Effect of shenfu injection on microcirculation in shock patients

Zhang, Xuemei; Guo, Ting; Zhang, Kaichen; Guo, Wenhui; An, Xing; Gao, Peiyang

doi:10.1097/md.0000000000022872

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…This SFI-induced improvement is partly mediated by its vasodilatory effects, which is via the PI3K/Akt/eNOS/NO pathway in vascular endothelial cells (28). In addition, in an animal model of shock, SFI improved microcirculation perfusion by increasing the number of capillary network openings and enlarging the diameter of arterioles (29). Therefore, the protective effects of SFI on microcirculation are achieved by improving endothelial dysfunction and exerting a vasodilating effect.…”

Section: Discussionmentioning

confidence: 99%

Effects of Shenfu Injection on Sublingual Microcirculation in Septic Shock Patients: A Randomized Controlled Trial

Wang

Liu

Chen

et al. 2022

Shock

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Background and Objective: The optimization of macrocirculatory hemodynamics is recommended by current sepsis guidelines. However, microcirculatory dysfunction is considered the cause of severe sepsis. In the present study, we designed to verify whether the application of Shenfu injection (SFI) restores microcirculation, thereby improving tissue perfusion and inhibiting organ dysfunction, resulting in improved outcomes. Design: We conducted a prospective, single-center, randomized, double-blind, placebo-controlled clinical trial. Intervention: Patients were randomly assigned to group receiving SFI (n = 20) or placebo (n = 20) for 5 days. We administered SFI or glucose injection for 5 days and blinded the investigators and clinical staff by applying light-proof infusion equipment that concealed therapy allocation. Measurements and Results: We measured the systemic dynamics and lactate levels, biomarkers of endothelial dysfunction, and inflammatory cytokines in the plasma. The parameters of sublingual microcirculation were assessed using side-stream dark-field imaging. Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) score, total dose, and duration of vasopressor use, emergency intensive care unit (EICU) stay, and 28-day mortality were evaluated. After treatment with SFI, the disturbance of the sublingual microcirculation was considerably alleviated, as indicated by the significant increase in total vessel density, perfused vessel density, and microvascular flow index. Moreover, the plasma biomarker levels of endothelial dysfunction, including Ang-2, Syn-1, and ET-1, were reversed after SFI treatment. Importantly, the SFI group had a more favorable prognosis than the control group in terms of the APACHE-II score, SOFA score, duration of vasopressor administration, and length of EICU stay. However, the difference in mortality at day 28 was not statistically different between the SFI (15%, 3/20) and placebo (25%, 5/20) groups (P = 0.693). Conclusions: Shenfu injection provided apparent effects in improving sublingual microcirculatory perfusion in patients with septic shock, and this protection may be related with the inhibition of endothelial dysfunction and vasodilatory effects.

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Section: Discussionmentioning

confidence: 99%

Effects of Shenfu Injection on Sublingual Microcirculation in Septic Shock Patients: A Randomized Controlled Trial

Wang

Liu

Chen

et al. 2022

Shock

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“…(hongshen) and Aconitum carmichaeli Debx (fuzi). In clinical treatment, SFI has been widely used to treat a variety of diseases including sepsis [3,4], shock [5], and heart failure [6] with good curative e ects. Experimental evidence supports that SFI is e ective in improving immune function in patients with sepsis [7,8], reducing septic lung injury [9], and improving the prognosis for patients with sepsis [7,10,11].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Mechanism and Key Active Ingredients of Shenfu Injection in Sepsis: A Network Pharmacology and Molecular Docking Approach

Yuan

Yang

Huang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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At present, although the early treatment of sepsis is advocated, the treatment effect of sepsis is unsatisfactory, and the mortality rate remains high. Shenfu injection (SFI) has been used to treat sepsis with good clinical efficacy. Based on network pharmacology, this study adopted a new research strategy to identify the potential therapeutic targets and key active ingredients of SFI for sepsis from the perspective of the pathophysiology of sepsis. This analysis identified 28 active ingredients of SFI based on UHPLC-QQQ MS, including 18 ginsenosides and 10 aconite alkaloids. 59 targets were associated with the glycocalyx and sepsis pathways. Based on the number of targets related to the pathophysiological process of sepsis, we identified songorine, ginsenoside Rf, ginsenoside Re, and karacoline as the key active ingredients of SFI for the treatment of sepsis. According to the cluster analysis of MCODE and the validation on the GEO dataset, LGALS3, BCHE, AKT1, and IL2 were identified as the core targets. This study further explored the therapeutic mechanism and the key active ingredients of SFI in sepsis and provided candidate compounds for drug development.

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“…[ 9 ] Shenfu injection is made from ginseng and aconite extract. Modern medical research has found that Shenfu injection can reduce peripheral vascular resistance, improve microcirculation, [ 10 ] protect cardiomyocytes, [ 11 ] and protect vascular endothelium. [ 12 ] At the same time, Shenfu injection has small clinical adverse reactions and a safe wide range of dose.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of Shenfu injection combined with sodium nitroprusside in the treatment of chronic heart failure in patients with coronary heart disease

et al. 2021

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Background: Coronary heart disease is a serious cardiovascular disease. There is coronary atherosclerosis, resulting in lumen stenosis, blockage, and then the symptoms of insufficient blood supply and hypoxia in the myocardium. Chronic heart failure is a kind of syndrome with abnormal ventricular filling and ejection function, which is the final stage of the development of coronary heart disease. At present, the treatment plan of Western medicine can significantly reduce the hospitalization rate, but it is still not satisfactory for the prognosis and mortality of patients. Shenfu injection has advantages in the treatment of heart failure in patients with coronary heart disease, but there is a lack of standard clinical studies to verify it, so the purpose of this randomized controlled study is to evaluate the efficacy and safety of Shenfu injection combined with sodium nitroprusside in the treatment of chronic heart failure in patients with coronary heart disease. Methods: This is a prospective randomized controlled trial to study the efficacy and safety of Shenfu injection combined with sodium nitroprusside in the treatment of chronic heart failure in patients with coronary heart disease. The patients will be randomly divided into a treatment group and the control group according to 1:1, in which the treatment group is treated with Shenfu injection combined with sodium nitroprusside, and the control group is treated with sodium nitroprusside alone. Both groups will be treated with standard treatment for 7 days and followed up for 30 days to pay attention to their efficacy and safety indexes. The observation indexes include TCM syndrome score, N-terminal pro-brain natriuretic peptide, left ventricular ejection fraction, brain natriuretic peptide, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, stroke volume, adverse reactions and so on. We will use SPSS 25.0 software for data analysis. Discussion: This study will evaluate the efficacy and safety of Shenfu injection combined with sodium nitroprusside in the treatment of chronic heart failure in patients with coronary heart disease. The results of this experiment will provide a clinical basis for Shenfu injection combined with sodium nitroprusside in the treatment of chronic heart failure in coronary heart disease. Trial registration: DOI 10.17605/OSF.IO/4KNG3

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Effect of shenfu injection on microcirculation in shock patients

Cited by 6 publications

References 35 publications

Effects of Shenfu Injection on Sublingual Microcirculation in Septic Shock Patients: A Randomized Controlled Trial

Effects of Shenfu Injection on Sublingual Microcirculation in Septic Shock Patients: A Randomized Controlled Trial

Therapeutic Mechanism and Key Active Ingredients of Shenfu Injection in Sepsis: A Network Pharmacology and Molecular Docking Approach

Efficacy and safety of Shenfu injection combined with sodium nitroprusside in the treatment of chronic heart failure in patients with coronary heart disease

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