Treating unstable angina with detoxifying and blood-activating formulae: A randomized controlled trial

J Ethnopharmacol. 2021 Dec 5:281:114530. doi: 10.1016/j.jep.2021.114530. Epub 2021 Aug 17.


Ethnopharmacological relevance: Detoxifying and blood-activating Chinese medicine granule formula, which includes 15 g of Polygonum cuspidatum Sieb. et Zucc. (Polygonum cuspidatum) and 10 g of Crataegus pinnatifida Bunge (Hawthorn), can relieve the symptoms and serve as supplementary treatment for unstable angina.

Aim of the study: This study aimed to explore the role of detoxifying and blood-activating formulae in the treatment of unstable angina and the potential mechanism involved.

Materials and methods: A total of 144 participants with unstable angina were randomly divided into experimental and control groups. Both groups were treated with standardized Western medicine; the experimental group was additionally treated with detoxifying and blood-activating Chinese medicine granules, which included 15 g of P. cuspidatum and 10 g of C. pinnatifida for 4 weeks. The primary endpoint was the frequency of weekly angina pectoris attacks before and after treatment. The secondary endpoints, also observed before and after treatment, included blood glucose, blood lipids, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-10, and adiponectin levels, as well as the ratio of pro/anti-inflammatory factors and evaluation scales of symptoms and syndromes in Chinese and Western medicine.

Results: In both experimental and control groups, the frequency of weekly angina pectoris attacks was lower after treatment (P < 0.01), but with no significant intergroup difference (P = 0.10). After intervention, the hs-CRP, TNF-α, and IL-6 levels decreased, while the IL-10 and adiponectin levels significantly increased in the experimental group (P < 0.05 or 0.01). The ratios of the inflammatory factors significantly decreased after treatment, particularly in the experimental group (P < 0.01). Symptoms and syndromes were also ameliorated in the experimental group (P < 0.01), showing a significant difference from the control group (P < 0.01).

Conclusions: Detoxifying and blood-activating formulae can reduce the frequency and relieve symptoms of unstable angina, and this mechanism may be related to a regulation of the balance of pro- and anti-inflammatory factors.

Keywords: Coronary artery disease; Detoxifying and blood-activating formula; Inflammation; Unstable angina.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angina, Unstable / drug therapy*
  • Cardiovascular Agents / therapeutic use
  • Crataegus / chemistry*
  • Cytokines / genetics
  • Cytokines / metabolism
  • Drugs, Chinese Herbal / chemistry
  • Drugs, Chinese Herbal / therapeutic use*
  • Fallopia japonica / chemistry*
  • Female
  • Gene Expression Regulation / drug effects
  • Humans
  • Inflammation / drug therapy
  • Male
  • Middle Aged
  • Phytotherapy*


  • Cardiovascular Agents
  • Cytokines
  • Drugs, Chinese Herbal