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用于心血管疾病的传统中药:疗效与安全性。

Traditional Chinese medicine for cardiovascular disease: efficacy and safety.

作者信息

Lin Youwei, Han Yuanshan, Wang Yuhong

机构信息

Institute of Innovation and Applied Research in Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China.

Scientific Research Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, China.

出版信息

Front Cardiovasc Med. 2024 Dec 3;11:1419169. doi: 10.3389/fcvm.2024.1419169. eCollection 2024.

Abstract

In China and other Asian nations, traditional medicine has long been utilized in the treatment of cardiovascular diseases (CVD). While Chinese authorities have incorporated traditional Chinese medicine (TCM) treatment experiences as a supplementary guide for CVD, its international recognition remains limited due to a scarcity of high-quality and reliable randomized controlled trials (RCTs) evidence. The purpose of this study was to examine the clinical outcomes with TCM for CVD after the recent publication of large trials adding >20,000 individuals to the published data. Here, we systematically reviewed 55 published RCTs (modified Jadad scores > 4) in the past 20 years, involving a total of 36,261 patients. In most studies, TCM has been associated with significant improvements in alternative endpoints such as hypertension, coronary heart disease, stroke and heart failure. A total of 19 trials reported on primary outcomes such as cardiovascular events and death events. During the follow-up period, some Chinese patent medicines can effectively reduce the "hard" endpoints of coronary heart disease, stroke, and heart failure, the overall trend of cardiovascular outcomes is lower. The risk of adverse effects was not significantly increased compared to the control group, suggesting its potential as an alternative approach for primary and secondary prevention of CVD based on the available evidence.

摘要

在中国和其他亚洲国家,传统医学长期以来一直被用于治疗心血管疾病(CVD)。虽然中国官方已将中医治疗经验纳入心血管疾病的辅助指导,但由于缺乏高质量和可靠的随机对照试验(RCT)证据,其国际认可度仍然有限。本研究的目的是在最近发表的纳入超过20000人的大型试验增加已发表数据后,研究中医治疗心血管疾病的临床结果。在此,我们系统回顾了过去20年发表的55项随机对照试验(改良Jadad评分>4),共涉及36261例患者。在大多数研究中,中医与高血压、冠心病、中风和心力衰竭等替代终点的显著改善有关。共有19项试验报告了心血管事件和死亡事件等主要结局。在随访期间,一些中成药可以有效降低冠心病、中风和心力衰竭的“硬”终点,心血管结局的总体趋势较低。与对照组相比,不良反应风险没有显著增加,表明基于现有证据,其有潜力作为心血管疾病一级和二级预防的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2393/11649660/2bb6cb3037b7/fcvm-11-1419169-g001.jpg

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