Institute of Integrated Chinese and Western Medicine, Peking University First Hospital, Beijing, China.
J Altern Complement Med. 2013 Jun;19(6):492-500. doi: 10.1089/acm.2012.0568. Epub 2013 Jan 29.
Diabetes mellitus with coronary heart disease (DM with CHD) poses a health challenge to people in China and elsewhere in the world. In Traditional Chinese Medicine (TCM), DM with CHD is classified as a type of disease called Xiaoke and Xiongbi. In Asia, TCM has been used to treat Xiaoke and Xiongbi conditions for centuries, especially in China. In this study, it was evaluated whether integrated strategies incorporating both TCM and Western medicines (iTCWM) could improve the curative efficacy of DM with CHD.
An extensive search for randomized clinical trials (RCTs) published up to November 2011 in either English or Chinese about iTCWM for DM with CHD was conducted. All listings in PubMed, EMBASE, the Cochrane Library, CBM, CNKI, VIP, and the Wanfang database were included in the literature search. The quality of each trial was assessed using the Cochrane Reviewers' Handbook 5.0. Data analysis was performed by the RevMan 5.0 provided by the Cochrane Collaboration.
After an initial selection of 207 articles, 21 RCTs and quasi-RCTs were ultimately included in the analysis for this study. All of these trials were conducted in China and published in Chinese journals. The methodological quality of the trials was low in most studies. Selection bias and measurement bias were common in all of the studies. A meta-analysis was not conducted, due to the poor quality of the available studies.
The current state of the literature regarding the utility of iTCWM for the treatment of DM with CHD is inadequate. The poor quality of the available trials makes it difficult to draw any conclusions regarding the efficacy of iTCWM for the treatment of DM with CHD. This study highlights the paucity of reliable clinical evidence for iTCWM and the need for higher quality RCTs to be conducted in the future.
糖尿病合并冠心病（DM 合并 CHD）对中国乃至世界其他地区的人们构成了健康挑战。在中医（TCM）中，DM 合并 CHD 被归类为一种名为消渴和胸痹的疾病。在亚洲，TCM 已经被用于治疗消渴和胸痹已有数百年的历史，尤其是在中国。本研究评估了整合 TCM 和西药（iTCWM）策略是否可以提高 DM 合并 CHD 的治疗效果。
对截止到 2011 年 11 月发表的关于 TCM 合并西药治疗 DM 合并 CHD 的英文和中文随机对照试验（RCT）进行了广泛的搜索。文献检索包括 PubMed、EMBASE、Cochrane 图书馆、CBM、CNKI、VIP 和万方数据库中的所有列表。使用 Cochrane 评审员手册 5.0 评估每个试验的质量。数据采用 Cochrane 协作提供的 RevMan 5.0 进行分析。
经过初步筛选出的 207 篇文章，最终有 21 项 RCT 和准 RCT 被纳入本研究进行分析。所有这些试验都是在中国进行的，发表在中文期刊上。大多数研究的试验方法质量较低。所有研究都存在选择偏倚和测量偏倚。由于可用研究的质量较差，无法进行荟萃分析。
目前关于 TCM 合并西药治疗 DM 合并 CHD 的文献不足以支持其有效性。现有研究的质量较差，使得难以得出关于 TCM 合并西药治疗 DM 合并 CHD 的疗效的任何结论。本研究强调了 TCM 合并西药治疗 DM 合并 CHD 的可靠临床证据不足，需要在未来进行更高质量的 RCT。
