步的工作。本研究没有证据表明通心络可以减少心脏病发病次数，猝死以及较少心脏手术（心脏搭桥以及血管成形术）。
The review also linked the herbal medicine to uncomfortable side effects, including gastrointestinal symptoms and blood vessel breakage under the skin.
本研究也指出了该药的副作用，包括胃肠道症状及皮肤血管破坏。
The studies offered only short-term analysis for a small number of patients. Most of the reviewed trials involved fewer than 100 participants, and all of the studies evaluated tongxinluo's effects for no longer than eight weeks.
这些研究都是短时间小样本研究，大多数研究病人数不倒100，通心络的治疗效果观察不到8周。
But the main shortcoming of the studies that evaluated the medicine was their poor quality. "Some trialists selected an incorrect drug as the control in their trial, thus resulting in a wrong conclusion," Taixiang said. As a result, he said, "we cannot recommend the use of [tongxinluo] based on current evidence that resulted from poor quality trials."
但是主要的缺陷是这些研究的质量较差。“一些研究在对照组的用药不正确，导致错误的结论，”泰翔指出。结果是：“因为研究质量较差，我们现在还不能根据目前的研究结果，建议使用通心络药物。”。
Weiss agreed that the review lacked evidence that the herbal medicine benefits angina patients. "It would require a controlled randomized clinical trial with a fairly large number of patients - hundreds at least - to see whether this agent added to usual treatment would benefit patients," he said.
Weiss指出本系统性分析缺乏该药缓解心绞痛的证据。“需要随机对照大样本研究－至少几百人－，来证实常规治疗结合该药是否有助于病人。”
People with new, worsening or persistent chest pain should be treated immediately in the emergency department of a hospital.
新发、严重或者持续性胸痛需要在医院急诊部立即进行治疗。
Taixiang W, et al. Tongxinluo (Tong xin luo or Tong-xin-luo) capsule for unstable angina pectoris (Review). The Cochrane Database of Systematic Reviews 2006, Issue 4.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.
Cochrane协作组织是一个国际性、非赢利性、独立的组织，主要是进行并传播卫生领域的系统性分析，鼓励研究临床研究及其他治疗手段的疗效证据的研究。可以登陆Visit http://www.cochrane.org获得更多信息。

2006-12-02 09:50

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1. Overall, though, the review did not provide solid evidence that the medicine routinely benefits cardiac patients with angina.
不过，常规应用该药是否有助于心绞痛病人方面，本文没有找到坚实的依据。

试译：不过，文章没有提供常规使用该药对心绞痛患者有益的确凿证据。

2. Patients taking it for cardiovascular conditions typically consume three to four capsules, three to four times daily, for four weeks.
心血管病人每次3~4个胶囊，每日如用3~4次，连续4周。

试译：心血管病患者每次服用3～4粒，每日3～4次，连用4周。

3. However, more work needs to be done, according to the study authors.
但是根据本研究人说意见，需要进一步的工作。

试译：但是该研究的作者认为，还需要做更多的工作。

4.The studies did not show that the use of tongxinluo reduced the number of heart attacks, sudden death or the need for cardiac procedures such as bypass or angioplasty.
本研究没有证据表明通心络可以减少心脏病发病次数，猝死以及较少心脏手术（心脏搭桥以及血管成形术）。

试译：这些研究并未显示通心络可减少心脏病发作次数和猝死人数，也未表明它可减少心脏手术（如冠脉搭桥术或血管成形术）的需要。

5. Angina is chest pain, squeezing or discomfort that occurs when the heart fails to get enough blood.
心绞痛是胸痛，是发生与心肌供血不足是的压榨样疼痛或者不适。

试译：心绞痛是心肌供血不足时发生的胸部压榨样痛或胸部不适感。

2006-12-04 10:49

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