Panax notoginseng extract combined with alprostadil in treatment of arteriosclerosis obliterans: Meta-analysis

Abstract

To evaluate the clinical efficacy of Panax notoginseng extract combined with alprostadil in the treatment of arteriosclerosis occlusion and investigate its effects on the degree of atherosclerosis. CNKI, Wanfang, VIP journal database, Chinese biomedical literature database(CBM), PubMed, the Cochrane Library and Science Citation Index(SCI) database were searched between inception to December 2017 for relevant studies. Two researchers independently screened and extracted the literature in strict accordance with the inclusion criteria and exclusion criteria. The bias risk assessment method recommended by Cochrane was used to evaluate the bias risk and extract data, and then Review Manager 5.3 was used for Meta analysis. 10 RCTs involving a total of 1 032 cases were included in the study. Analysis results showed that the P. notoginseng extract combined with alprostadil had higher clinical efficacy than alprostadil alone in the treatment of arteriosclerosis occlusion disorder, with statistically significant difference(OR=6.39, 95%CI[3.97, 10.30], P<0.000 01); the atherosclerosis was obviously improved, including ankle brachial index(ABI) (MD=0.08, 95%CI[0.04, 0.13], P=0.000 3), toe brachial index(TBI) (MD=0.09, 95%CI[0.05, 0.12], P<0.000 01), and maximum walking distance(WD) (MD=471.62, 95%CI[383.54, 559.70], P<0.000 01). Studies have shown that P. notoginseng extract combined with the conventional treatment had significantly improved clinical efficacy in the treatment of arteriosclerosis occlusion, and could improve the atherosclerosis degree of lower extremities. However, the quality of the included literature was not high, in addition, due to the small number of included literature as well as bias and low-quality bias in some of the literature, more high quality RCTs are still needed to further verify the clinical effect of P. notoginseng extract in the treatment of arteriosclerosis occlusion.