Journal of Traditional Chinese Medicine ›› 2023, Vol. 43 ›› Issue (4): 640-649.DOI: 10.19852/j.cnki.jtcm.20230506.001
• Meta-analysises • Previous Articles Next Articles
WANG Chao1,2, WU Qiong3, LI Ping4, WANG Zhigang5, LOU Xusheng4, LI Yuanyuan4, ZHANG Lin6()
Received:
2022-03-29
Accepted:
2022-08-26
Online:
2023-08-15
Published:
2023-05-06
Contact:
Prof. ZHANG Lin, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China, zhanglin@bucm.edu.cn. Telephone: +86-10-84068569
Supported by:
WANG Chao, WU Qiong, LI Ping, WANG Zhigang, LOU Xusheng, LI Yuanyuan, ZHANG Lin. Effect of Traditional Chinese Medicine combined with Western Medicine on blood lipid levels and inflammatory factors in patients with angina pectoris in coronary heart disease identified as intermingled phlegm and blood stasis syndrome: a network Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2023, 43(4): 640-649.
Included study | Sample size (n) | Follow-up time (weeks) | Intervention | Measures number | Outcome indicator | ||||
---|---|---|---|---|---|---|---|---|---|
T (Male/Female) | C (Male/Female) | T | C | T | C | ||||
Diao YJ et al 2020 | 35 (19/16) | 35 (17/18) | 4 | MWD+CWM | CWM | 2 | 1 | ①② | |
Wang ZG et al 2017 | 40 (24/16) | 40 (22/18) | 4 | MWD+CWM | CWM | 2 | 1 | ① | |
Li FG et al 2017 | 40 (21/19) | 40 (17/23) | 12 | MWD+CWM | CWM | 2 | 1 | ① | |
Luo G,Ye HL 2017 | 30- | 30- | 4 | MWD+CWM | CWM | 2 | 1 | ②⑦ | |
Hou BS et al 2018 | 30 (18/12) | 30 (19/11) | 2 | MXD+CWM | CWM | 3 | 1 | ① | |
Guan F et al 2018 | 50 (29/21) | 50 (34/16) | 4 | MXD+CWM | CWM | 3 | 1 | ②⑦ | |
Ou XX et al 2021 | 82 (43/39) | 80 (41/39) | 2 | MGXBD+CWM | CWM | 4 | 1 | ③④⑤⑥ | |
Qiu WF, Luo JQ 2021 | 42 (23/19) | 42 (21/21) | 4 | MGXBD+CWM | CWM | 4 | 1 | ② | |
Tian PP et al 2021 | 40 (24/16) | 40 (26/14) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥⑦ | |
Gong XT et al 2021 | 35 (23/12) | 35 (24/11) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥ | |
Hu XQ 2020 | 57 (35/22) | 57 (39/18) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥⑦ | |
Wang M et al 2020 | 80 (44/36) | 80 (42/38) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥ | |
Zhu R et al 2020 | 42 (25/17) | 42 (26/16) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①⑦ | |
Xu JJ et al 2017 | 48 (26/22) | 48 (24/24) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①②③④⑤⑥⑦ | |
Dong LG et al 2021 | 48 (23/25) | 48 (22/26) | 16 | MED+CWM | CWM | 5 | 1 | ②③④⑤⑥ | |
Hu F et al 2021 | 38 (20/18) | 38 (21/17) | 12 | MED+CWM | CWM | 5 | 1 | ①②③④⑤⑥ | |
Bai YM, Huang L 2019 | 40 (22/18) | 40 (22/19) | 4 | MED+CWM | CWM | 5 | 1 | ③④⑤⑥ | |
Yuan QY et al 2021 | 81 (48/33) | 80 (46/34) | 2 | MZXGD+CWM | CWM | 6 | 1 | ①⑦ | |
Li FT et al 2021 | 34 (19/15) | 34 (18/16) | 8 | MZXGD+CWM | CWM | 6 | 1 | ①② | |
Li M et al 2021 | 35- | 35- | 4 | MZXGD+CWM | CWM | 6 | 1 | ①③④⑤⑥ | |
Tan XD et al 2019 | 51 (32/19) | 51 (34/17) | 4 | MZXGD+CWM | CWM | 6 | 1 | ①③④⑤ | |
Liu Y et al 2018 | 73 - | 72- | 4 | MZXGD+CWM | CWM | 6 | 1 | ①③④⑤⑥ | |
Zhai H et al 2019 | 52 (33/19) | 52 (32/20) | 6 | DT+CWM | CWM | 7 | 1 | ① | |
Yang K 2019 | 33 (19/14) | 33 (17/16) | 52 | DT+CWM | CWM | 7 | 1 | ①⑦ | |
Zhang JH et al 2018 | 45 (22/23) | 45 (24/21) | 6 | DT+CWM | CWM | 7 | 1 | ③④⑤⑥ | |
Chen JF et al 2018 | 98 (57/42) | 99 (54/44) | 4 | DT+CWM | CWM | 7 | 1 | ① | |
Diao YJ et al 2020 | 35 (19/16) | 35 (17/18) | 4 | MWD+CWM | CWM | 2 | 1 | ② |
Table 1 Basic characteristics of included studies
Included study | Sample size (n) | Follow-up time (weeks) | Intervention | Measures number | Outcome indicator | ||||
---|---|---|---|---|---|---|---|---|---|
T (Male/Female) | C (Male/Female) | T | C | T | C | ||||
Diao YJ et al 2020 | 35 (19/16) | 35 (17/18) | 4 | MWD+CWM | CWM | 2 | 1 | ①② | |
Wang ZG et al 2017 | 40 (24/16) | 40 (22/18) | 4 | MWD+CWM | CWM | 2 | 1 | ① | |
Li FG et al 2017 | 40 (21/19) | 40 (17/23) | 12 | MWD+CWM | CWM | 2 | 1 | ① | |
Luo G,Ye HL 2017 | 30- | 30- | 4 | MWD+CWM | CWM | 2 | 1 | ②⑦ | |
Hou BS et al 2018 | 30 (18/12) | 30 (19/11) | 2 | MXD+CWM | CWM | 3 | 1 | ① | |
Guan F et al 2018 | 50 (29/21) | 50 (34/16) | 4 | MXD+CWM | CWM | 3 | 1 | ②⑦ | |
Ou XX et al 2021 | 82 (43/39) | 80 (41/39) | 2 | MGXBD+CWM | CWM | 4 | 1 | ③④⑤⑥ | |
Qiu WF, Luo JQ 2021 | 42 (23/19) | 42 (21/21) | 4 | MGXBD+CWM | CWM | 4 | 1 | ② | |
Tian PP et al 2021 | 40 (24/16) | 40 (26/14) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥⑦ | |
Gong XT et al 2021 | 35 (23/12) | 35 (24/11) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥ | |
Hu XQ 2020 | 57 (35/22) | 57 (39/18) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥⑦ | |
Wang M et al 2020 | 80 (44/36) | 80 (42/38) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①③④⑤⑥ | |
Zhu R et al 2020 | 42 (25/17) | 42 (26/16) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①⑦ | |
Xu JJ et al 2017 | 48 (26/22) | 48 (24/24) | 4 | MGXBD+CWM | CWM | 4 | 1 | ①②③④⑤⑥⑦ | |
Dong LG et al 2021 | 48 (23/25) | 48 (22/26) | 16 | MED+CWM | CWM | 5 | 1 | ②③④⑤⑥ | |
Hu F et al 2021 | 38 (20/18) | 38 (21/17) | 12 | MED+CWM | CWM | 5 | 1 | ①②③④⑤⑥ | |
Bai YM, Huang L 2019 | 40 (22/18) | 40 (22/19) | 4 | MED+CWM | CWM | 5 | 1 | ③④⑤⑥ | |
Yuan QY et al 2021 | 81 (48/33) | 80 (46/34) | 2 | MZXGD+CWM | CWM | 6 | 1 | ①⑦ | |
Li FT et al 2021 | 34 (19/15) | 34 (18/16) | 8 | MZXGD+CWM | CWM | 6 | 1 | ①② | |
Li M et al 2021 | 35- | 35- | 4 | MZXGD+CWM | CWM | 6 | 1 | ①③④⑤⑥ | |
Tan XD et al 2019 | 51 (32/19) | 51 (34/17) | 4 | MZXGD+CWM | CWM | 6 | 1 | ①③④⑤ | |
Liu Y et al 2018 | 73 - | 72- | 4 | MZXGD+CWM | CWM | 6 | 1 | ①③④⑤⑥ | |
Zhai H et al 2019 | 52 (33/19) | 52 (32/20) | 6 | DT+CWM | CWM | 7 | 1 | ① | |
Yang K 2019 | 33 (19/14) | 33 (17/16) | 52 | DT+CWM | CWM | 7 | 1 | ①⑦ | |
Zhang JH et al 2018 | 45 (22/23) | 45 (24/21) | 6 | DT+CWM | CWM | 7 | 1 | ③④⑤⑥ | |
Chen JF et al 2018 | 98 (57/42) | 99 (54/44) | 4 | DT+CWM | CWM | 7 | 1 | ① | |
Diao YJ et al 2020 | 35 (19/16) | 35 (17/18) | 4 | MWD+CWM | CWM | 2 | 1 | ② |
Figure 2 Network evidence results A: overall response rate; B: hs-CRP expression; C: TC; D: TG; E: LDL-C; F: HDL-C; G: duration of angina attack. MXD: modified Xiaoxianxiong decoction; DT: Danlou tablet; MGXBD: modified Gualou Xiebai Banxia decoction; MWD: modified Wendan decoction; MZXGD: modified Zhishi Xiebai Guizhi decoction; MED: modified Erchen decoction; CWM: Conventional Western Medicine. hs-CRP: hypersensitive C-reactive protein; TC: total cholesterol; TG: triglyceride; LDL-C: low density lipoprotein cholesterol; HDL-C: high density lipoprotein cholesterol.
Figure 3 Area under the curve ranking results A: overall response rate; B: hs-CRP expression; C: TC; D: TG; E: LDL-C; F: HDL-C; G: duration of angina attack. MXD: modified Xiaoxianxiong decoction; DT: Danlou tablet; MGXBD: modified Gualou Xiebai Banxia decoction; MWD: modified Wendan decoction; MZXGD: modified Zhishi Xiebai Guizhi decoction; MED: modified Erchen decoction; CWM: Conventional Western Medicine. hs-CRP: hypersensitive C-reactive protein; TC: total cholesterol; TG: triglyceride; LDL-C: low density lipoprotein cholesterol; HDL-C: high density lipoprotein cholesterol.
CWM | 0.66 (0.10, 1.22)a | 1.98 (1.26, 2.70)a | 0.43 (0.06, 0.79)a | 1.89 (1.46, 2.33)a | 3.02 (2.32, 3.72)a | — |
---|---|---|---|---|---|---|
0.29 (0.13, 0.65)a | MWD | 1.32 (0.41, 2.23)a | -0.23 (-0.90, 0.44) | 1.23 (0.52, 1.94)a | 2.36 (1.46, 3.26)a | — |
0.20 (0.04, 1.02) | 0.69 (0.11, 4.34) | MXD | -1.55 (-2.36, -0.75)a | -0.09 (-0.93, 0.75) | 1.04 (0.04, 2.04)a | — |
0.27 (0.17, 0.45)a | 0.96 (0.37, 2.49) | 1.39 (0.25, 7.74) | MGXBD | 1.46 (0.90, 2.03)a | 2.59 (1.80, 3.38)a | — |
0.29 (0.09, 0.92)a | 1.02 (0.25, 4.22) | 1.48 (0.20, 11.09) | 1.07 (0.30, 3.75) | MED | 1.13 (0.30, 1.95)a | — |
0.28 (0.17, 0.47)a | 0.99 (0.37, 2.61) | 1.43 (0.26, 8.06) | 1.03 (0.51, 2.11) | 0.97 (0.27, 3.42) | MZXGD | — |
0.25 (0.13, 0.49)a | 0.89 (0.31, 2.56) | 1.29 (0.22, 7.63) | 0.93 (0.41, 2.13) | 0.87 (0.23, 3.30) | 0.90 (0.39, 2.08) | DT |
Table 2 Network Meta-analysis comparisons of overall response rate (lower left) vs hs-CRP (upper right) (OR/MD value vs 95% CI)
CWM | 0.66 (0.10, 1.22)a | 1.98 (1.26, 2.70)a | 0.43 (0.06, 0.79)a | 1.89 (1.46, 2.33)a | 3.02 (2.32, 3.72)a | — |
---|---|---|---|---|---|---|
0.29 (0.13, 0.65)a | MWD | 1.32 (0.41, 2.23)a | -0.23 (-0.90, 0.44) | 1.23 (0.52, 1.94)a | 2.36 (1.46, 3.26)a | — |
0.20 (0.04, 1.02) | 0.69 (0.11, 4.34) | MXD | -1.55 (-2.36, -0.75)a | -0.09 (-0.93, 0.75) | 1.04 (0.04, 2.04)a | — |
0.27 (0.17, 0.45)a | 0.96 (0.37, 2.49) | 1.39 (0.25, 7.74) | MGXBD | 1.46 (0.90, 2.03)a | 2.59 (1.80, 3.38)a | — |
0.29 (0.09, 0.92)a | 1.02 (0.25, 4.22) | 1.48 (0.20, 11.09) | 1.07 (0.30, 3.75) | MED | 1.13 (0.30, 1.95)a | — |
0.28 (0.17, 0.47)a | 0.99 (0.37, 2.61) | 1.43 (0.26, 8.06) | 1.03 (0.51, 2.11) | 0.97 (0.27, 3.42) | MZXGD | — |
0.25 (0.13, 0.49)a | 0.89 (0.31, 2.56) | 1.29 (0.22, 7.63) | 0.93 (0.41, 2.13) | 0.87 (0.23, 3.30) | 0.90 (0.39, 2.08) | DT |
CWM | 0.49 (0.12, 0.86)a | 1.23 (0.72, 1.75)a | 1.16 (0.62, 1.71)a | 0.33 (—0.55, 1.21) |
---|---|---|---|---|
0.73 (0.21, 1.24)a | MGXBD | 0.74 (0.11, 1.38)a | 0.68 (0.02, 1.33)a | —0.16 (—1.11, 0.80) |
0.89 (0.18, 1.61)a | 0.17 (—0.72, 1.05) | MED | —0.07 (—0.82, 0.68) | —0.90 (—1.92, 0.12) |
1.41 (0.68, 2.14)a | 0.68 (—0.21, 1.58) | 0.52 (—0.51, 1.54) | MZXGD | —0.83 (—1.87, 0.20) |
0.76 (—0.48, 2.00) | 0.03 (—1.31, 1.38) | —0.13 (—1.57, 1.30) | —0.65 (—2.10, 0.79) | DT |
Table 3 Network Meta—analysis comparisons of TC (lower left) vs TG (upper right) (MD value vs 95% CI)
CWM | 0.49 (0.12, 0.86)a | 1.23 (0.72, 1.75)a | 1.16 (0.62, 1.71)a | 0.33 (—0.55, 1.21) |
---|---|---|---|---|
0.73 (0.21, 1.24)a | MGXBD | 0.74 (0.11, 1.38)a | 0.68 (0.02, 1.33)a | —0.16 (—1.11, 0.80) |
0.89 (0.18, 1.61)a | 0.17 (—0.72, 1.05) | MED | —0.07 (—0.82, 0.68) | —0.90 (—1.92, 0.12) |
1.41 (0.68, 2.14)a | 0.68 (—0.21, 1.58) | 0.52 (—0.51, 1.54) | MZXGD | —0.83 (—1.87, 0.20) |
0.76 (—0.48, 2.00) | 0.03 (—1.31, 1.38) | —0.13 (—1.57, 1.30) | —0.65 (—2.10, 0.79) | DT |
CWM | —0.17 (—0.27, —0.07)a | —0.47 (—0.60, —0.34)a | —0.23 (—0.46, —0.01)a | —0.05 (—0.25, 0.15) |
---|---|---|---|---|
0.66 (0.34, 0.98)a | MGXBD | —0.30 (—0.47, —0.14)a | —0.06 (—0.31, 0.18) | 0.12 (—0.10, 0.35) |
0.51 (0.06, 0.96)a | —0.14 (—0.69, 0.41) | MED | 0.24 (—0.02, 0.50) | 0.42 (0.19, 0.66)a |
1.00 (0.52, 1.48)a | 0.34 (—0.24, 0.92) | 0.49 (—0.17, 1.15) | MZXGD | 0.18 (—0.12, 0.48) |
0.66 (—0.10, 1.42) | 0.00 (—0.82, 0.83) | 0.15 (—0.73, 1.03) | —0.34 (—1.24, 0.56) | DT |
Table 4 Network Meta—analysis comparisons of LDL—C (lower left) vs HDL—C (upper right) (MD value vs 95% CI)
CWM | —0.17 (—0.27, —0.07)a | —0.47 (—0.60, —0.34)a | —0.23 (—0.46, —0.01)a | —0.05 (—0.25, 0.15) |
---|---|---|---|---|
0.66 (0.34, 0.98)a | MGXBD | —0.30 (—0.47, —0.14)a | —0.06 (—0.31, 0.18) | 0.12 (—0.10, 0.35) |
0.51 (0.06, 0.96)a | —0.14 (—0.69, 0.41) | MED | 0.24 (—0.02, 0.50) | 0.42 (0.19, 0.66)a |
1.00 (0.52, 1.48)a | 0.34 (—0.24, 0.92) | 0.49 (—0.17, 1.15) | MZXGD | 0.18 (—0.12, 0.48) |
0.66 (—0.10, 1.42) | 0.00 (—0.82, 0.83) | 0.15 (—0.73, 1.03) | —0.34 (—1.24, 0.56) | DT |
CWM | |||||
---|---|---|---|---|---|
0.85 (—0.18, 1.88) | MWD | ||||
—0.49 (—1.98, 1.00) | —1.34 (—3.16, 0.48) | MXD | |||
1.54 (1.00, 2.07)a | 0.69 (—0.48, 1.85) | 2.03 (0.44, 3.62)a | MGXBD | ||
2.14 (1.09, 3.19)a | 1.29 (—0.18, 2.76) | 2.63 (0.80, 4.46)a | 0.60 (—0.58, 1.78) | MZXGD | |
0.97 (—0.11, 2.05) | 0.12 (—1.38, 1.62) | 1.46 (—0.38, 3.30) | —0.57 (—1.78, 0.64) | —1.17 (—2.68, 0.34) | DT |
Table 5 Network Meta—analysis comparisons of duration of angina attack (MD value vs 95% CI)
CWM | |||||
---|---|---|---|---|---|
0.85 (—0.18, 1.88) | MWD | ||||
—0.49 (—1.98, 1.00) | —1.34 (—3.16, 0.48) | MXD | |||
1.54 (1.00, 2.07)a | 0.69 (—0.48, 1.85) | 2.03 (0.44, 3.62)a | MGXBD | ||
2.14 (1.09, 3.19)a | 1.29 (—0.18, 2.76) | 2.63 (0.80, 4.46)a | 0.60 (—0.58, 1.78) | MZXGD | |
0.97 (—0.11, 2.05) | 0.12 (—1.38, 1.62) | 1.46 (—0.38, 3.30) | —0.57 (—1.78, 0.64) | —1.17 (—2.68, 0.34) | DT |
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