Origin: Original Investigation Article Published in the Journal of the American Medical Association (JAMA) on October 24/31, 2023

Original Article Title: Traditional Chinese Medicine Compound (Tongxinluo) and Clinical Outcomes of Patients With Acute Myocardial Infarction

Tongxinluo and Acute Myocardial Infarction

What is Tongxinluo?

Tongxinluo, a revered formula from the realm of Traditional Chinese Medicine (TCM), enjoys widespread acclaim across China and parts of Asia for its potential heart health benefits.  Employed to combat coronary artery disease, angina, and the aftereffects of strokes, it is credited with enhancing blood flow, diminishing the thickness of blood, and fortifying against the formation of arterial plaques.  This concoction blends a diverse array of components, such as herbs and animal extracts, each chosen for their unique contributions inline with TCM philosophies.

Chinese Herbal Market
Chinese herbal market

The precise mix of ingredients in Tongxinluo might show slight variations among different producers, but it typically encompasses elements like ginseng, leech, centipede, scorpion, and a variety of herbs.  This blend aims to tackle the intricate web of causes that TCM identifies as underlying cardiovascular disorders, including the stagnation of qi or vital energy, the stasis of blood, and the imbalance of yin and yang forces within the body.

Although there exists a body of scientific research pointing to Tongxinluo’s positive impact on heart health, for instance, easing angina symptoms and lowering risk indicators for cardiovascular conditions—the evidence remains inconclusive.  Further, rigorously conducted studies are essential to ascertain its true effectiveness and how it works.  Therefore, individuals are advised to seek medical advice before incorporating Tongxinluo into their regimen, particularly due to potential interactions with other drugs and considerations for individual health conditions.

What Is Interesting About This Article?

This article presents a fascinating exploration into the realm of TCM, which stands as the most frequently utilized therapeutic agent on a global scale.  With an impressive repertoire of approximately 12,800 traditional Chinese medicines, the majority of these compounds are sourced from plant-based materials, or from intricate blends incorporating animal and mineral elements. A prime example of such a compound is Tongxinluo, a TCM crafted from a carefully curated mixture of both plants and animal products.

The significance of this study lies in its findings regarding the efficacy of Tongxinluo, particularly observed at the 30-day and 1-year marks post-treatment.  The research underscores a noteworthy clinical improvement in patients who were administered Tongxinluo, highlighting its potential as a beneficial therapeutic option within the vast and diverse spectrum of traditional Chinese medicines.  This study not only contributes to our understanding of TCM’s role in modern healthcare but also opens avenues for further research into the mechanisms and broader applications of Tongxinluo in treating various conditions.

JournalDoc Notes

The intersection between TCM and the rigorous methodologies characteristic of Western medical research remains a sparsely explored territory. However, this particular study, conducted by Chinese researchers, stands out as a commendable effort to bridge this gap, adhering to the stringent criteria of evidence-based medicine through the use of randomized controlled trials (RCTs). This approach not only lends credibility to the findings but also paves the way for a more integrative global healthcare perspective.

Dr. Richard Bach, in his insightful editorial, draws attention to the unconventional yet intriguing composition of Tongxinluo, which includes such ingredients as the dried bodies of cockroaches, centipedes, leeches, cicadas, and scorpions.  While at first glance, the constituents may seem unconventional to those accustomed to Western pharmacology, they underscore the rich diversity and complexity inherent in TCM formulations.

The study’s revelation that the primary adverse reactions associated with Tongxinluo were stomach discomfort and nausea is not entirely unexpected, given the nature of its components.  Nonetheless, the reported relative risk reduction of 37% for adverse cardiovascular outcomes following Tongxinluo treatment is both striking and compelling.  Such a significant finding not only highlights the potential therapeutic benefits of Tongxinluo but also underscores the need for further rigorous research.

The impressive outcomes of this study about Tongxinluo and acute myocardial infarction underscore the importance of conducting more randomized controlled trials to explore the efficacy and safety of traditional Chinese medicines.  By doing so, the medical community can better understand how these ancient practices can be harmonized with modern medical standards, ultimately leading to enhanced patient care and a broader array of treatment options.


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CTS-AMI Investigators:

Yuejin Yang, MD, PhD
Xiangdong Li, MD, PhD
Guihao Chen, MD, PhD
Runlin Gao, MD
Eric D. Peterson, MD, MPH
Yaling Han, MD, PhD
Boli Zhang, MD
Ying Xian, MD, PhD
Haitao Zhang, MD, PhD
Yuan Wu, MD
Yanmin Yang, MD
Jianhua Wu, MD
Chuntong Wang, MD
Shenghu He, MD
Zhong Wang, MD
Yixin Wang, MD
Zhifang Wang, MD
Hui Liu, MD
Xiping Wang, MD
Minzhou Zhang, MD
Jun Zhang, MD, PhD
Jia Li, MD
Tao An, MD
Hao Guan, MD
Lin Li, MD
Meixia Shang, MD
Chen Yao, MD
Jun Zhang, MD, PhD (Listed twice, assuming leadership role or different individuals with same name and title)

Author Affiliations

1. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital’s Cardiology Department, National Center for Cardiovascular Diseases, affiliated with the Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
2. University of Texas Southwestern Medical Center’s Departments of Neurology and Population and Data Science, Dallas.
3. Fuwai Hospital’s Emergency Center, part of the National Center for Cardiovascular Disease, under the Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
4. Xiuyan Manchu Autonomous County Central People’s Hospital’s Cardiology Department, Anshan, Liaoning, China.
5. Xihua County People’s Hospital’s Cardiology Department, Zhoukou, Henan, China.
6. Northern Jiangsu People’s Hospital’s Cardiology Department, Yangzhou, Jiangsu, China.
7. The First Affiliated Hospital of Medical College, Shihezi University’s Cardiology Department, Shihezi, Xinjiang, China.
8. Xiajin People’s Hospital of Shandong Province’s Cardiology Department, Xiajin, Shandong, China.
9. Xinxiang Central Hospital’s Cardiology Department, Xinxiang, Henan, China.
10. Anyang District Hospital’s Cardiology Department, Anyang, Henan, China.
11. Shihezi People’s Hospital’s Cardiology Department, Shihezi, Xinjiang, China.
12. The Second Affiliated Hospital of Guangzhou Medical University’s Cardiology Department, Guangzhou, Guangdong, China.
13. Peking University Clinical Research Institute’s Department of Biostatistics, located at Peking University First Hospital, Beijing, China.
14. General Hospital of Northern Theater Command’s Cardiology Department, Shenyang, Liaoning, China.
15. State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
16. University of Texas Southwestern Medical Center’s Department of Medicine, Dallas.