Dai Shuang, Ding Yukun, Guo Jianbo, Wang Xian
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Science and Education Departmen, Beijing Fengtai Hospital of Integrated Traditional Chinese and Modern Medicine, Beijing, China.
Front Pharmacol. 2024 Dec 12;15:1487119. doi: 10.3389/fphar.2024.1487119. eCollection 2024.
Danshen [Salvia miltiorrhiza Bunge (Lamiaceae; Salviae miltiorrhizae radix et rhizoma)] class injections (DSCIs) are widely used in the treatment of coronary heart disease (CHD). However, there are various types of DSCIs available on the market, and it remains uncertain which DSCI has the best clinical efficacy, as well as which one is most effective in regulating inflammatory markers and oxidative stress indicators. The aim of this network meta-analysis (NMA) is to compare the therapeutic effects of different DSCIs to identify the optimal DSCI for the treatment of CHD.
The databases searched to identify randomized controlled trials (RCTs) of DSCIs for CHD included the China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, Web of Science, and Cochrane Library. The search period spanned from the inception of each database up to June 2024. NMA was conducted using RevMan 5.3 and Stata 16.0 software.
A total of 106 studies including 14,979 patients, involving 10,931 patients, with 5,640 in the experimental group and 5,291 in the control group. And ten DSCIs were extracted, namely: Danhong injection (DH), Danshen injection (DS), Danshenchuanxiongqin injection (DSCXQ), Dansenduofensuanyan injection (DSDFSY), Danshenfen injection (DSFZ), Fufang Danshen injection (FFDS), Guanxinning injection (GXN), Sodium Tanshinone IIA Sulfonate injection (STS), Xiangdan injection (XD), Shenxiongputaotang injection (SXPTT). The results of NMA showed that, XD injection significantly enhances clinical efficacy; STS is more effective in reducing hs-CRP levels; DSDFSY shows better efficacy in decreasing IL-1 and increasing NO levels; DSCXQ has a greater advantage in reducing IL-6 levels; GXN is more effective in regulating SOD levels; and DH is better at reducing MDA levels.
The combined treatment of DSCIs and WM more significant efficacy in patients with CHD compared to WM treatment alone, including clinical efficacy evaluation, inflammatory markers, and oxidative stress markers. Overall, DSDFSY and DSCXQ show better performance in clinical efficacy evaluation and regulation of inflammatory markers, while DH exhibits a more stable effect in regulating oxidative stress. However, larger sample sizes and high-quality RCTs are still necessary to further compare the various DSCIs.
[PROSPERO], identifier [CRD42024548928].
丹参[丹参（唇形科；丹参根及根茎）]类注射剂（DSCIs）广泛用于治疗冠心病（CHD）。然而，市场上有多种类型的DSCIs，目前仍不确定哪种DSCI具有最佳临床疗效，以及哪种在调节炎症标志物和氧化应激指标方面最有效。本网络荟萃分析（NMA）的目的是比较不同DSCIs的治疗效果，以确定治疗CHD的最佳DSCI。
检索用于识别DSCIs治疗CHD的随机对照试验（RCTs）的数据库包括中国知网（CNKI）、万方数据库、维普资讯中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）、PubMed、Web of Science和Cochrane图书馆。检索期从每个数据库创建起至2024年6月。使用RevMan 5.3和Stata 16.0软件进行NMA。
共纳入106项研究，涉及14979例患者，其中试验组10931例，对照组5291例。提取了十种DSCIs，即：丹红注射液（DH）、丹参注射液（DS）、丹参川芎嗪注射液（DSCXQ）、丹参多酚酸盐注射液（DSDFSY）、丹参粉针剂（DSFZ）、复方丹参注射液（FFDS）、冠心宁注射液（GXN）、丹参酮IIA磺酸钠注射液（STS）、香丹注射液（XD）、参芎葡萄糖注射液（SXPTT）。NMA结果显示，XD注射液显著提高临床疗效；STS在降低hs-CRP水平方面更有效；DSDFSY在降低IL-1水平和升高NO水平方面疗效更佳；DSCXQ在降低IL-6水平方面具有更大优势；GXN在调节SOD水平方面更有效；DH在降低MDA水平方面效果更好。
与单纯西医治疗相比，DSCIs与西医联合治疗对冠心病患者的疗效更显著，包括临床疗效评估、炎症标志物和氧化应激标志物。总体而言，DSDFSY和DSCXQ在临床疗效评估和炎症标志物调节方面表现更佳，而DH在调节氧化应激方面效果更稳定。然而，仍需要更大样本量和高质量的RCTs来进一步比较各种DSCIs。
[PROSPERO]，标识符[CRD42024548928]。
