Aspirin Resistance and Promoting Blood Circulation and Removing Blood Stasis: Current Situation and Prospectives

Table 2

Clinical trials of Chinese herbal interventions in treating AR with a concomitant population.

Reference (year)	Study design	Participants T/C	Intervention (herb included)	Control	Outcome measure	Treatment duration	Main finding (𝑃 value)
Chai et al. (2008) [48]	RCT	10/10	Composite salvia dropping pill (10 pills, tid); aspirin (100 mg, qd)	Aspirin (100 mg, qd)	Platelet aggregation rate induced by AA and ADP	2 w	Composite salvia dropping pill can enhance patients’ sensitivity to aspirin. The combining use can synergisticly exert antiplatelet effect.
Peng et al. (2011) [49]	RCT	12/13	Huo xue capsule (4 pills, tid); aspirin (100 mg, qd)	Aspirin (100 mg, qd)	Platelet aggregation rate induced by AA and ADP	12 w	The combination of huo xue capsule and aspirin can decrease the platelet aggregation rate significantly.
Yang et al. (2011) [50]	RCT	130/130	Nao xin tong capsule (2 pills, tid); aspirin (100 mg, qd)	Aspirin (100 mg, qd)	Platelet aggregation rate induced by AA and ADP, the incidence of AR and ASR of each group.	24 w	The combining use of nao xin tong capsule and aspirin can significantly decrease the platelet aggregation rate. Incidence of AR and ASR is lower than single aspirin group.
Yin et al. (2010) [51]	RCT	30/29	Tong xin luo capsule (3 pills, tid); aspirin (100 mg, qd)	Aspirin (100 mg, qd)	COL and platelet aggregation rate induced by AA and ADP	30 d	Tong xin luo capsule has some effects on decreasing the platelet aggregation rate induced by ADP and COL.
Song (2008) [52]	RCT	24/23	Tong xinluo capsule (4 pills, tid)	Clopidogrel (75 mg, qd)	CRP, TXB2, and platelet aggregation rate induced by AA and ADP	30 d	Tongxinluo capsule has antiplatelet aggregation and anti-inflammatory effect in ACS patients with AR and can improve AR in ACS patients in a certain degree.
Liu (2011) [53]	RCT	30/30	Xinnao shutong capsule (9 pills, qd); aspirin (100 mg, qd)	Aspirin (100 mg, qd)	Uric acid, Blood lipid, Hs-CRP, TXB2, and platelet aggregation rate induced by AA and ADP; AA, ADP, and so on.	1 y	The combining use of aspirin and xinnao shutong capsule can decrease the adverse cadiovascular events of patients with AR.
Wu (2012) [54]	RCT	30/30	Xuefu zhuyu decoction (1 dose, qd); aspirin (100 mg, qd)	Aspirin (100 mg, qd)	The expression of AA and ADP in serum.	4 w	The combining use of aspirin and Xuefu zhuyu decoction can significantly decrease the platelet aggregation rate induced by ADP and AA.
Luo et al. (2012) [55]	RCT	30/30	Zhilong huoxue capsule (1.6 g, tid)	Aspirin (300 mg, qd)	The mean platelet aggregation rate, TXB2, and 6-K-PGF1α.	4 w	Capsule zhilong huoxue of aspirin resistance has better efficacy and safety. The mechanism may be related to its effect of decreasing TXB2, increasing 6-K-PGF1α, and decreasing TXB2/6-K-PGF1α.
Xiu (2012) [56]	RCT	30/30	Di’ao xinxuekang capsule (1.6 g, tid)	Aspirin (300 mg, qd)	Platelet aggregation rate induced by AA and ADP	4 w	Capsule di’ao xinxuekang of aspirin resistance has better efficacy and safety. The mechanism may be related to its effect of decreasing TXB2, increasing 6-K-PGF1α, and decreasing TXB2/6-K-PGF1α.
Yang et al. (2011) [57]	RCT	50/50	Ginkgo biloba extract (19.2 mg, tid); aspirin (100 mg, qd)	Aspirin (100 mg, qd)	Platelet aggregation rate induced by AA, ADP, and FAP	2 w	Combination of ginkgo biloba extract and low dosage of aspirin can decrease AR and decrease incidence of adverse cadiovascular events.

Notes: T/C: treatment group and control group; CT: clinical trial; RCT: randomized clinical trial; NR: not reported; ADP: adenosine diphosphate; COL: collagen.