Efficacy of Jiangzhi Mai'an Granules in the treatment of stable angina pectoris with phlegm and blood stasis obstruction and carotid artery plaque: A prospective randomized study.

BACKGROUND: Stable angina pectoris, resulting from coronary artery atherosclerosis, significantly affects quality of life and carries a high risk of cardiovascular events. Despite modern therapies, managing this condition remains challenging. Traditional Chinese medicine (TCM) views it as a syndrome of heart meridian obstruction by phlegm and blood stasis, necessitating improved circulation and phlegm resolution. This study aims to evaluate the efficacy of Jiangzhi Mai'an Granules, a TCM formulation, in treating stable angina pectoris and carotid atherosclerosis, with the goal of integrating TCM with Western medicine to enhance clinical outcomes and patients' quality of life.

METHODS: A total of 120 patients diagnosed with stable angina pectoris and carotid atherosclerotic plaques of the phlegm and blood stasis types were randomly divided into 2 groups. The control group (n = 60) received standard Western medical treatment, whereas the treated group (n = 60) received JZMA in addition to the standard regimen. The treatment duration in both the groups was 3 months. The outcomes measured included carotid intima-media thickness (CIMT), carotid plaque dimensions, TCM syndrome scores, and serum lipid profiles (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], apolipoprotein B [Apo B], and non-HDL-C) and lipoprotein phospholipase A2 (Lp-PLA2) levels before and after treatment.

RESULTS: The treated group achieved a total efficacy rate of 93.3% (56/60), which surpassed the control group rate of 78.3% (47/60). The CIMT, carotid plaque thickness, and area in the treated group were significantly reduced posttreatment compared to baseline (P < .05) and were also lower than those in the control group (P < .05). Serum lipid levels, including TC, TG, LDL-C, ApoB and non-HDL-C were significantly decreased in both groups posttreatment (P < .05), and the treated group showed a further increase in HDL-C levels (P < .05). The treated group exhibited lower serum lipid levels than the control group posttreatment (P < .05). The TCM syndrome scores improved significantly in both groups after treatment (P < .05), with the treated group demonstrating a more pronounced reduction in scores than the control group (P < .05). The incidence of adverse events did not differ significantly between the 2 groups.

CONCLUSIONS: JZMA combined with standard treatment effectively reduced CIMT, plaque size, and serum lipid levels, thereby enhancing clinical outcomes in patients with stable angina and carotid atherosclerosis.