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Investigation of the Cellular Pharmacological Mechanism and Clinical Evidence of the Multi-Herbal Antiarrhythmic Chinese Medicine Xin Su Ning

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机构: [1]Oxford Chinese Medicine Research Centre & Department of Physiology, Anatomy and Genetics, University of Oxford,Oxford, United Kingdom [2]Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, CapitalMedical University, Beijing, China [3]Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing,, China [4]Department of Cardiology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China [5]Instituteof Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China [6]Department ofCardiovascular Diseases, West China Hospital, School of Clinic Medicine, Sichuan University, Chengdu, China [7]Department ofCardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [8]GeriatricsDepartment, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China [9]Clinical Departmentsof Cardiology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China [10]Department of Cardiology, ShanghaiJiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China [11]Department of Cardiology, First Teaching Hospital ofTianjin University of Traditional Chinese Medicine, Tianjin, China [12]Department of Cardiology, Xiyuan Hospital CACMS, Beijing,, China [13]Department of Cardiology, the First Hospital of Jilin University, Changchun, China [14]Department of Cardiology,Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China [15]Department of Cardiology, the Affiliated Hospital ofShandong University of Traditional Chinese Medicine, Jinan, China [16]Department of Cardiology, Hengyang Hospital ofTraditional Chinese Medicine, Hengyang, China [17]Department of Cardiology, Tianjin Hospital of ITCWM Nankai Hospital, Tianjin,China [18]Department of Traditional Chinese Medicine, Liaocheng People’s Hospital, Liaocheng, China
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关键词: Xin Su Ning traditional Chinese medicine multicomponent antiarrhythmic medicine cellular electrophysiology premature ventricular contraction

摘要:
Xin Su Ning (XSN), a China patented and certified multi-herbal medicine, has been available in China since 2005 for treating cardiac ventricular arrhythmia including arrhythmia induced by ischemic heart diseases and viral myocarditis, without adverse reactions being reported. It is vitally important to discover pharmacologically how XSN as a multicomponent medicine exerts its clinical efficacy, and whether the therapeutic effect of XSN can be verified by standard clinical trial studies. In this paper we report our discoveries in a cellular electrophysiological study and in a three-armed, randomized, double-blind, placebo-controlled, parallel-group, multicenter trial. Conventional electrophysiological techniques were used to study the cellular antiarrhythmic mechanism of XSN. Data was then modeled with computational simulation of human action potential (AP) of the cardiac ventricular myocytes. The clinical trial was conducted with a total of 861 eligible participants randomly assigned in a ratio of 2:2:1 to receive XSN, mexiletine, or the placebo for 4 weeks. The primary and secondary endpoint was the change of premature ventricular contraction (PVC) counts and PVC-related symptoms, respectively. This trial was registered in the Chinese Clinical Trial Register Center (ChiCTR-TRC-14004180). We found that XSN prolonged AP duration of the ventricular myocytes in a dose-dependent, reversible manner and blocked potassium channels. Patients in XSN group exhibited significant total effective responses in the reduction of PVCs compared to those in the placebo group (65.85% vs. 27.27%, P < 0.0001). No severe adverse effects attributable to XSN were observed. In conclusion, XSN is an effective multicomponent antiarrhythmic medicine to treat PVC without adverse effect in patients, which is convincingly supported by its class I & III pharmacological antiarrhythmic mechanism of blocking hERG potassium channels and hNaV1.5 sodium channel reported in our earlier publication and prolongs AP duration both in ventricular myocytes and with computational simulation of human AP presented in this report.

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出版当年[2019]版:
大类 | 2 区 医学
小类 | 2 区 药学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 药学
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出版当年[2018]版:
Q1 PHARMACOLOGY & PHARMACY
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Q1 PHARMACOLOGY & PHARMACY

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第一作者机构: [1]Oxford Chinese Medicine Research Centre & Department of Physiology, Anatomy and Genetics, University of Oxford,Oxford, United Kingdom
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