Liu Lan-Chun, Mao Qi-Yuan, Liu Chao, Hu Jun, Duan Lian, Wang Jie
Cardiovascular Department, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Beijing University of Chinese Medicine, Beijing 100029, China.
Evid Based Complement Alternat Med. 2021 Jun 9;2021:5541228. doi: 10.1155/2021/5541228. eCollection 2021.
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).
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.
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 ( < 0.00001). The effective rate of BSHXD treatment group on ECG was also significantly higher than that of CWM group ( < 0.00001). The low-density lipoprotein cholesterol was decreased in the treatment groups compared with those in the control groups ( < 0.00001). There was also a reduction in frequency and duration of angina pectoris ( < 0.00001). There were no significant differences in TC level (=0.08), TG level (=0.86), and HDL level (=0.76) between the treatment and control groups. Five studies had informed adverse events, including nausea and diarrhea.
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.
本荟萃分析旨在系统评价中药补肾活血汤治疗冠心病（CHD）的有效性和安全性。
通过六个电子数据库（PubMed、Cochrane图书馆、中国知网、万方、中国生物医学文献数据库和维普）检索截至2020年3月补肾活血汤治疗冠心病的随机对照试验（RCT）。本研究采用Cochrane手册中的Cochrane风险偏倚工具评估方法学质量。使用Review Manager（RevMan）5.3分析结果。证据质量分类采用推荐分级评估、制定与评价（GRADE）标准。
本荟萃分析最终纳入10项RCT，涉及901例患者。结果显示，补肾活血汤治疗冠心病的有效性显著优于传统西药治疗（<0.00001）。补肾活血汤治疗组心电图有效率也显著高于西药组（<0.00001）。与对照组相比，治疗组低密度脂蛋白胆固醇降低（<0.00001）。心绞痛发作频率和持续时间也有所降低（<0.00001）。治疗组与对照组在总胆固醇水平（=0.08）、甘油三酯水平（=0.86）和高密度脂蛋白水平（=0.76）方面无显著差异。五项研究报告了不良事件，包括恶心和腹泻。
我们的研究结果为中药补肾活血汤联合传统西药治疗冠心病奠定了基础。然而，由于纳入研究质量的限制，除了潜在的报告偏倚外，上述结论仍需更高质量、设计更好的研究进行验证。
