Abstract
BackgroundGiven the severity of pulmonary heart disease and the wide utilization of Chinese herbal injections, this network meta-analysis was devised to assess the comparative efficacy of seven Chinese herbal injections (Ciwujia injection, Dazhuhongjingtan injection, Huangqi injection, Shenfu injection, Shengmai injection, Shenmai injection, and Shenqi Fuzheng injection) that were combined with Western medicines in the treatment of pulmonary heart disease.MethodsA literature search was performed in PubMed, Cochrane Library, EMBASE, Chinese Biological Medicine Database, China National Knowledge Infrastructure, Wanfang Database, and the Chinese Scientific Journal Database from their inception to July14, 2019. This network meta-analysis was conducted in accordance with a priori eligibility criteria and methodological quality recommendations. Data analysis was performed with WinBUGS 1.4.3 and Stata 13.0 software focusing on clinical effectiveness rate, arterial blood gas analysis, hemorheology and hemodynamic indexes and right ventricular dimensions. In addition to the odds ratio or mean difference in various outcomes, the ranking probability of interventions calculated by the surface under the cumulative ranking area curve was demonstrated. The surface under the cumulative ranking area was equal to the rank of the intervention and was aimed to assess the best intervention.ResultsUltimately, 118 randomized controlled trials including 10,085 patients were included. Integrating the outcome results, all eligible Chinese herbal injections plus Western medicines were superior to Western medicines alone, especially Shenfu injection+ Western medicines, Shenmai injection+ Western medicines, and Shenqi Fuzheng injection+ Western medicines. Regarding safety, the drip rate was an essential element for clinicians to consider during treatment.ConclusionsIn conclusion, Shenfu injection+ Western medicines, Shenmai injection+ Western medicines and Shenqi Fuzheng injection+ Western medicines may be potential optimal treatments for pulmonary heart disease. A larger sample size and high-quality randomized controlled trials are needed to confirm and support this network meta-analysis.
Highlights
Pulmonary heart disease (PHD), a pathologic condition that increases pulmonary vascular resistance and pulmonary artery pressure, is caused by lesions in bronchial and lung tissue and the pulmonary vascular system and leads to the irreversible development of pulmonary hypertension and ultimate overload of the right heart or even right heart failure (Forfia et al, 2013; Wang et al, 2016).With an estimated average prevalence of 0.46% worldwide for PHD, the heavy burden of these patients and their families has been placed on society (Yun et al, 2016)
The odds ratio (OR) of the comparisons were significantly different as follows: Ciwujia injection+Western medicine (WM) vs. WM (OR = 0.27, 95% 95% credible interval (CI): 0.13–0.55), Dazhuhongjingtian injection+WM vs. WM (OR = 0.35, 95% confidence intervals (95% CI): 0.11–0.91), Huangqi injection+WM vs. WM (OR = 0.23, 95% CI: 0.18–0.29), Shenfu injection+WM vs. WM (OR = 0.21, 95% CI: 0.12–0.35), Shengmai injection+WM vs. WM (OR = 0.29, 95% CI: 0.22–0.39), Shenmai injection+WM vs. WM (OR = 0.24, 95% CI: 0.20–0.30), and Shenqi Fuzheng injection+WM vs. WM (OR = 0.25, 95% CI: 0.11–0.54)
The results revealed that Shenfu injection+WM, Shenmai injection+WM, and Shenqi Fuzheng injection+WM were the highest ranked amongst the eligible interventions
Summary
Pulmonary heart disease (PHD), a pathologic condition that increases pulmonary vascular resistance and pulmonary artery pressure, is caused by lesions in bronchial and lung tissue and the pulmonary vascular system and leads to the irreversible development of pulmonary hypertension and ultimate overload of the right heart or even right heart failure (Forfia et al, 2013; Wang et al, 2016).With an estimated average prevalence of 0.46% worldwide for PHD, the heavy burden of these patients and their families has been placed on society (Yun et al, 2016). The use of traditional Chinese medicine combined with WM has been extensively promoted in routine practice in China. In light of traditional Chinese medicine theories, PHD is an aspect of “lung distension” and “dyspnea” and is caused by the lungs and heart. For the past twenty years, their effectiveness has been confirmed in clinical trials (Liao et al, 2004; China association of traditional Chinese medicine of lung diseases, 2014; Yun et al, 2016). Given the severity of pulmonary heart disease and the wide utilization of Chinese herbal injections, this network meta-analysis was devised to assess the comparative efficacy of seven Chinese herbal injections (Ciwujia injection, Dazhuhongjingtan injection, Huangqi injection, Shenfu injection, Shengmai injection, Shenmai injection, and Shenqi Fuzheng injection) that were combined with Western medicines in the treatment of pulmonary heart disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
