Coronary in-stent is the most common treatment in
coronary heart disease (CHD). It can
improve myocardial ischemiaand release angina immediately. About 800,000 Americans receive stents each year. Although coronary
artery stent is very effective on CHD, but the ischaemic heart disease still is the world’s biggest killer according to WHO’s report (2012). Statistical data showed 73,000 people died from CHD every year in the UK. (200 died per day). The biggest problem in the treatment of CHD is
restenosis or re-narrowing of the coronary artery.
Restenosis usually occurs 6-9 months after stent placement, as a result
of neointimal hyperplasia due to the proliferation and migration of vascular
smooth muscle cells. A recent research report showed that from 2006 to
2014, 65,443 patients underwent percutaneous coronary intervention
(PCI) and 6,872 patients (10.5%) with 8,921 lesions were treated for
in-stent restenosis (ISR). The proportion of
patients undergoing revascularization for restenosis increased
0.28% per year[1].
The small scaffold stent props open the diseased artery to prevent heart
attacks, but because
the body treats
stents as foreign, the risk of blood clots is ever present. That is why its
short term effects are good, but long term effects are not satisfactory. Dr Aseem Malhotra said to Daily Mail: ‘There is no evidence that coronary angioplasty reduces risk
of heart attack or death in patients with uncomplicated stable angina’
In traditional Chinese medicine
(TCM) angina is known as Xin Tong or Xiong Bi. The common pathological
mechanisms of this disease were due to heart blood stagnation, heart yang
deficiency, cold stagnation or phlegm obstruction. Chinese medicine usually selects
different herb formula to treat different individual cases. Some formulas have
been used for thousands of years. Every prescription was modified according to
the symptoms of the individual patients.
In
China, Chinese herbal medicines are widely used for
preventing restenosis after stent placement. A Meta-analysis on 52
trials (4905 patients), the result
showed at the end of at least 3 months' follow up, Chinese herb medicine could
significantly reduce restenosis rate, cardiac mortality, recurrence
rate of angina, acute myocardial infarction, numbers of repeat PCI, and numbers
of coronary artery bypass graft[2]. Chinese herb treatment
includes extracts from mixtures of herbs,
single herbs, or a compound of herb decoction.
The most commonly used single herb is Dan Shen (Salvia miltiorrhiza).
More than 230 randomized controlled trials (RCTs) of Danshen dripping pillin
treating angina pectoris. Among the included 109 RCTs with 11,973 participants,
the efficacy of Danshen was better than isosorbide dinitrate in treating
angina pectoris[3]. Dan Shen also showed a good effect on preventing
restenosis after coronary stent[4].
Xiong Shao capsule is an herbal remedy which was composed
by Chuanxiong（Ligusticum chuanxiong）and
Chishao (red paeony root). Clinical study showed it can effectively prevent
restenosis after PCI in combination with conventional western medical treatment.[5]
If you have time to read all of
reference below this article, you will understand coronary stent and by-pass
operation are not only option in CHD treatment. TCM as an alternative option is
the right choice, because it can reduce the mortality rate and save lives.
Reference:
1. Waldo SW. Incidence,
procedural management, and clinical outcomes of coronary in-stent restenosis: Insights from the National VA CART Program.Catheter
Cardiovasc Interv. 2017
Jun 28. doi:
10.1002/ccd.27161.
2. Zheng GH.Systematic Review of Chinese Herbal Medicines for Preventing
in-Stent Coronary Restenosis after
Percutaneous Coronary Intervention. Evid
Based Complement Alternat Med. 2012;2012:253409.
3. Jia Y. How Efficacious is Danshen (Salvia
miltiorrhiza) Dripping Pill in Treating Angina Pectoris? Evidence Assessment
for Meta-Analysis of Randomized Controlled Trials. J Altern Complement Med. 2017 Jun 26. doi: 10.1089/acm.2017.0069
4. Fu GS. Clinical observation
of compound Danshen drop pill preventing restenosis of patients with coronary
heart disease after stenting operation (Part 1) China Medical
Herald. 2009;
6:68–69.
5. Lu XY. Clinical study on
effect of Xiong Shao capsule on restenosis after percutaneous coronary
intervention. Chinese Journal of Integrated Traditional and
Western Medicine. 2006;26(1):13–17.
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