A Critical Overview of Systematic Reviews of Shenfu Injection for Heart Failure.

Jinke Huang,Min Shen,Xiaohui Qin,Fang Yan,Yong Huang,Yanlu Wang,Suihe Huang,Hangang Yu

doi:10.1155/2021/8816590

Abstract

Objectives Shenfu Injection (SFI) was widely used in the treatment of heart failure (HF) in China. A plethora of systematic reviews/meta-analyses (SRs/MAs) has been conducted in this research area, although with scattered results. The purpose of this overview was to conduct a comprehensive review to summarize and critically evaluate the existing evidence. Methods Digital databases were searched for SRs/MAs up to January 28, 2021. Two authors independently screened the reviews and assessed the methodological quality of included SRs/MAs using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2). Quality of evidence for outcomes evaluated within the reviews was appraised with the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE). Results Thirteen SRs/MAs met the inclusion criteria. Based on AMSTAR-2, the quality of all SRs/MAs was critically low, because all of them have more than one critical domains that were unmet. Based on GRADE, the evidence quality of 24 outcome measures was low or very low, 27 outcome measures was moderate, and none outcome measure was high. Descriptive analysis showed that SFI was an effective and safe method for HF. Conclusions The use of SFI for the treatment of HF may be clinically effective and safe. However, this conclusion must be interpreted cautiously due to the generally low methodological quality and low evidence quality of the included SRs/MAs. More rigorously designed SRs/MAs and RCTs with high methodological quality are necessary for further proof.

Highlights

Heart failure (HF) is one of the leading causes of human morbidity and mortality worldwide
Firm conclusion towards the validity and safety of Shenfu Injection (SFI) cannot be drown owing to the low quality of included trails
On the basis of routine treatment of western medicine (WM), SFI is more effective than WM alone in the treatment of acute left HF

Summary

Introduction

Heart failure (HF) is one of the leading causes of human morbidity and mortality worldwide. Over the past 30 years, improvements in treatments that consist of some effective medicines, such as diuretics, digoxin, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and β-blockers, have improved survival and reduced the hospitalization rate in patients with HF. It cannot obtain a desired effect own to poor compliance, lower heart rate of patients, and other questions [5]. Shenfu Injection (SFI) has been used in treating cardiac diseases for a long time in China; pharmacological studies have suggested that SFI can reduce peripheral circulation resistance and improve microcirculation [6]. To comprehensively evaluate the evidence and applicability of the results of SRs/MAs on SFI for HF, we composed an overview

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Discussion

Conclusion