Abstract
Ginkgo leaf extract and dipyridamole injection (GLED), a kind of Chinese herbal medicine preparation, has been considered as a promising supplementary treatment for chronic cor pulmonale (CCP). Although an analysis of the published literature has been performed, the exact effects and safety of GLED have yet to be systematically investigated. Therefore, a wide-ranging systematic search of electronic databases from which to draw conclusions was conducted. All randomized controlled trials concerning the GLED plus conventional treatments for CCP were selected in the present study. Main outcomes were treatment efficacy, blood gas and hemorrheology indexes, and adverse events. Data from 28 trials with 2457 CCP patients were analyzed. The results indicated that, compared with conventional treatments alone, the combination of conventional treatments with GLED obviously improved the markedly effective rate (RR = 1.44, 95% CI = 1.31–1.58, P < 0.00001) and total effective rate (RR = 1.28, 95% CI = 1.18–1.38, P < 0.00001). Moreover, the hemorrheology (PaO2, P < 0.00001; PaCO2, P < 0.00001; SaO2, P < 0.00001; pH value, P = 0.05) and blood gas indexes (PV, WBHSV, WBMSV, WBLSV, hematocrit and FBG, P < 0.01) of CCP patients were also significantly ameliorated after the combined therapy. The frequency of adverse events did not differ significantly between the two groups (P > 0.05). In summary, evidence from the meta-analysis suggested that the combination of conventional treatments and GLED appeared to be effective and relatively safe for CCP. Therefore, GLED mediated therapy could be recommended as an adjuvant treatment for CCP.
Highlights
Chronic cor pulmonale (CCP), a common type of heart disease, has become a rising major public problem that threatens people’s health and quality of life around the world [1]
Literatures were searched across nine electronic databases, including PubMed, Embase, Web of Science, Cochrane Library, Medline, Chinese Scientific Journal Database (VIP), Wanfang database, China National Knowledge Infrastructure (CNKI) and Chinese Biological Medicine Database (CBM), before December 2019, with key terms “ginkgo biloba” or “ginkgo leaf extract” or “ginkgo dipyidamolum” and “dipyridamole injection” or “Ginkgo leaf extract and dipyridamole injection” or “yinxingdamo injection” and “pulmonary heart disease” or “chronic cor pulmonale” or “cor pulmonale” or “fei yuan xing xin zang bing” or “fei xin bing” (Supplementary Table S1)
Inclusion criteria: (1) Randomized controlled trials (RCTs) concerning patients diagnosed with CCP were included; (2) Articles involving more than 50 CCP patients; (3) There were no other medicines in combination with the conventional treatments in the experimental group, except for Ginkgo leaf extract and dipyridamole injection (GLED), compared with the conventional treatments as a control; (4) One or more outcome measures, including the therapeutic effect, or hemorheology or blood gas indexes, or adverse events must be included in each study
Summary
Chronic cor pulmonale (CCP), a common type of heart disease, has become a rising major public problem that threatens people’s health and quality of life around the world [1]. World Health Organization (WHO) defined CCP as “hypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs, and may further leading to heart failure” [4]. Pulmonary hypertension resulting from disorders of the respiratory system and/or from chronic hypoxaemia is the main pathological mechanism of CCP [1,5,6]. Is the main clinical therapy for CCP [1]. Many researchers in China and some other Asian countries indicated that the combination of Chinese and Western medicine for CCP might be the potential trend of clinical treatment development in future [7–12]
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