Title: Observation of the Efficacy of Jiaotai Diaomai Formula in Treating Unstable Angina Pectoris in Coronary Heart Disease and Its Mechanism of Action on Endothelial Function
Abstract
Objectives:
- To observe the clinical efficacy of Jiaotai Diaomai Formula in patients with unstable angina pectoris (UAP) characterized by blood stasis and disharmony between the heart and kidneys.
- To explore the potential mechanisms by which Jiaotai Diaomai Formula affects endothelial function in patients with UAP characterized by blood stasis and disharmony between the heart and kidneys.
Methods: A total of 66 patients with UAP characterized by blood stasis and disharmony between the heart and kidneys, treated at the Department of Cardiology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine from January 2025 to January 2026, were selected and randomly divided into a control group and an experimental group, each consisting of 33 patients. The control group received standardized Western medical treatment alone, while the experimental group received a combination of standardized Western medical treatment and Jiaotai Diaomai Formula (comprising Salvia miltiorrhiza, Fructus Mori, Coptis chinensis, and Cinnamomum cassia). The treatment duration was 28 days. The TCM symptom scores, effective rates, Seattle Angina Questionnaire (SAQ) scores, lipid levels, high-sensitivity C-reactive protein (hs-CRP), serum miR-92a, and nitric oxide (NO) levels were compared before and after treatment.
The relative expression of serum miR-92a was measured using real-time quantitative polymerase chain reaction (RT-qPCR) to determine the Ct values, and the 2-ΔΔCt method was used for calculation. NO levels were determined using the nitrate reductase method.
Results: A total of 69 cases were included in this study, with 1 case voluntarily withdrawing from the control group and 2 cases being excluded from the experimental group (1 due to taking other traditional Chinese medicines during enrollment and 1 for self-discontinuation of the medication). Ultimately, there were 33 valid cases in both the control and experimental groups.
- There were no statistically significant differences in age, gender, comorbidities, or smoking and alcohol history between the two groups (P > 0.05). There were also no statistically significant differences in TCM symptom scores, SAQ (PL, AF) scores, lipid levels (TC, TG, HDL-C, LDL-C), hs-CRP, miR-92a, and NO levels before treatment (P > 0.05).
- Both the experimental and control groups showed significantly lower TCM symptom scores after treatment compared to before (P < 0.05), and the experimental group had significantly lower scores than the control group after treatment (P < 0.05). The effective rate of TCM symptom scores in the experimental group was 93.9%, while the overall effective rate in the control group was 39.4% (P < 0.01).
- PL scores in both groups were higher after treatment compared to before, but the increase was not significant (P > 0.05). AS scores in both groups were significantly higher after treatment compared to before (P < 0.01). AF scores in both groups were significantly higher after treatment compared to before (P < 0.01), and the experimental group had significantly higher AF scores than the control group after treatment (P < 0.05). TS scores in the experimental group were significantly higher after treatment compared to before (P < 0.05), while TS scores in the control group were higher after treatment, but the increase was not significant (P > 0.05). DS scores in the experimental group were higher after treatment compared to before, but the increase was not significant (P > 0.05), and there was no significant difference in DS scores in the control group before and after treatment (P > 0.05).
- Cholesterol levels in the experimental group were significantly lower after treatment compared to before (P < 0.05). Triglyceride levels in both groups were lower after treatment compared to before, but the decrease was not significant (P > 0.05). HDL-C levels in both groups were higher after treatment compared to before, but the increase was not significant (P > 0.05). LDL-C levels in the experimental group were significantly lower after treatment compared to before (P < 0.05), while the decrease in the control group was not significant (P > 0.05). Lp(a) levels in both groups were lower after treatment compared to before, but the difference was not significant (P > 0.05).
- There were no significant differences in hs-CRP levels before and after treatment in both groups (P > 0.05).
- miR-92a levels in the experimental group were significantly lower after treatment compared to before (P < 0.01), and they were significantly lower than those in the control group after treatment (P < 0.05).
- NO levels in the experimental group were significantly higher after treatment compared to before (P < 0.05), while NO levels in the control group were higher after treatment, but the increase was not significant (P > 0.05).
- There was no significant correlation between miR-92a and NO levels before and after treatment in both groups (P > 0.05).
Conclusions:
- Jiaotai Diaomai Formula can significantly improve the clinical symptoms of patients with UAP characterized by blood stasis and disharmony between the heart and kidneys, reduce angina attacks, enhance quality of life, and has no obvious adverse reactions.
- Jiaotai Diaomai Formula can lower lipid levels in patients with UAP, particularly improving cholesterol and low-density lipoprotein cholesterol levels.
- Jiaotai Diaomai Formula can significantly downregulate the expression of serum miR-92a and upregulate NO levels, thereby improving endothelial function. This may be one of the mechanisms by which the formula treats UAP.
Keywords: Jiaotai Diaomai Formula; Coronary Heart Disease; Unstable Angina Pectoris; miR-92a; NO; Endothelial Function
