Mao WeiLi, Lu Peng, Wan Renhong, Mao Kaili, Lv Yanzhu, Hu Jie, Fu Zhenling, Wang Jun
Department of Pharmacy, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China.
Department of Pharmacy, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China.
Front Cardiovasc Med. 2023 Jun 7;10:1100006. doi: 10.3389/fcvm.2023.1100006. eCollection 2023.
Danlou tablets exert auxiliary advantages in treating coronary heart disease (CHD), but a summary of evidence-based proof is lacking. This study aims to systematically evaluate Danlou tablets in treating CHD from two aspects, including efficacy and safety.
By a thorough retrieval of the four English databases, namely, PubMed, The Cochrane Library, Embase, and Web of Science, and the four Chinese databases, namely, CNKI, Wanfang, VIP database, and China Biomedical Literature Service System, we found all randomized controlled trials (RCTs) related to Danlou tablets in treating CHD. The retrieval time was from the construction of the database to April 2022. We engaged two researchers to screen the studies, extract the required data, and assess the risk of bias. We then used RevMan5.3 and STATA.14 software to conduct a meta-analysis. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of outcome indicators.
Seventeen RCTs involving 1,588 patients were included. The meta-analysis results are displayed as follows: clinical treatment effect [risk ratio (RR) = 1.22, 95% confidence interval (CI): 1.16, 1.28, < 0.00001], angina pectoris duration [MD = -0.2.15, 95% CI: -2.91, -1.04, < 0.00001], angina pectoris frequency [standard mean difference (SMD) = -2.48, 95% CI: -3.42, -1.54, < 0.00001], angina pectoris degree [SMD = -0.96, 95% CI: -1.39, -0.53, < 0.0001], TC [MD = -0.71, 95% CI: -0.92, -0.51, < 0.00001], TG [MD = -0.38, 95% CI: -0.53, -0.22, < 0.00001], low-density lipoprotein cholesterol [MD = -0.64, 95% CI: -0.76, -0.51, < 0.00001], high-density lipoprotein cholesterol [MD = 0.16, 95% CI: 0.11, 0.21, < 0.00001], and adverse events [RR = 0.46, 95% CI: 0.24, 0.88, = 0.02].
The current evidence suggests that the combination of Danlou tablets and Western medicine can enhance the efficacy of CHD and does not increase adverse events. However, because of the limited number and quality of the included studies, the results of our study should be treated with caution. Further large-scale RCTs are necessary to verify the benefits of this approach.
丹蒌片在冠心病（CHD）治疗中具有辅助优势，但缺乏循证依据的总结。本研究旨在从疗效和安全性两个方面系统评价丹蒌片治疗冠心病的效果。
通过全面检索四个英文数据库，即PubMed、Cochrane图书馆、Embase和Web of Science，以及四个中文数据库，即中国知网（CNKI）、万方、维普数据库和中国生物医学文献服务系统，我们找到了所有与丹蒌片治疗冠心病相关的随机对照试验（RCT）。检索时间从数据库建立至2022年4月。我们聘请两名研究人员筛选研究、提取所需数据并评估偏倚风险。然后，我们使用RevMan5.3和STATA.14软件进行荟萃分析。采用推荐分级评估、制定和评价（GRADE）方法评估结局指标的质量。
纳入17项RCT，涉及1588例患者。荟萃分析结果如下：临床治疗效果[风险比（RR）=1.22，95%置信区间（CI）：1.16，1.28，<0.00001]、心绞痛持续时间[平均差（MD）=-2.15，95%CI：-2.91，-1.04，<0.00001]、心绞痛发作频率[标准化平均差（SMD）=-2.48，95%CI：-3.42，-1.54，<0.00001]、心绞痛程度[SMD=- .96，95%CI：-1.39，-0.53，<0.0001]、总胆固醇（TC）[MD=-0.71，95%CI：-0.92，-0.51，<0.00001]、甘油三酯（TG）[MD=-0.38，95%CI：-0.53，-0.22，<0.00001]、低密度脂蛋白胆固醇[MD=-0.64，95%CI：-0.76，-0.51，<0.00001]、高密度脂蛋白胆固醇[MD=0.16，95%CI：0.11，0.21，<0.00001]以及不良事件[RR=0.46，95%CI：0.24，0.88，=0.02]。
目前证据表明，丹蒌片与西药联合使用可提高冠心病的治疗效果，且不增加不良事件。然而，由于纳入研究的数量和质量有限，本研究结果应谨慎对待。有必要进行进一步的大规模随机对照试验以验证这种方法的益处。
