Infección de oído o dolor de oído

Acetyl-L-Carnitine (ALC), a derivative of L-carnitine, enhances myocardial energy metabolism and may reduce ischemia. Several small clinical RCTs have shown modest improvements in exercise tolerance, reduction in anginal attack frequency, and decreased nitroglycerin use in stable angina patients receiving ALC as adjunct to standard therapy. It is listed in authoritative evidence databases as an angina-relevant ingredient.

A 1992 randomized placebo-controlled crossover trial in 20 men with severe coronary artery disease showed that oral D-ribose (60 g/day for 3 days) significantly increased treadmill walk time to 1 mm ST-segment depression and delayed the onset of angina versus placebo. A later randomized double-blind trial confirmed D-ribose plus creatine improved exercise tolerance in ischemic heart disease.

Terminalia arjuna bark has been used in Ayurvedic medicine as a cardiotonic for centuries. A landmark double-blind, placebo-controlled crossover RCT (Bharani et al., Indian Heart J 2002; n=58) found arjuna significantly decreased anginal frequency and isosorbide dinitrate consumption versus placebo (5.69 vs 18.22 mg/week, p<0.005), with efficacy comparable to isosorbide mononitrate. A DARE-registered systematic review and meta-analysis confirmed its efficacy in chronic stable angina.

Clinical studies in China document astragalus reducing the frequency of angina attacks and improving myocardial ischemic injury in patients with coronary heart disease. AS-IV has been shown in a systematic review of 18 preclinical studies to significantly reduce myocardial infarction size and improve ejection fraction. A registered RCT has evaluated astragalus injection in stable coronary heart disease with angina as an outcome measure.

Bromelain is documented in PMC reviews to prevent or minimize the severity of angina pectoris via its fibrinolytic, antiplatelet, and antithrombotic properties. It may break down cholesterol plaques and exerts potent fibrinolytic activity, reducing thrombus formation relevant to ischemic cardiac conditions. Two large-scale clinical studies on heart patients reportedly showed near-complete elimination of thrombosis.

Angina pectoris is among the most well-documented clinical indications for Danshen. Multiple RCTs show Salvia miltiorrhiza preparations reduce angina frequency, improve ECG outcomes, and improve quality of life in stable and unstable angina patients. Danshensu sodium injection and salvianolic acid B injection are under active clinical trial evaluation for angina.

CoQ10 plays a critical role in mitochondrial energy production, and its myocardial deficiency is implicated in ischemic heart disease. A 1985 double-blind, placebo-controlled crossover RCT in 12 stable angina patients showed 150 mg/day for 4 weeks significantly increased exercise time (345 to 406 s, p<0.05) and delayed ST-segment depression onset (196 to 284 s, p<0.01). The Linus Pauling Institute lists CoQ10 as potentially improving exercise tolerance and reducing ischemia signs in stable angina.

Corn silk decoction was specifically evaluated in a 2019 meta-analysis of four RCTs conducted in patients with angina pectoris, demonstrating significant improvements in lipid profiles including HDL-C, LDL-C, TC, and TG. This represents the most specific human clinical evidence for corn silk in a cardiovascular disease context.

A double-blind placebo-controlled crossover trial published in The Lancet (1992) showed that D-ribose significantly extended the time to onset of angina and ST-segment changes during treadmill exercise in men with stable coronary artery disease. A dobutamine stress echocardiography study further confirmed anti-ischemic effects. The mechanism involves enhanced myocardial ATP repletion.

Danshen (Salvia miltiorrhiza) is a cornerstone Chinese medicinal herb for cardiovascular disease including angina. A 2025 PMC review of 10 RCTs confirmed compound Danshen dripping pills provide significant anti-ischemic, vasodilatory, and antioxidative benefits in stable angina pectoris with favorable safety profiles. A 2019 meta-analysis of 22 RCTs (n=2,587) showed Danshen significantly reduced angina frequency and improved ECG results.

Eicosapentaenoic acid (EPA) reduces platelet aggregation, lowers triglycerides, decreases inflammation, and improves endothelial function in coronary artery disease. Authoritative sources list EPA as a proposed natural treatment for angina. The REDUCE-IT trial demonstrated high-dose EPA (4 g/day) significantly reduced major cardiovascular events including unstable angina by 25% versus placebo in high-risk patients.

EPA (Eicosapentaenoic Acid) is an omega-3 fatty acid with documented effects on platelet aggregation, triglycerides, inflammation, and endothelial function relevant to coronary artery disease and angina. Authoritative sources list EPA among natural treatments proposed for angina. The REDUCE-IT trial demonstrated 25% relative reduction in major cardiovascular events including unstable angina with high-dose EPA versus placebo.

Hawthorn (Crataegus spp.) has been used for cardiovascular disease since the late 1800s and is currently marketed for angina, hypertension, arrhythmia, and early heart failure. Multiple clinical trials and reviews document vasodilating, anti-ischemic, and antioxidant effects. A 1983 German clinical trial (Hanak & Brückel) specifically demonstrated benefit in mild stable angina pectoris with Crataegus extract. Placebo-controlled trials consistently show improved exercise tolerance and reduced anginal symptoms.

Inositol nicotinate is a form of niacin (vitamin B3) listed in authoritative evidence databases as a natural treatment proposed for angina pectoris. As a niacin derivative, it shares niacin's cardiovascular vasodilatory and lipid-modifying properties relevant to the atherosclerotic basis of angina. Nicotinic acid has historical direct vasodilatory use in angina management.

A preliminary clinical report (Tripathi et al., Indian J Physiol Pharmacol, 1984) documented beneficial effects of Inula racemosa root (pushkarmoola) in angina pectoris patients. Combination therapy with guggulu showed anti-anginal and hypolipidemic effects in patients with ischemic heart disease. Animal studies further confirm adrenergic beta-blocking and negative chronotropic activity that mechanistically support anti-anginal effects.

Khella (Ammi visnaga) contains khellin, a potent coronary vasodilator studied extensively for angina in 1940s–1950s clinical trials published in NEJM, JAMA, Circulation, and Annals of Internal Medicine. In 250 patients treated with khellin for angina, distinct improvement occurred in 140 and moderate improvement in 85. Khellin was used continuously for both prophylaxis and acute angina relief before modern nitrates became available.

Puerarin has been used clinically in China for angina pectoris treatment for decades, and a published clinical trial in stable angina patients demonstrated a total effective rate of 89% vs. 65% in controls after 28 days. Puerarin improves coronary blood flow, reduces inflammatory markers, and enhances endothelial function. TCM lists angina among kudzu's cardiovascular indications.

L-arginine is the substrate for endothelial nitric oxide synthase, generating nitric oxide that mediates coronary vasodilation. Long-term L-arginine supplementation was shown to improve small-vessel coronary endothelial function in humans (Lerman et al., Circulation 1998). The EBSCO Research Starters on Natural Treatments for Angina and the Preventive Cardiology literature cite L-arginine as having preliminary evidence of benefit in angina.

L-carnitine facilitates mitochondrial fatty acid oxidation, the primary cardiac energy source. The Linus Pauling Institute states that oral L-carnitine added to standard pharmacologic therapy modestly improves exercise tolerance and decreases ischemia signs in chronic stable angina. Systematic reviews confirm L-carnitine reduces angina frequency in ischemic heart disease, and the Preventive Cardiology literature cites beneficial effects on angina.

An 8-week uncontrolled human study in 22 patients with vasospastic angina given 800 mg/day L-citrulline found significant improvements in brachial artery flow-mediated dilation (FMD) at 4 and 8 weeks, along with reductions in plasma ADMA levels and oxidized LDL. A separate RCT showed that L-citrulline restores endothelial function via arginase inhibition and increased NO levels, a mechanism directly relevant to the vasospastic pathophysiology of angina.

Omega-3 fatty acids (primarily EPA and DHA from marine sources) reduce platelet aggregation, lower triglycerides, decrease inflammation, and improve endothelial function in coronary artery disease. They are listed in authoritative sources as proposed natural treatments for angina. The GISSI-Prevenzione trial showed 45% reduction in sudden cardiac death with omega-3 supplementation post-myocardial infarction.

A 20-month randomized, double-blind, placebo-controlled trial in 45 coronary heart disease patients with documented myocardial ischemia found that policosanol (5 mg twice daily) was associated with a decrement in both rest and exercise angina and a decrease in cardiac events. A 14-month pilot study in 23 CHD patients also found improvement in coronary heart disease clinical evolution in treated subjects.

Propionyl-L-Carnitine specifically replenishes Krebs cycle intermediates depleted in ischemic cardiac tissue. The Linus Pauling Institute reports it may benefit ischemic tissue by replenishing energy metabolism intermediates and increasing blood vessel dilation, and that it modestly improves exercise tolerance and decreases ischemia in chronic stable angina when added to standard therapy.

Puerarin, an isoflavone from Pueraria lobata (kudzu root), has been evaluated as adjunctive therapy for angina in multiple Chinese RCTs. A 2022 systematic review and meta-analysis found puerarin injection superior to conventional Western medicine alone in reducing angina symptoms (RR=1.22, 95% CI 1.16–1.28, p<0.00001) and improving ECG. A 2015 meta-analysis reached the same conclusion for unstable angina pectoris.

Pycnogenol (French maritime pine bark extract) improves endothelial function in stable coronary artery disease. A 2012 double-blind, randomized, placebo-controlled crossover RCT published in the European Heart Journal found Pycnogenol improved endothelial function in stable CAD patients by reducing oxidative stress. Authoritative evidence databases list Pycnogenol among natural treatments associated with angina.

Salvianolic acid is the major hydrophilic phenolic constituent of Danshen (Salvia miltiorrhiza) with potent antioxidant and antiplatelet properties. Meta-analysis evidence shows Danshen depside salts (primarily salvianolic acids) are superior to conventional treatment alone in improving angina symptoms. Salvianolic acids A and magnesium tanshinoate B specifically inhibit LDL oxidation, a key mechanism in coronary artery disease pathogenesis.

A meta-analysis of 16 RCTs assessed ligustrazine (TMP from CX) for unstable angina pectoris, providing clinical-grade evidence for its efficacy. CX is listed in classical TCM prescriptions for chest bi-syndrome (equivalent to angina). Ferulic acid from CX has also been clinically used in China to treat angina pectoris.

Tanshinone is the key lipophilic diterpene active constituent group of Danshen (Salvia miltiorrhiza), contributing to its cardiovascular efficacy in angina. Multiple RCTs and meta-analyses on Danshen preparations for stable and unstable angina demonstrate tanshinone-mediated anti-ischemic, antioxidant, and platelet-inhibiting effects. Tanshinone IIA specifically improves coronary microcirculation and reduces myocardial ischemia.

Terminalia arjuna bark has been evaluated in multiple clinical trials for chronic stable angina. A landmark double-blind, placebo-controlled crossover RCT (n=58 males, NYHA class II–III) found arjuna reduced angina frequency and need for rescue nitrates comparably to isosorbide mononitrate. A systematic review and meta-analysis confirmed these findings across several trials, though methodological quality was variable.

Trichosanthis Fructus is documented in both the Chinese Pharmacopoeia and extensive modern clinical practice in China for the treatment of angina and thoracic obstruction. Pericarpium Trichosanthis injection is clinically used for unstable angina in China. Network pharmacology and preclinical studies identify anti-inflammatory, anti-hypoxic, and anti-platelet mechanisms. Clinical use in China is substantial but RCT evidence meeting international standards is limited.

Ubiquinol is the reduced, bioactive form of CoQ10 with superior oral bioavailability compared to ubiquinone. As the active antioxidant and electron-carrier form of coenzyme Q10, ubiquinol supports mitochondrial energy production in ischemic myocardium. Authoritative sources list ubiquinol as an angina-relevant nutrient, sharing the clinical evidence base of CoQ10.

TCM texts list coronary heart disease and angina pectoris among amber's indications, attributed to its action of invigorating blood and dispelling stasis. It appears in compound TCM formulas for chest pain. No clinical trials isolate amber as a single agent for angina.

Chrysanthemum has a documented traditional and clinical TCM use for angina pectoris, attributed to its vasodilatory effects and ability to increase coronary blood flow. MSK Cancer Center and RxList both document this indication from traditional use. Preclinical evidence supports vasodilation and cardiac protection, but isolated human RCT evidence for chrysanthemum in angina is lacking.

Coleus forskohlii has been used in Ayurvedic medicine specifically for chest pain and angina for centuries. The herb's vasodilatory and smooth-muscle-relaxing properties via cAMP elevation provide pharmacological plausibility. No human clinical trials for angina have been conducted.

Coleus forskohlii is documented across Ayurvedic, Siddha, and Unani traditions for chest pain (angina), attributed to its vasodilatory and antispasmodic pharmacology. No human RCTs specifically targeting angina have been published.

Angina (chest pain of cardiac origin) is listed among the traditional indications for nattokinase based on its historical use in Japan for circulatory and cardiac conditions. Natto has been used as a folk remedy for cardiovascular disease for hundreds of years. No RCTs specifically targeting angina as a primary endpoint have been identified; studies in CAD patients (who may have angina) tested lipid and antithrombotic endpoints rather than anginal symptom relief.

Ophiopogon root is a constituent of Shengmai preparations traditionally and clinically used for coronary heart disease in China, where angina is a primary indication. TCM texts and Chinese Pharmacopoeia list myocardial ischemia protection among its actions. Preclinical studies show protection against ischemia-reperfusion injury. However, isolated clinical trials specifically for angina using ophiopogon root alone are not available.

Bromelain's fibrinolytic and platelet aggregation-inhibiting properties form the traditional mechanistic basis for its use in angina. Restorative medicine monographs document angina among pineapple extract's traditional indications. Formal clinical trials specifically in angina patients are not available.

TT saponins have been used in traditional Chinese medicine for angina pectoris, with an older Chinese clinical observation reporting a high effective rate. There is also evidence of coronary artery dilation in pharmacological studies. No modern double-blind RCT exists.