Guan Xin II Arizona

Protecting myocardium from injury: In ischemic myocardial injury, both the structure and function of the cellular membranes undergo considerable changes. Guanxin-II can stabilize the myocyte membrane, lower the membrane permeability, protect the mitochondria and lysosome from injury, and raise the hypoxia endurance of the myocytes.(3)

Immunization: Guanxin-II has dual actions on the macrophage phagocytic function. At a low dosage, it can inhibit the phagocytic ability. At a high dosage, it can enhance the phagocytic ability.(4)

Lowering blood-lipid: In rabbits with experimental atherosclerosis and hyperlipidemia, Guanxin-II can lower serum total cholesterol, neutral fat, beta-lipoprotein levels, the total cholesterol, and total lipid levels in the aortic wall. This significantly reduces the proportion and the mean thickness of plaques in the total area of the intima in the aortic wall. In addition, it lowers the incidence of plaque in the anterior descending branch of the coronary artery and the small arteries, and lessens the blocking severity of the coronary cavity. When seen under a microscope, the lipid stain of the atherosclerotic plaques is uneven and the lipids move towards the middle layer of the artery, suggesting a tendency to disintegrate plaques.(5)

Anti-thrombus action:In rats, a Guanxin-II injection can inhibit thrombosis in vitro, shorten the length and lighten the weight of the thrombus, and prolong the specific thrombosis duration.(6) In the rat, the formula has antagonistic actions on acute myocardial infarction caused by stress-induced myocardial intravascular platelet aggregation.(7) Except Jiang Xiang (Dalbergia Wood), the other four ingredients in Guanxin-II, particularly Chi Shao (Peony Red), prolonged the duration of the specific thrombus and the fibrinous thrombus formation. Guanxin-II and its ingredients all caused thrombus weight (dry or damp) to decrease, and the effects of Chi Shao (Peony Red) were the strongest, while Jiang Xiang (Dalbergia Wood) was the weakest.(8) When used in small doses, Guanxin-II had no apparent effect on fibrin, while used in large doses however, it could lower the concentration of fibrin stable factor.(9) It could also raise cAMP levels via inhibiting the activity of phosphodiesterase of platelet.(10)

Improving microcirculation: Guanxin-II has certain effects in preventing and treating adrenaline induced disturbances of mesenteric microcirculation in the mouse, and in treating adrenaline induced vasoconstriction by improving micrangium formation, lowering capillary permeability, and reducing vascular exudation.(11)

Wang Hong observed the therapeutic effects of modified Guanxin-II in 105 cases of CHD with angina pectoris (treatment group) and compared them with the effects of Dan Shen Tablets (4 tablets 3 times a day) in 104 cases of CHD (control group). The modified Guanxin-II was composed of Dan Shen (Salvia), Chuan Xiong (Cnidium), Hong Hua (Carthamus), Xie Bai (Bakeri), Gui Zhi (Cinnamon Twig), Chi Shao (Peony Red), Gua Lou (Trichosanthes Fruit), and Jiang Xiang (Dalbergia Wood). One dose of the modified formula was administered daily. 20 days constituted one course of treatment. After 3 courses of treatment, the results for treatment and control groups were, respectively: 51 and 27 cases had significant improvement in angina attacks, 48 and 47 had some improvement, and 6 and 30 did not respond to the treatment. The total effectiveness rates were 94.3% and 71.2%, respectively. With respect to ECG, the results for the treatment and control groups were, respectively: 18 and 9 cases had significant improvement, 33 and 23 cases had some improvement, and 54 and 72 did not respond to the treatment. The total effectiveness rates were 49.6% and 30.8%, respectively. The therapeutic effects in the treatment group were significantly superior to that of control group (P<0.01).(13)

Hu Qi Xing reported that in the treatment of 15 cases of CHD with angina pectoris, Guanxin-II was used in combination with other ingredients according to the individual's symptoms. For concomitant symptoms of a choking sensation in the chest and suffocation, the herbs added were Tan Xiang (Lignum Santali), Yu Jin (Curcuma Root), Xie Bai (Bakeri), Gua Lou Pi (Trichosanthes Peel), and Ge Gen (Pueraria). For palpitations, shortness of breath, and weakness, the herbs added were Huang Qi (Astragalus), Dang Shen (Codonopsis), Mai Dong (Ophiopogon Root), Wu Wei Zi (Schizandra), and Huang Jing (Polygonatum Root). For cold limbs and palpitations, Huang Qi (Astragalus), Gui Zhi (Cinnamon Twig), Wu Fu Pian (prepared Aconite), Gan Jiang (Ginger), and Xian Ling Pi (Epimedium) were added. For blood stasis, the herbs used included Pu Huang (Pollen Typhae), Wu Ling Zhi (Faeces Trogopterorum), Yu Jin (Radix Curcumae), Tao Ren (Semen Persicae), and Yi Mu Cao (Herba Leonuri). One dose of these formulas in a decoction was administered daily. 30 days constituted one therapeutic course of treatment. After the treatment, 10 cases had significantly improved, 4 had somewhat improved, and one case did not respond to the treatment.(14)

Hu Tian Zhen, et al. used Guanxin-II combined with a supplemented Gua Lou Xie Bai Tang decoction to treat 172 cases of CHD with concurrent angina pectoris. Gua Lou Xie Bai Tang was comprised of Gua Lou Pi (Trichosanthes Peel), Chi Shao (Peony Red), Dang Shen (Codonopsis), Xie Bai (Bakeri), Chuan Xiong (Cnidium), Jiang Xiang (Dalbergia Wood), Huang Qi (Astragalus), Bai Zhu (White Atractylodes), Fang Feng (Siler), and Hong Hua (Carthamus). One dose of the formula in a decoction was administered twice a day. The therapeutic results were compared with 64 cases treated with Western medicine. In this control group, isosorbide (10mg/time) and nifedipine (10 to 20mg/time) were taken 3 times a day. 30 days constituted one course of treatment. The results for the herbal medicine group and Western medicine group were, respectively: 56 and 12 cases showed significant improvement, 100 and 28 had some improvement, 16 and 18 cases did not respond to the treatment, and lastly, 0 and 6 cases became worse. The total effectiveness rates were 90.69% and 62.5% respectively for angina pectoris. The therapeutic effects of the herbal medicine were significantly superior to that of Western medicine (P< 0.05). With respect to ECG, in the above two groups, 8 and 6 cases had significant improvement, 80 and 31 had improvement, 84 and 25 did not respond, 0 and 2 became worse. The total effectiveness rates were 51.16% and 57.81%, respectively (P>0.05).(15)

Liu Xing Xin reported that in 68 CHD patients treated with Guanxin-II combined with a modified Tao Hong Si Wu decoction, the total effectiveness rate was 91.06%.(16)

High Performance Liquid Chromatography (HPLC)
In 5 healthy people, after the administration of water-treated Guanxin-II, the serum ferulic acid (FA) content was detected directly and qualitatively with two and three-dimensional HPLC and ultraviolet spectrophotometry. This was followed by the determination of the quality by the way of the internal standard (coumarin) method. The results were, for the mobile phase, formaldehyde: acetic acid: water = 38: 0.3: 61.7; for the fixed phase, the C18 (ODS2) column was 150mm X 4.6mm, 5m, and the lowest limit of detection of FA was 6 ng (N/S=3). The lowest serum concentration was 20.2 g/L, the linear range 33.7 to 2156.8g/L, range =0.9993, the mean recovery rate (93.59±2.36)% and RSD among days and in one same day were less than 8.44%.(17)