Journal of Traditional Chinese Medicine ›› 2024, Vol. 44 ›› Issue (6): 1082-1090.DOI: 10.19852/j.cnki.jtcm.2024.06.001
• Meta-Analyses • Previous Articles Next Articles
Chinese patent medicine for atherosclerosis: a systematic review and Meta-analysis of randomized controlled trials
XU Jian1,2, LIU Yuntao1,2, LUO Zhihao3, ZHAO Zhen4, WANG Dawei5,6(
), LIU Qing4()
- 1 Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, State Key Laboratory of Traditional Chinese Medicine Syndrome, the Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
2 Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510006, China
3 Guangdong Provincial Hospital of Chinese Medicine-Hainan Hospital, Haikou 570100, China
4 Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
5 Guangdong Provincial Hospital of Chinese Medicine, State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
6 State Key Laboratory of Traditional Chinese Medicine Syndrome, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
-
Received:2022-12-22Accepted:2023-03-12Online:2024-12-15Published:2024-11-12 -
Contact:WANG Dawei, Guangdong Provincial Hospital of Chinese Medicine, State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; State Key Laboratory of Traditional Chinese Medicine Syndrome, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510006, China. davidwang33@139.com
LIU Qing, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510006, China. 851757626@qq.com -
Supported by:National Natural Science Foundation of China: Regulation of nanomedicine on the immune microenvironment in the macrophage-rich area of arterial plaques based on IL-17 immunity(82274279, to Q.L.)
Cite this article
XU Jian, LIU Yuntao, LUO Zhihao, ZHAO Zhen, WANG Dawei, LIU Qing. Chinese patent medicine for atherosclerosis: a systematic review and Meta-analysis of randomized controlled trials[J]. Journal of Traditional Chinese Medicine, 2024, 44(6): 1082-1090.
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Figure 1 Study flow chart
Figure 1 Study flow chart
Table 1 Main characteristics of the studies
| Study ID | Sample (overall/dropout); sex: M/F | Age (years) | Participant | Intervention group | Control group | Treatment (months) | Follow-up (months) | Outcome measure | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Moriarty et al 2014 | 116/19; T1: 36 (6/30), T2: 42 (13/29), C:38(9/27) | T1: 57.8±9, T2: 56.3±10.8, C: 56.0±12.5 | Dyslipidemia | Xuezhikang 1200 mg, or Xuezhikang 2400 mg daily | Placebo | 12 | 0 | LDL-C, adverse events | ||||||||
| Van Poppel et al 2015 | 23/3; T: 12, C: 11 (14/6) | 58.0±7.7 | Hyperlipidemia and hypertension | Danshen capsule | Placebo | 2 | 0 | LDL-C, adverse events | ||||||||
| Kwok et al 2014 | 165/22; T: 85 (0/85), C: 80 (0/80) | T: 56.5±4.1, C: 56.0±3.8 | Postmenopausal women with borderline hypercholesterolemia | Danshen and Gegen capsule | Placebo | 12 | 1 | IMT, LDL-C, adverse events | ||||||||
| Woo et al 2013 | 90/0; T1: 31 (27/4), T2: 30 (20/10), C: 29 (20/9) | T1: 51.7±7.7, T2: 56.9±7.4, C: 55.6±8.2 | Essential hypertension | Danshen and Gegen capsule | Placebo | 12 | 0 | FMD, IMT | ||||||||
| Li et al 2019 | 150/19; T: 75 (28/47), C: 75 (30/45) | T: 43.71±11.56, C: 45.54±10.16 | T2DM plus hyperlipemia | Simvastatin+ Maixuekang capsule | Simvastatin | 24 | 0 | IMT | ||||||||
| Zhang et al 2019 | 1212/204; T: 607 (367/240), C: 605 (355/350) | T: 61.4±8.4, C: 61.4±8.2 | Patients with a focal IMT of ≥1.2 mm of the carotid arteries | Tongxinluo capsule | Placebo | 24 | 0 | clinical endpoint, IMT, LDL-C, hs-CRP, adverse events | ||||||||
| Liu et al 2007 | 103/20; T: 43 (37/6), C: 40 (33/7) | T: 59.83±7.83, C: 58.47±8.60 | Atherosclerosis in carotid arteries | Rhubarb capsules+CT | Placebo+CT | 6 | 9 | LDL-C, adverse events | ||||||||
| Wang et al 2015 | 57/5; T: 36 (17/19), C: 16 (11/5) | T: 68.72±10.92, C: 66.56±10.26 | Atherosclerotic renal artery stenosis | Huanshuai Recipe Oral Liquid+CT | Placebo+CT | 6 | 0 | LDL-C, clinical endpoint | ||||||||
| Myasoedova et al 2016 | 157/26; T: 77 (0/77), C: 80 (0/80) | T: 65±7, C: 65±6 | Subclinical carotid atherosclerosis in healthy postmenopausal women | Isoflavonoid-rich herbal preparation | Placebo | 12 | 12 | IMT, LDL-C, adverse events | ||||||||
| Zhao et al 2018 | 130/9; T: 65 (36/29), C: 65 (38/27) | T: 68.88±5.75, C: 67.26±5.49 | ACS patients after PCI | Danhong injection+Naoxintong capsule+CT | Placebo+CT | 3 | 3 | Clinical endpoint, adverse events | ||||||||
| Chen et al 2006 | 335/21; T: 157 (124/33), C: 157 (123/34) | T: 58.52±10.30, C: 58.74±9.91 | CHD after PCI | XS0601+CT | Aspirin+ CT | 6 | 6 | Clinical endpoint, adverse events | ||||||||
| Ge et al 2014 | 236/0; T: 116 (68/48), C: 120 (72/48) | T: 65.23±12.19, C: 67.03±13.46 | ACS after PCI | Maixuekang Capsule+CT | CT | 6 | 6 | hs-CRP, LDL-C, clinical endpoint | ||||||||
| Zhao et al 2004 | 50/0; T: 25 (15/10), C: 25 (14/11) | T: 58.2±14.2, C: 59.1±6.3 | CHD | Xuezhikang+CT | Placebo+CT | 3/2 | 0 | LDL-C | ||||||||
| Zhang et al 2008 | 120; T: 60 (36/24), C: 60 (35/25) | T: 55.9±16.1, C: 54.2±14.3 | CHD complicated by diabetes mellitus | Shengmai injection+CT | CT | 3/4 | 0 | FMD, adverse events | ||||||||
| Xu et al 2018 | 710/24; T: 353 (157/196), C: 357 (147/210) | T: 58.31±9.82, C:57.20±9.84 | Patients with CHD or at high risk of CHD | Zhibitai compound capsule+CT | CT | 2 | 0 | LDL-C, adverse events | ||||||||
| Cheng et al 2006 | 79; T: 39 (33/6), C: 40 (31/9) | T: 52.73±7.89, C: 53.11±7.01 | Primary hypertension and coronary artery disease | Garlicin+CT | CT | 13 | 0 | Hs-CRP, IMT, adverse events | ||||||||
| Liu et al 2017 | 62; T: 32 (22/10), C: 30 (20/10) | T: 61.1±12.0, C: 60.4±13.4 | CHD and hyperhomocysteinemia | Allicin+CT | CT | 3 | 0 | IMT | ||||||||
| Study ID | Sample (overall/dropout); sex: M/F | Age (years) | Participant | Intervention group | Control group | Treatment (months) | Follow-up (months) | Outcome measure | ||||||||
| Chu et al 2010 | 90/4; T1: 30 (18/12), T2: 30 (15/15), C: 30 (20/10) | T1: 61.7±9.6, T2: 61.6±9.2, C: 58.8±8.9 | Patients with unstable angina and blood-stasis syndrome after PCI | T1: Xuefu Zhuyu capsule + placebo of Shenmai capsule + CT T2: Shengmai capsule + placebo of Xuefu Zhuyu capsule + CT | Placebo of Xuefu Zhuyu capsule and Shengmai capsule +CT | 1 | 0 | Adverse events | ||||||||
Table 1 Main characteristics of the studies
| Study ID | Sample (overall/dropout); sex: M/F | Age (years) | Participant | Intervention group | Control group | Treatment (months) | Follow-up (months) | Outcome measure | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Moriarty et al 2014 | 116/19; T1: 36 (6/30), T2: 42 (13/29), C:38(9/27) | T1: 57.8±9, T2: 56.3±10.8, C: 56.0±12.5 | Dyslipidemia | Xuezhikang 1200 mg, or Xuezhikang 2400 mg daily | Placebo | 12 | 0 | LDL-C, adverse events | ||||||||
| Van Poppel et al 2015 | 23/3; T: 12, C: 11 (14/6) | 58.0±7.7 | Hyperlipidemia and hypertension | Danshen capsule | Placebo | 2 | 0 | LDL-C, adverse events | ||||||||
| Kwok et al 2014 | 165/22; T: 85 (0/85), C: 80 (0/80) | T: 56.5±4.1, C: 56.0±3.8 | Postmenopausal women with borderline hypercholesterolemia | Danshen and Gegen capsule | Placebo | 12 | 1 | IMT, LDL-C, adverse events | ||||||||
| Woo et al 2013 | 90/0; T1: 31 (27/4), T2: 30 (20/10), C: 29 (20/9) | T1: 51.7±7.7, T2: 56.9±7.4, C: 55.6±8.2 | Essential hypertension | Danshen and Gegen capsule | Placebo | 12 | 0 | FMD, IMT | ||||||||
| Li et al 2019 | 150/19; T: 75 (28/47), C: 75 (30/45) | T: 43.71±11.56, C: 45.54±10.16 | T2DM plus hyperlipemia | Simvastatin+ Maixuekang capsule | Simvastatin | 24 | 0 | IMT | ||||||||
| Zhang et al 2019 | 1212/204; T: 607 (367/240), C: 605 (355/350) | T: 61.4±8.4, C: 61.4±8.2 | Patients with a focal IMT of ≥1.2 mm of the carotid arteries | Tongxinluo capsule | Placebo | 24 | 0 | clinical endpoint, IMT, LDL-C, hs-CRP, adverse events | ||||||||
| Liu et al 2007 | 103/20; T: 43 (37/6), C: 40 (33/7) | T: 59.83±7.83, C: 58.47±8.60 | Atherosclerosis in carotid arteries | Rhubarb capsules+CT | Placebo+CT | 6 | 9 | LDL-C, adverse events | ||||||||
| Wang et al 2015 | 57/5; T: 36 (17/19), C: 16 (11/5) | T: 68.72±10.92, C: 66.56±10.26 | Atherosclerotic renal artery stenosis | Huanshuai Recipe Oral Liquid+CT | Placebo+CT | 6 | 0 | LDL-C, clinical endpoint | ||||||||
| Myasoedova et al 2016 | 157/26; T: 77 (0/77), C: 80 (0/80) | T: 65±7, C: 65±6 | Subclinical carotid atherosclerosis in healthy postmenopausal women | Isoflavonoid-rich herbal preparation | Placebo | 12 | 12 | IMT, LDL-C, adverse events | ||||||||
| Zhao et al 2018 | 130/9; T: 65 (36/29), C: 65 (38/27) | T: 68.88±5.75, C: 67.26±5.49 | ACS patients after PCI | Danhong injection+Naoxintong capsule+CT | Placebo+CT | 3 | 3 | Clinical endpoint, adverse events | ||||||||
| Chen et al 2006 | 335/21; T: 157 (124/33), C: 157 (123/34) | T: 58.52±10.30, C: 58.74±9.91 | CHD after PCI | XS0601+CT | Aspirin+ CT | 6 | 6 | Clinical endpoint, adverse events | ||||||||
| Ge et al 2014 | 236/0; T: 116 (68/48), C: 120 (72/48) | T: 65.23±12.19, C: 67.03±13.46 | ACS after PCI | Maixuekang Capsule+CT | CT | 6 | 6 | hs-CRP, LDL-C, clinical endpoint | ||||||||
| Zhao et al 2004 | 50/0; T: 25 (15/10), C: 25 (14/11) | T: 58.2±14.2, C: 59.1±6.3 | CHD | Xuezhikang+CT | Placebo+CT | 3/2 | 0 | LDL-C | ||||||||
| Zhang et al 2008 | 120; T: 60 (36/24), C: 60 (35/25) | T: 55.9±16.1, C: 54.2±14.3 | CHD complicated by diabetes mellitus | Shengmai injection+CT | CT | 3/4 | 0 | FMD, adverse events | ||||||||
| Xu et al 2018 | 710/24; T: 353 (157/196), C: 357 (147/210) | T: 58.31±9.82, C:57.20±9.84 | Patients with CHD or at high risk of CHD | Zhibitai compound capsule+CT | CT | 2 | 0 | LDL-C, adverse events | ||||||||
| Cheng et al 2006 | 79; T: 39 (33/6), C: 40 (31/9) | T: 52.73±7.89, C: 53.11±7.01 | Primary hypertension and coronary artery disease | Garlicin+CT | CT | 13 | 0 | Hs-CRP, IMT, adverse events | ||||||||
| Liu et al 2017 | 62; T: 32 (22/10), C: 30 (20/10) | T: 61.1±12.0, C: 60.4±13.4 | CHD and hyperhomocysteinemia | Allicin+CT | CT | 3 | 0 | IMT | ||||||||
| Study ID | Sample (overall/dropout); sex: M/F | Age (years) | Participant | Intervention group | Control group | Treatment (months) | Follow-up (months) | Outcome measure | ||||||||
| Chu et al 2010 | 90/4; T1: 30 (18/12), T2: 30 (15/15), C: 30 (20/10) | T1: 61.7±9.6, T2: 61.6±9.2, C: 58.8±8.9 | Patients with unstable angina and blood-stasis syndrome after PCI | T1: Xuefu Zhuyu capsule + placebo of Shenmai capsule + CT T2: Shengmai capsule + placebo of Xuefu Zhuyu capsule + CT | Placebo of Xuefu Zhuyu capsule and Shengmai capsule +CT | 1 | 0 | Adverse events | ||||||||
Figure 2 Forest plot of clinical endpoint
Figure 2 Forest plot of clinical endpoint
Figure 3 Forest plot of the change of carotid artery intima-media thickness
Figure 3 Forest plot of the change of carotid artery intima-media thickness
Figure 4 Forest plot of the change of low-density lipoprotein-C
Figure 4 Forest plot of the change of low-density lipoprotein-C
Figure 5 Forest plot of the change of flow-mediated dilation
Figure 5 Forest plot of the change of flow-mediated dilation
Figure 6 Forest plot of the change of high sensitive C-reactive protein
Figure 6 Forest plot of the change of high sensitive C-reactive protein
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