Abstract
Objective The aim of this meta-analysis was to systematically evaluate the effectiveness and safety of the traditional Chinese medicine (TCM) formula Bushen Huoxue Decoction (BSHXD) in treating coronary heart disease (CHD). Methods Randomized controlled trials (RCTS) of BSHXD in treating CHD were searched until March 2020, through six electronic databases: PubMed, Cochrane Library, CNKI, WanFang, SinoMed, and VIP. This study used the Cochrane Risk Test bias tool in the Cochrane Handbook to assess the quality of the methodology. Review Manager (RevMan) 5.3 was used to analyze the results. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were applied in the classification of evidence quality. Results Ten RCTs involving 901 patients were finally included in this meta-analysis. It revealed that the effectiveness of BSHXD in treating CHD was significantly better than that of the conventional western medicine (CWM) treatment (P < 0.00001). The effective rate of BSHXD treatment group on ECG was also significantly higher than that of CWM group (P < 0.00001). The low-density lipoprotein cholesterol was decreased in the treatment groups compared with those in the control groups (P < 0.00001). There was also a reduction in frequency and duration of angina pectoris (P < 0.00001). There were no significant differences in TC level (P=0.08), TG level (P=0.86), and HDL level (P=0.76) between the treatment and control groups. Five studies had informed adverse events, including nausea and diarrhea. Conclusion Our findings laid the foundation to the use of TCM Formula BSHXD in combination with conventional western medicine for treating CHD. However, due to the limitation of the quality of the included researches, in addition to potential reporting bias, the above conclusions still need verification by higher-quality and better-designed studies.
Highlights
Coronary heart disease (CHD) is the representative of cardiovascular disease and the main cause of human death
A preliminary search of 351 related articles was conducted, including 3 articles in PubMed database, 2 articles in Cochrane Library database, 69 articles in China National Knowledge Infrastructure (CNKI), 120 articles in WanFang database, 74 articles in China Biomedical Document Service System (SinoMed), and 83 articles in China Science and Technology Journal Full-Text Database (VIP). e document management software NoteExpress was used to eliminate 126 duplicate studies, and 225 documents remained after deduplication. 156 nontherapeutic articles were deleted for the preliminary screening of the remaining literature reading titles and abstracts, and the remaining 69 articles were rescreened
Primary Outcome. e primary outcome indicator is the total effective rate of angina pectoris which had been reported in ten studies [18,19,20,21,22,23,24,25,26,27], and the results significantly showed differences between two groups. e fixed-effects model was performed for statistical analysis, because these trials exhibited nonsignificant heterogeneity (χ2 5.68, P 0.77, I2 0%). e effective rate of the treatment group combined with Bushen Huoxue Decoction (BSHXD) was significantly higher than that of the control group [N 901, risk ratio (RR) 1.32, 95% confidence interval (CI) (1.23, 1.43), Z 7.42, P < 0.00001] (Figure 3)
Summary
Coronary heart disease (CHD) is the representative of cardiovascular disease and the main cause of human death. In the previous study of our research team, it was found that Qi deficiency was the main pathogenesis through the investigation of 297 patients with CHD, of which the Kidney Qi deficiency was the main cause [4]. It shows that Kidney Qi plays an important role in maintaining the function of the heart. En, our research team extracted the symptoms of 1069 patients with CHD. “fatigue, spontaneous sweating, dark purple tongue, and petechiae on tongue” were the main symptoms of Qi deficiency and blood stasis, accounting for about 21% [5]
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