Chinese Medicine Intravenous Preparations For Treatment Of Acute Myocardial Infarction Meta-analysis Of The Impact Of Mortality And Complications

Acute myocardial infarction (AMI) is an acute and serious disease which is common in clinics. Traditional Chinese medicine (TCM) has a long history in China, and has its own theory and clinical experience in dealing with the disease. In the review part, we briefly recapitulate the etiopathogenisis and pathogenesis of AMI in different points of view in recent years, report current research about traditional Chinese medicine treatment, and summarize the clinical experience of many specialists on treating AMI.Clinical trials showed that TCM has positive effect on reducing mortality rate, decreasing complications, lowering blood fat, and relieving chest distress. But we don't have enough related clinical trials and the trials are of low quality. So it is necessary that we increase the quantity and the quality of the trials. We have little evidence-based-medicine (EBM) evidence on the effect of TCM on AMI, so it need further study.The writer did a Meta analysis on the effect of the mortality and the complications rate of using TCM powder injections and injections as an adjunct therapy to AMI, aiming to assess the efficacy of the treatment on AMI by EBM methods.Method: CBMdisc(1978-Oct.2006), CNKI(1979-Oct.2006), and VIP database (1989 -Oct.2006) were searched to identify randomized controlled trials (RCT) and quasi -randomized controlled trials compared TCM powder injection and injection plus routine AMI therapy with routine AMI therapy. The methodological quality of trials was evaluated according to Jaded score and allocation concealment standard in Cochrane handbook. A meta-analysis was performed using Ravman 4.2.8.Result: Fifteen RCTs (n=1732) were included. All were of low methodological quality according to Jadad score. The combined results showed that TCM had positive effects on reducing mortality: RR=0.39, 95%CI [0.17-0.88],total effect:Z=2.25,P=0.02;reducing recanalization rate RR=1.07, 95%CI [1.01-1.14],total effect:Z=2.15,P=0.03;reducing cardiac insufficiency rate RR=0.31,95%CI [0.16-0.61],total effect:Z=3.39,P=0.0007;reducing post infarction angina pectoris rate RR=0.19, 95%CI[0.08-0.48],total effect:Z=3.57,P=0.0004. No serious side effect was reported.Conclusion: TCM powder injection and injection may have positive effects on reducing mortality, raising recanalization rate, reducing cardiac insufficiency rate and postinfarction angina pectoris rate. The available information didn't show any evidence on serious side effect. There is not enough clinical research about the effect on arrhythmia rate, cardiac shock rate, and reinfarction rate. The methodological quality of the clinical trials using TCM power injection and injection should be improved.