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Journal of Traditional Chinese Medicine >

2023 , Vol. 43 >Issue 4: 640 - 649

DOI: https://doi.org/10.19852/j.cnki.jtcm.20230506.001

Meta-analysises

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

  • Chao WANG ,
  • Qiong WU ,
  • Ping LI ,
  • Zhigang WANG ,
  • Xusheng LOU ,
  • Yuanyuan LI ,
  • Lin ZHANG
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  • 1 Postdoctoral Mobile Station of Chinese Academy of Traditional Chinese medicine, Beijing 100700, China
    2 China Academy of Chinese Medical Sciences, Beijing 100700, China
    3 Zang-xiang Teaching and Research Department, the Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
    4 Department of Cardiovascular Medicine Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
    5 Shandong College of Traditional Chinese Medicine, Yantai 264199, China
    6 School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China

Received date: 2022-03-29

  Accepted date: 2022-08-26

  Online published: 2023-05-06

Supported by

Fundamental Research Funds for the Central Public Welfare Research Institutes: Theoretical Study of Combination of Facial Color and Pulses Mode in Traditional Chinese Medicine(KJ-202013);Objective Study of “Wei Qi” in Pulse Based on Color Doppler Flow Imaging (CDFI) Technology(YZ-202124)

Fold

Abstract

OBJECTIVE: To evaluate the clinical efficacy of Traditional Chinese Medicine prescriptions for resolving phlegm in the treatment of angina pectoris of phlegm-stasis coronary heart disease by a network Meta-analysis.

METHODS: Randomized controlled trials (RCTs) on clinical efficacy of CHD angina pectoris with interaction of phlegm and blood stasis were searched in PubMed, Springer, the Cochrane Library and Chinese-language databases China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Data from their inception to December 2021. Literature was screened and literature bias risk was assessed by RevMan5.4 software. The overall response rate, the duration of angina attack, the levels of serum lipids such as total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C), and expression of hypersensitive C-reactive protein (hs-CRP) were selected as outcome indicators for network Meta-analysis and mapped using Stata15.1 software.

RESULTS: Totally, 26 RCTs were included, involving 2098 participants. There were 6 TCM formulas with the effects of dispelling phlegm and removing blood stasis. Taking conventional Western Medicine as the common intervention measures, the results showed that the overall response improvement rate from high to low was displayed as modified Xiaoxianxiong decoction (小陷胸汤, MXD), Danlou tablet (丹蒌片, DT), modified Gualou Xiebai Banxia decoction (瓜蒌薤白半夏汤, MGXBD), modified Wendan decoction (温胆汤, MWD), modified Zhishi Xiebai Guizhi decoction (枳实薤白桂枝汤, MZXGD), and modified Erchen decoction (二陈汤, MED). The sequence of angina attack duration improvement from high to low was MZXGD, MGXBD, DT, MWD, MXD. The sequence of TC improvement from high to low was MZXGD, MED, DT, and MGXBD. Sequence of improving TG from high to low was MED, MZXGD, MGXBD, and DT. For LDL-C improvement, the effect from good to poor was MZXGD, MGXBD, DT, and MED. With regard to HDL-C improvement, the effect was ranked as MED, MZXGD, MGXBD, and DT from good to poor. hs-CRP expression from high to low was MZXGD, MXD, MED, MWD, and MGXBD.

CONCLUSION: TCM formula with the effects of dispelling phlegm and removing blood stasis combined with conventional Western Medicine has obvious advantages in treating CHD angina pectoris with interaction of phlegm and blood stasis. MZXGD has great potential in increasing the overall response rate, reducing Duration of angina attack improving blood lipids, and reducing inflammatory factors. However, due to the limitations of extant studies, the conclusions of this study need to be confirmed by numerous reasonably-designed RCTs.

Key words： coronary disease; angina pectoris; phlegm and blood stasis interaction; blood lipid; inflammatory factors; medicine, traditional Chinese; network Meta-analysis; randomized controlled trial

Cite this article

Chao WANG , Qiong WU , Ping LI , Zhigang WANG , Xusheng LOU , Yuanyuan LI , Lin ZHANG . 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 . DOI: 10.19852/j.cnki.jtcm.20230506.001

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