Liang Shi-Bing, Wang Yi-Fei, Niu Zhen-Chao, Li Yu-Fei, Zheng Hui-Min, Huan Jia-Ming, Yuan Jie, Robinson Nicola, Liu Jian-Ping, Li Yun-Lun
Clinical Study Center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
Centre for Evidence-Based Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
Front Cardiovasc Med. 2025 Jan 7;11:1499585. doi: 10.3389/fcvm.2024.1499585. eCollection 2024.
Chronic coronary syndromes (CCS) is a common clinical condition that increases the risk of cardiovascular events at any time. Tongxinluo capsules (TXL) are widely used in China for treating CCS.
To systematically evaluate the therapeutic effects and safety of adding TXL to Western medical treatment (WM) for CCS.
We searched PubMed, Cochrane Library, CNKI, VIP, and Wanfang databases up to August 2024 for randomized controlled trials (RCTs) investigating the therapeutic effects and safety of combining TXL with WM compared to WM alone for CCS. Data analyses were conducted using RevMan 5.4 software.
Twenty studies involving 2091 participants were identified. Evidence supports the use of TXL plus WM for reducing angina frequency [SMD -2.50, 95% CI (-3.53, -1.48)], improving seattle angina questionnaire scores ( < 0.05), decreasing nitroglycerin dose [SMD -1.63, 95% CI (-2.26, -1.00)], and shortening angina duration [MD -1.50 min/once, 95% CI (-1.98, -1.02)]. Adding TXL to WM showed a non-significant trend toward reducing myocardial infarction [RR 0.34, 95% CI (0.05, 2.12); NNT = 41] and sudden cardiac death [RR 0.34, 95% CI (0.01, 8.28); NNT = 65]. No increase in adverse events was observed when TXL was added to WM [RR 1.02, 95% CI (0.70, 1.49); NNT = 149].
Our review suggests that TXL may offer additional therapeutic benefits for CCS patients and appears to be safe when combined with WM. Further investigations are warranted to confirm the potential impact of adding TXL to WM for CCS.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024499031, PROSPERO (CRD42024499031).
慢性冠状动脉综合征（CCS）是一种常见的临床病症，随时会增加心血管事件的风险。通心络胶囊（TXL）在中国被广泛用于治疗CCS。
系统评价在西医治疗（WM）基础上加用TXL治疗CCS的疗效和安全性。
检索截至2024年8月的PubMed、Cochrane图书馆、中国知网、维普和万方数据库，查找关于TXL与WM联合治疗CCS相较于单纯WM治疗的疗效和安全性的随机对照试验（RCT）。使用RevMan 5.4软件进行数据分析。
共纳入20项研究，涉及2091名参与者。有证据支持加用TXL联合WM可降低心绞痛发作频率[标准化均数差（SMD）-2.50，95%置信区间（CI）（-3.53，-1.48）]，提高西雅图心绞痛问卷评分（P<0.05），减少硝酸甘油用量[SMD -1.63，95% CI（-2.26，-1.00）]，并缩短心绞痛持续时间[平均差（MD）-1.50分钟/次，95% CI（-1.98，-1.02）]。在WM基础上加用TXL在降低心肌梗死[风险比（RR）0.34，95% CI（0.05，2.12）；需治疗人数（NNT）=41]和心源性猝死[RR 0.34，95% CI（0.01，8.28）；NNT = 65]方面显示出不显著的趋势。在WM基础上加用TXL未观察到不良事件增加[RR 1.02，95% CI（0.70，1.49）；NNT = 149]。
我们的综述表明，TXL可能为CCS患者带来额外的治疗益处，并且与WM联合使用似乎是安全的。有必要进行进一步研究以证实加用TXL治疗CCS的潜在影响。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024499031，PROSPERO（CRD42024499031）
