The Usefulness of Xuefu Zhuyu Tang for Patients with Angina Pectoris: A Meta-Analysis and Systematic Review

Objective.To evaluate the efficacy of Xuefu Zhuyu Tang (XFZYT) for treating angina pectoris (AP).Methods.Six databases were searched (up to December, 2013). Eligible randomized controlled trials (RCTs) evaluating the efficiency of XFZYT plus traditional antianginal medications (TAMs) compared with TAMs alone in patients with AP were included. The outcomes were relief of anginal symptoms (RAS) and improvement of electrocardiogram (ECG) and blood high-density lipoprotein cholesterol (HDL-C) level.Result.Finally 14 RCTs were included. There were evidences that XFZYT combined with TAMs was more effective in improving RAS (RR = 1.29; 95% CI = [1.20, 1.38]), ECG (RR = 1.37; 95% CI = [1.22, 1.54]), and blood HDL-C level (MD = 0.29 mmol/L; 95% CI = [0.23, 0.35]) compared with TAMs alone. Our meta-analysis also showed the pooled number needed to treat (NNT) of the group with stable angina pectoris (SAP) was smaller in improving RAS (4.2 versus 5.7) and ECG (3.1 versus 5.5) compared with the group with both SAP and unstable angina pectoris (UAP).Conclusion.Combination therapy with XFZYT and TAMs is more effective in treating AP compared with TAMs alone. And XFZYT may be a more suitable choice for the treatment of SAP. However, the findings should be interpreted with caution due to the mediocre methodological quality of the included RCTs.

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The Effect of Acupuncture on Glucose Metabolism and Lipid Profiles in Patients with PCOS: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/5555028 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Ruqun Zheng ◽

Peng Qing ◽

Mei Han ◽

Jinlong Song ◽

Min Hu ◽

...

Keyword(s):

Glucose Metabolism ◽

Randomized Controlled Trials ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Methodological Quality ◽

Meta Analysis ◽

Density Lipoprotein ◽

Controlled Trials ◽

Fasting Insulin ◽

Randomized Controlled

Objective. To evaluate the effectiveness of acupuncture on glucose metabolism and lipid profiles in patients with polycystic ovary syndrome (PCOS). Methods. Databases, including the China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal Database (VIP), Wanfang, PubMed, and the Cochrane Library were searched for the relevant literature, with the retrieval deadline being February 2020. Two reviewers independently screened, selected, and extracted the data and validated the results. The methodological quality of the included studies was evaluated with the risk of bias tool, and the meta-analysis was performed using the RevMan 5.3.5 software. Results. A total of 737 patients with PCOS from 10 randomized controlled trials were included in the meta-analysis. A pooled analysis showed significant decreases in body mass index (mean difference (MD) = –1.47, 95% CI –2.35 to –0.58, P < 0.001) and waist-to-hip ratio (MD = –0.04, 95% CI [–0.06, –0.02], P < 0.001) in the acupuncture group along with significant improvements in fasting plasma glucose (MD = –0.38, 95% CI [–0.70, –0.07], P = 0.02), homeostasis model assessment of insulin resistance (MD = –0.22, 95% CI [–0.41, –0.02], P = 0.03), and triglycerides (MD = –0.26, 95% CI [–0.48, –0.04], P = 0.02). No significant differences were observed in the Ferriman–Gallwey score, 2 h fasting plasma glucose, fasting insulin, 2 h fasting insulin, serum total cholesterol, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol. Conclusion. Acupuncture is relatively effective and safe in improving glucose metabolism and insulin sensitivity in patients with PCOS. The included studies were generally of not bad methodological quality, but further large-scale, long-term randomized controlled trials with rigorous methodological standards are still warranted.

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Were Traditional Chinese Medicine Injections Efficacious for Angina Pectoris? A Frequentist Network Meta-Analysis of Randomized Controlled Trials

10.21203/rs.3.rs-137394/v1 ◽

2020 ◽

Author(s):

Guoying Gao ◽

Siu-wai Leung ◽

Yongliang Jia

Keyword(s):

Chinese Medicine ◽

Angina Pectoris ◽

Traditional Chinese Medicine ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Quality Of Evidence ◽

Randomized Controlled ◽

Grade Approach

Abstract Background: The efficacy of traditional Chinese medicine injections (TCMIs) for angina pectoris has never been well investigated for lacking quality assessment of evidence. This study aimed to conduct a comprehensive and rigorous network meta-analysis and assess the quality of evidence according to the Grading of Recommendations and Assessment, Development, and Evaluation (GRADE) approach to compare the efficacy of all TCMIs in treating angina pectoris.Methods: Following the protocol (reference: CRD42018117720), randomized controlled trials (RCTs) which compared one TCMI with another TCMI or conventional treatments on anginal outcome measures (i.e. symptomatic improvement, electrocardiography improvement, symptomatic recovery, and electrocardiography recovery) were included. The risk of bias among included RCTs was assessed with the revised Cochrane’s risk of bias tool 2. Frequentist statistical analyses including subgroup analysis, sensitivity analysis, meta-regression and publication bias analysis were performed. The certainty of evidence was assessed with the GRADE approach.Results: Totally, 475 RCTs including all 24 TCMIs were identified, while the quality of all but two included RCTs was poor. According to the network meta-analysis, Honghua (Safflower) injection were preferable both in improving symptoms and electrocardiography. However, significant inconsistency showed the intransitivity among indirect comparisons, results in network meta-analysis seemed thus not trustworthy. The quality of evidence was assessed as low or very low.Conclusions: The low-quality evidence reduced the confidence in the efficacious results. Current evidence hardly supports the beneficial effects of TCMIs in treating angina pectoris.

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Clinical Efficacy and Safety of Shensong Yangxin Capsule-Amiodarone Combination on Heart Failure Complicated by Ventricular Arrhythmia: A Meta-Analysis of Randomized Controlled Trials

Frontiers in Pharmacology ◽

10.3389/fphar.2021.613922 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xinfu Cao ◽

Mingxue Zhou ◽

Hongxu Liu ◽

Xiufen Chen ◽

Xiang Li ◽

...

Keyword(s):

Heart Failure ◽

Ventricular Arrhythmia ◽

Methodological Quality ◽

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled

Background: Shensong Yangxin capsule (SSYX) is a well-known traditional Chinese patent medicine for treating arrhythmia. Recently, a flurry of randomized controlled trials (RCTs) of SSYX combined with amiodarone (SSYX-amiodarone) was reported in the treatment of heart failure (HF) complicated by ventricular arrhythmia (VA) in China. However, these RCTs have not been systematically evaluated. Therefore, this study aimed to evaluate the efficacy and safety of SSYX-amiodarone in the treatment of heart failure complicated by ventricular arrhythmia (HF-VA).Methods: Seven electronic literature databases (the Cochrane Library, PubMed, EMBASE, China Biomedical database web, China National Knowledge Infrastructure Databases, Chinese Scientific Journal database and Wanfang database) were searched from their inceptions to June 1, 2020 to identify RCTs of SSYX-amiodarone in the treatment of HF-VA. The primary outcomes included the total effective rate and adverse events (ADRs). The secondary outcomes included the frequency of ventricular premature complexes, left ventricular ejection fraction, N terminal pro Btype natriuretic peptide (NT-proBNP), and QT dispersion (QTd). The quality of the included RCTs was assessed using the Cochrane risk-of-bias tool. All data was analyzed using RevMan 5.3 software. The registration number of this protocol is PROSPERO CRD42020196689.Results: There are Eighteen trials involving 1,697 patients were included in this study. Meta-analysis showed that SSYX-amiodarone group was superior to the amiodarone group in improving the total effective rate [RR = 1.21; 95%CI (1.16, 1.27); p < 0.01], meanwhile reducing the ADRs [RR = 0.65; 95%CI (0.45, 0.95); p = 0.03], VPCs [MD = 170.96; 95%CI (159.88, 182.04); p < 0.01] and QTd [MD = 8.39; 95%CI (6.91, 9.87); p < 0.01]. No significant difference of enhancing LVEF [MD = 4.32; 95%CI (−0.56, 9.20); p = 0.08] and reducing NT-proBNP [SMD = 0.17; 95%CI (−0.81, 1.14); p = 0.73] was observed between SSYX-amiodarone and amiodarone group.Conclusions: Despite the apparent positive findings reported, the evidence provided by this meta-analysis was still insufficient to support the routine use of SSYX-amiodarone for HF-VA due to the poor methodological quality of included studies. The overall effect should to be verified in further through more well-design clinical studies with reasonable sample and good methodological quality.

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Effectiveness of Text Messaging Interventions on Blood Pressure Control Among Patients With Hypertension: Systematic Review of Randomized Controlled Trials (Preprint)

10.2196/preprints.24527 ◽

2020 ◽

Author(s):

Hon Lon Tam ◽

Eliza Mi Ling Wong ◽

Kin Cheung ◽

Siu Fung Chung

Keyword(s):

Systematic Review ◽

Text Messaging ◽

Methodological Quality ◽

Meta Analysis ◽

Text Message ◽

Controlled Trials ◽

Randomized Controlled ◽

Reduction Effect ◽

Text Messaging Intervention

BACKGROUND Controlling blood pressure (BP) is an international health concern, and high BP is a major contributor to cardiovascular disease mortality. Evidence has shown that educational interventions directed at patients potentially improve BP control and adherence to medications and lifestyle modifications. In addition, a text messaging intervention has a potential effect on BP control; however, the dosage of a text messaging intervention has not been determined in previous reviews, resulting in difficult application in practice. OBJECTIVE This review aimed to identify the effectiveness of a text messaging intervention on hypertension management with a specific focus on the dosage of text messaging and the type of additional interventions with text messaging. METHODS A systematic review was conducted and reported on in accordance with PRISMA guideline. Participants were aged 18 years and older and diagnosed with primary hypertension. The included studies used text messaging as a component of the intervention. We searched for randomized controlled trials published until June 30, 2020, from the following health-related electronic databases: Embase, Medline, CINAHL Complete, PsycINFO, and Scopus. Data were extracted for qualitative synthesis and meta-analysis. The Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study, and the quality of the included studies was assessed independently by two authors. RESULTS Twelve studies met the inclusion criteria. The overall methodological quality was fair (mean score 5.75). The frequency of text message delivery varied from daily to biweekly. Health education was identified in 4 studies as an additional intervention with text messaging. The overall results showed that the text messaging intervention significantly reduced systolic BP (SBP) but not diastolic BP (DBP). There was no significant difference in BP reduction between studies that lasted 6 months or less and those that lasted more than 7 months. Seven studies that lasted 6 months or less involving 1428 patients with hypertension were pooled for further meta-analysis. Text messages delivered at a lower frequency (once per week or less) had a small effect on SBP reduction (effect size 0.35, P<.01) and DBP reduction (effect size 0.28, P=.01). In addition, the use of a text messaging intervention halved the odds of uncontrolled BP among patients with hypertension in 6 months (odds ratio 0.46, P=.02). CONCLUSIONS This review found that a text messaging intervention was effective in BP control. One-way text messaging delivered in a weekly manner was suggested to be effective and required fewer resources. Future studies should use different forms of text message and be integrated into other interventions to improve adherence behaviors and BP control among patients with hypertension.

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The Effects of Wenxin Keli on P-Wave Dispersion and Maintenance of Sinus Rhythm in Patients with Paroxysmal Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/245958 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 13

Author(s):

Yu Chen ◽

Shaoping Nie ◽

Hai Gao ◽

Tao Sun ◽

Xiaoqiu Liu ◽

...

Keyword(s):

Sinus Rhythm ◽

Western Medicine ◽

Methodological Quality ◽

Meta Analysis ◽

Wave Dispersion ◽

P Wave ◽

Controlled Trials ◽

P Wave Dispersion ◽

Randomized Controlled

Objective. To evaluate the beneficial and adverse effects of Wenxin Keli (WXKL), alone or combined with Western medicine, on P-wave dispersion (Pd) and maintenance of sinus rhythm for the treatment of paroxysmal atrial fibrillation (PAF).Methods. Seven major electronic databases were searched to retrieve randomized controlled trials (RCTs) designed to evaluate the clinical effectiveness of WXKL, alone or combined with Western medicine, for PAF, with Pd or maintenance rate of sinus rhythm as the main outcome measure. The methodological quality of the included studies was assessed using criteria from the Cochrane Handbook for Systematic Review of Interventions, version 5.1.0, and analysed using RevMan 5.1.0 software.Results. Fourteen RCTs of WXKL were included. The methodological quality of the trials was generally evaluated as low. The results of meta-analysis showed that WXKL, alone or combined with Western medicine, was more effective in Pd and the maintenance of sinus rhythm, compared with no medicine or Western medicine alone, in patients with PAF or PAF complicated by other diseases. Seven of the trials reported adverse events, indicating that the safety of WXKL is still uncertain.Conclusions. WXKL, alone or combined with Western medicine, appears to be more effective in improving Pd as well as maintenance of sinus rhythm in patients with PAF and its complications.

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L-Carnitine’s Effect on the Biomarkers of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽

10.3390/nu12092795 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2795

Author(s):

Munji Choi ◽

Seongmin Park ◽

Myoungsook Lee

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Randomized Controlled Trials ◽

Methodological Quality ◽

Meta Analysis ◽

Density Lipoprotein ◽

Cochrane Library ◽

Controlled Trials ◽

Carnitine Supplementation ◽

Randomized Controlled

A systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out to assess L-carnitine supplements’ influence on the biomarkers of metabolic syndrome (MetSyn). PubMed, EMBASE, Cochrane library, and CINAHL were used to collect RCT studies published prior to February 2020. RCT studies were included if they had at least one of the following biomarker outcome measurements: waist circumference (WC), blood pressure (BP), fasting blood sugar (FBS), triglyceride (TG), or high density lipoprotein-cholesterol (HDLc). Nine of twenty studies with adequate methodological quality were included in this meta-analysis. The dose of L-carnitine supplementation administered varied between 0.75 and 3 g/day for durations of 8–24 weeks. L-carnitine supplementation significantly reduced WC and systolic BP (SBP), with no significant effects on FBS, TG, and HDLc. We found that L-carnitine supplementation at a dose of more than 1 g/d significantly reduced FBS and TG and increased HDLc. In conclusion, L-carnitine supplementation is correlated with a significant reduction of WC and BP. A dose of 1–3 g/d could improve the biomarkers of MetSyn by reducing FBS and TG and increasing HDLc.

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Compound Danshen Dripping Pill for Treating Nonproliferative Diabetic Retinopathy: A Meta-Analysis of 13 Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2017/4848076 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Wenjing Huang ◽

Qi Bao ◽

De Jin ◽

Fengmei Lian

Keyword(s):

Diabetic Retinopathy ◽

Randomized Controlled Trials ◽

Methodological Quality ◽

Vision Loss ◽

Meta Analysis ◽

Controlled Trials ◽

Fundus Fluorescein Angiography ◽

Quality Of Evidence ◽

Randomized Controlled

Objective. We assess the clinical effect of compound Danshen dripping pill (CDDP) for treating diabetic retinopathy (DR). Methods. Electronic databases were searched from January 2001 to October 2016 to locate randomized controlled trials (RCTs). Efficacy was measured as main outcome and microaneurysms, hemorrhage, exudate, vision, and fundus fluorescein angiography (FFA) were measured as second outcomes. Methodological quality for each study was evaluated, RevMan 5 software was used to assess treatment effects, and GRADE was used to rate quality of evidence. Results. We located 13 RCTs and methodological quality was evaluated as high risk. Statistics indicated CDDP for treating DR was better than controls and DR risk was reduced 64% with CDDP (RR: 0.36, P=0.68); retinal microaneurysms (MD = −4.32NO, P<0.00001); retinal hemorrhages (MD = −0.70PD, P=0.03); exudate improvements (MD = −0.09PD, P=0.79); visual changes (MD = −0.12 letter, P=0.006); FFA (RR: 0.40, P=0.003). About GRADE, quality of evidence was “low.” Conclusion. CDDP may be safe and efficacious for treating or delaying DR and may improve vision or delay vision loss.

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Zhen Gan Xi Feng Decoction, a Traditional Chinese Herbal Formula, for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/982380 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 15

Author(s):

Xingjiang Xiong ◽

Xiaochen Yang ◽

Bo Feng ◽

Wei Liu ◽

Lian Duan ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Randomized Controlled Trials ◽

Methodological Quality ◽

Antihypertensive Drugs ◽

Meta Analysis ◽

Clinical Effectiveness ◽

Controlled Trials ◽

Randomized Controlled

Objectives. To assess the clinical effectiveness and adverse effects of Zhen Gan Xi Feng Decoction (ZGXFD) for essential hypertension (EH).Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of ZGXFD for EH reported in any language, with main outcome measure as blood pressure (BP).Results. Six randomized trials were included. Methodological quality of the trials was evaluated as generally low. Four trials compared prescriptions based on ZGXFD with antihypertensive drugs. Meta-analysis showed that ZGXFD was more effective in BP control and TCM syndrome and symptom differentiation (TCM-SSD) scores than antihypertensive drugs. Two trials compared the combination of modified ZGXFD plus antihypertensive drugs with antihypertensive drugs. Meta-analysis showed that there is significant beneficial effect on TCM-SSD scores. However, no significant effect on BP was found. The safety of ZGXFD is still uncertain.Conclusions. ZGXFD appears to be effective in improving blood pressure and hypertension-related symptoms for EH. However, the evidence remains weak due to poor methodological quality of the included studies. More rigorous trials are warranted to support their clinical use.

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