In recent years, Delphi method has been widely applied in traditional Chinese medicine (TCM) clinical research. This article analyzed the present application situation of Delphi method in TCM clinical research, and discussed some problems presented in the choice of evaluation method, classification of observation indexes and selection of survey items. On the basis of present application of Delphi method, the author analyzed the method on questionnaire making, selection of experts, evaluation of observation indexes and selection of survey items. Furthermore, the author summarized the steps of application of Delphi method in TCM clinical research.

ObjectiveOn the basis of the analysis for the related literatures,to study the relation between seasons and traditional Chinese medicine(TCM)syndromes distribution of coronary artery disease (CAD) preliminarily.MethodsBy the reviewed analysis for the related literatures and the summary for different seasons,to study the relation between seasons and TCM syndromes distribution of CAD.Results In summer and autumn season,the most commonly seen TCM syndromes are blood stasis in heart,heart-Qi deficiency,and phlegm blocking heart vessel.While,in winter and spring season are blood stasis in heart,phlegm blocking heart vessel,and Qi-yin deficiency.The syndrome of blood stasis in heart is common in four seasons of whole year.There is more heart-Qi deficiency syndrome in summer and autumn season.The proportion of phlegm blocking heart vessel syndrome is higher in winter and spring season.Cold accumulated in heart pulse syndrome also can be often found in summer and autumn season.ConclusionAs the preliminary study on the relation between seasons and TCM syndromes distribution,the results can provide some experience for the treatment of CAD,but more accurate conclusions need to be supported by large samples of clinical investigation through four seasons.

This study was aimed to take an expert survey on the application of traditional Chinese medicine (TCM) in different clinical classifications of coronary heart disease (CHD) in order to master its medication characteristics and principles . Delphi method was applied in different clinical classifications of CHD , which contain angina pectoris, acute myocardial infarction, heart failure, arrhythmia, after percutaneous coronary inter-vention ( PCI ) and after coronary artery bypass graft ( CABG ) . Two rounds of nationwide expert survey were giv-en on the commonly-used TCM decoction , oral administration of TCM patent drugs and TCM intravenous preparations in CHD treatment . The results showed that TCM medications in the treatment of angina pectoris contain Xuefu Zhuyu decoction, Gualou Xiebai Banxia decoction, Tongxinluo capsules, Compound Danshen dripping pills, Shexiang Baoxin pill, Danshen injection, Danhong injection, and etc. And commonly used TCM medications for the treatment of acute myocardial infarction include Xue fu Zhuyu decoction , Gualou Xiebai Banxia decoction, Compound Danshen dripping pills, Shexiang Baoxin pill, Suxiao Jiuxin pills, Shengmai injec-tion , She nmai injection and so on . Heart failure of CHD was treated by Zhenwu decoction , Qili Qiangxin cap-sule, Qishen Yiqi dripping pills, Shenfu injection, Shengmai injection, Shenmai injection and so on. TCM treatments of arrhythmia of CHD usually include Zhigancao decoction , Tianwang Buxin boluses , Wenxin gran-ules, Shensong Yangxin capsule, Shengmai injection, Shenmai injection and so on. The commonly used TCM medications after PCI contain Xuefu Zhuyu decoction, Tongxinluo capsules, Compound Danshen dripping pills, Shengmai injection and Danshen injection and so on. Commonly used TCM medications after CABG include Xuefu Zhuyu decoction, Buyang Huanwu decoction, Tongxinluo capsules, Shexiang Baoxin pill, Compound Dan-shen dripping pills, Shengmai injection and Danhong injection and so on. It was concluded that different clini-cal classifications of CHD had characteristics and commonness in the application of TCM . Findings based on expert consensus through the survey provide certain reference values in the clinical syndrome differentiation of CHD .

BACKGROUD: Coronary artery disease (CAD), a common disease with high incidence and mortality rate, has seriously threatened the health and life of the public. Traditional Chinese medicine (TCM) has an important role in the prevention and treatment of this disease. Through clinical epidemiological survey, a deeper understanding of TCM etiology and syndrome characteristics in CAD would further improve clinical efficacy in the treatment of this disease.

To explore the effects of Shenmai Injection (SMI), a compound traditional Chinese herbal medicine, on pharmacokinetics and serum concentration of digoxin when applied together with digoxin.

Objective To investigate the effects of Optimized New Shengmai Powder on myocardial fibrosis in rats with heart failure based on the β1-AR/cAMP/PKA/CREB signaling pathway.Methods Totally 50 SD rats were randomly divided into sham-operation group(10 rats)and operation group(40 rats).The left anterior descending coronary artery was ligated to establish a rat model of heart failure.The modeling rats were randomly divided into the model group,the captopril group,and TCM low-and high-dosage groups,with 8 rats in each group.The administration groups received relevant medicine for gavage for 4 weeks.LVEF and LVFS in rats were detected by echocardiography,and measurement of heart and lung mass and calculation of heart and lung organ coefficients were performed,myocardial fibrosis degree was observed by histopathology,serum NT-ProBNP and cAMP,Col Ⅰ,and Col Ⅲcontent in myocardial tissue were detected by ELISA,immunohistochemical was used to detect β1-AR,cAMP positive expression,and Western blot was used to detect the expression of β1-AR/cAMP/PKA/CREB signaling pathway related proteins.Results Compared with the sham-operation group,the LVEF and LVFS of the model group rats were significantly decreased(P<0.01),and the heart and lung organ coefficient significantly increased(P<0.01);the number of myocardial cells decreased,collagen volume fraction increased,and the proportion of type Ⅰ/Ⅲcollagen fibers increased(P<0.01),the contents of serum NT-ProBNP and myocardial tissue Col Ⅰ and Col Ⅲincreased significantly,while the cAMP content in myocardial tissue decreased significantly(P<0.01),the positive expressions of β1-AR and cAMP were significantly decreased(P<0.01),the expressions of β1-AR,AC1,cAMP,p-PKA,and p-CREB proteins were significantly decreased,while protein expressions of p-Smad2,Col Ⅰ,Col Ⅲ,and α-SMA significantly increased(P<0.05,P<0.01).Compared with the model group,the administration groups could increase LVEF and LVFS and decrease heart and lung organ coefficient to different degrees in rats;increase the number of myocardial cells,decrease collagen volume fraction and the proportion of type Ⅰ/Ⅲ collagen fibers,down-regulate serum NT-ProBNP and the content of Col Ⅰ and Col Ⅲ in myocardial tissue,up-regulate the content of cAMP,increase the positive expressions of β1-AR and cAMP in myocardial tissue,up-regulate β1-AR,AC1,cAMP,p-PKA,p-CREB protein expression,and inhibit p-Smad2,Col Ⅰ,Col Ⅲ,and α-SMA protein expression,in which the effects of the TCM high-dosage group and captopril group were more pronounced(P<0.01,P<0.05).Conclusion Optimized New Shengmai Powder can effectively reduce myocardial fibrosis in heart failure rats,improve myocardial hypertrophy and remodeling,and increase left ventricular contractility,and the mechanism may be related to the activation of the β1-AR/cAMP/PKA/CREB signaling pathway.