Dr. Li Yugui, a Ph.D. supervisor at Hebei Provincial Hospital of Traditional Chinese Medicine, and Dr. Li Zhenbin, a senior physician at Bethune International Peace Hospital, collaborated on a research project funded by the Natural Science Foundation of Hebei Province. Their study focused on the development of anti-endothelin traditional Chinese medicine (TCM) for experimental myocardial ischemia/reperfusion injury. Through macroscopic and microscopic analysis, they discovered that certain cold-natured TCM herbs exhibited significant anti-ischemic properties. This breakthrough challenged the conventional approach of using "Xinwen" TCM for myocardial ischemia, deepening the understanding of the pathogenesis of ischemic heart disease. Additionally, the research revealed that "Hanliang" TCM could counteract endothelin, further expanding the therapeutic potential of cold-natured medicines. The findings were recognized with the third prize in the Science and Technology Awards from the China Association of Chinese Medicine.
Ischemic heart disease remains a major global health concern, with endothelin playing a key role in the development of myocardial ischemia/reperfusion injury. Recent studies have shown that endothelin shares structural similarities with snake venom and exhibits comparable biological effects. Anti-venom TCM has been found to counteract endothelin-induced vasoconstriction, cell death, and other harmful effects in mice. Based on this, Li and colleagues hypothesized that traditional anti-venom TCM may act as an endothelin antagonist, offering potential for treating cardiovascular conditions such as myocardial ischemia.
To test this hypothesis, Dr. Li Yugui and his team formulated Qingxinyin Recipe, combining cold-natured anti-venom herbs like motherwort and andrographis paniculata. They conducted in vitro and in vivo experiments, along with preliminary clinical trials, to evaluate the protective effects of Qingxinyin on myocardial ischemia and reperfusion injury.
Experimental results showed that Qingxinyin significantly improved ischemic T-wave and ST-segment changes induced by pituitrin, with a dose-dependent effect. It also alleviated ECG abnormalities caused by isoproterenol hydrochloride in rats, reduced the release of CK and LDH in ischemic cardiomyocytes, and enhanced SOD activity. In animals with ischemia/reperfusion injury, Qingxinyin reduced infarct size and lowered serum MDA levels. Moreover, tetrandrine, a component of the formula, improved cardiac function and inhibited vascular smooth muscle cell proliferation, showing strong anti-inflammatory and anti-proliferative effects.
Clinically, the team observed 56 patients with asymptomatic myocardial ischemia (SMI). Both the treatment and control groups saw a reduction in SMI episodes and duration, but the Qingxinyin group showed more significant improvements in ST-segment depression and overall ischemic events compared to the control group, confirming its superior anti-ischemic efficacy.
According to Li Yugui and colleagues, the mechanism of Qingxinyin’s anti-ischemic action goes beyond its anti-venom and anti-endothelin effects. It may also involve anti-platelet aggregation, improvement of microcirculation, and reduction of blood viscosity, making it a promising multi-target therapy for ischemic heart disease.
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