| This article contains two parts:A meta-analysis of using Chinese herbal medicine in reducing the incidence of cardiovascular adverse events in patients with coronary heart disease and a Double-blind randomized controlled trial of Yugengtongyu granules in reducing major cardiovascular events in patients with coronary heart disease.1 A Meta-analysis of Using Chinese Herbal Medicine In Reducing the Incidence of Cardiovascular Adverse Events In Patients With Coronary Heart DiseaseObjective:Evaluate the effecton the incidence of adverse cardiovascular events in patients diagnosed with coronary heart disease of Traditional Chinese Medicine,in order to provide objective evidence for the clinical intervention of coronary heart disease by using TCM.Methods:Search literature of randomized controlled trials on the use of oral traditional Chinese medicine in the treatment of cardiovascular events in patients with coronary heart disease in Chinese Academic Journal Database CNKI,Wanfang Database,VIP Database,Pubmed Bibliography Database,Cochrane Library,SCI(Science Citation Index)Database.Publication of articles is limited to February 2018.All the collected RCTs were screened,extracted,evaluated,and quality graded.The experimental group used oral Chinese herbal medicine combined with standard treatment routine,and the control group was treated standard treatment routine or combined with placebo.The included literature was evaluated by using Revman 5.3 software for meta-analysis.The observed outcomes were cardiac death,revascularization,non-fatal myocardial infarction,hospitalization for unstable angina,hospitalization for cardiac insufficiency,hospitalization for malignant arrhythmia,stroke,major cardiovascular events,combined endpoint events and coronary restenosis.Outcomes:A total of 28 randomized controlled trials with 4,419 patients were eventually analyzed.Meta-analsys showed that the incidence of various cardiovascular events in the experimental group decreased to varying degrees compared with the control group,among which the occurrence of non-fatal acute myocardial infarction(OR=0.36,95%CI[0.22-0.60],P<0.0001),revascularization(OR=0.45,95%CI[0.30-0.66],P<0.0001),major cardiovascular events(OR=0.41,95%CI[0.21-0.54],P<0.00001),hospitalization for heart failure(OR=0.27,95%CI[0.13-0.57],P=0.0006),hospitalization for unstable angina(OR=0.39,95%CI[0.24-0.65],P=0.0003),joint endpoint(OR=0.36,95%CI[0.29-0.45],P<0.00001)and intracoronary restenosis(OR=0.41,95%CI[0.27-0.61],P<0.0001)has statistical differences(P<0.05)or significant statistical differences(P<0.01).And the sensitivity analysis confirmed the stability of the outcome.The outcome of experimental group in cardiac death(OR=0.43,95%CI[0.18-1.00],P=0.05),Stroke(OR=0.40,95%CI[0.16-1.01],P=0.05)and hospitalization for malignant arrhythmia(OR=0.28,95%CI[0.07-1.16],P=0.08)has a decreasing trend compared with the control group,but the difference was not statistically significant(P>0.05)with a poor stability.There was no significant heterogeneity in the studies included in each indicator.Conclusion:According to the studies included,treatment with oral Chinese herbal medicine combined with standardized treatment routine may reduce the incidence of various types of adverse cardiovascular events of patients with coronary heart disease,thereby improving the patient’s clinical prognosis.2 A Double-blind Randomized Controlled Trial of Yugengtongyu Granules in Reducing The Incidence of Adverse Cardiovascular Events In Patients With Coronary Heart DiseaseObjective:To evaluate the effect of using Yugengtongyu Granules on the clinical prognosis and reducing the impact of major cardiovascular events in patients diagnosed with coronary heart disease,and analyze the factors that influence the prognosis.Methods:A 1-year follow-up observation was conducted on 114 patients from the Department of Cardiology and TCM Department of Cardiology in the China-Japan Friendship Hospital between December 2014 and August 2016.The control group(n=57)received standard routine treatment and oral placebo,The treatment group(n=57)received standard routine treatment and Yugengtongyu Granules orally.Patients were interviewed or telephoned at the time of enrollment and the 1st,3rd,6th,9th,and 12th month after enrollment.Follow-up observation includes endpoint indicators(Primary endpoint:Cardiac death,non-fatal myocardial infarction,revascularization,successful resuscitation of cardiac arrest;Secondary endpoints:all-cause mortality,unstable angina/heart failure/malignant arrhythmia hospitalization,stroke,and other thrombotic complications),TCM syndrome indicators(Including Blood stasis scores,TCM secondary syndrome scores,information scales of objective pattern differentiation,etc),Effectiveness indicators(Including blood glucose,blood lipids,Hs-CRP,ECG,UCG,ultrasound vascular endothelial function detection FMD,etc).Safety indicators(Including blood/urine/stool regular routines and coagulation).SPSS22.0 was used for statistical analysis.Outcomes:①The incidence of cardiovascular events in the experimental group was significantly lower than that in the control group,and there was a statistically significant difference between the occurance of the combined endpoint events.②The scores of the four dimensions of the Seattle angina pectoris scale in the test group:physical limitations,symptom onset,treatment satisfaction,and disease awareness were significantly improved at the 3rd or 6th month of follow-up,compared with the control group.Statistical significance;There was no significant difference in the degree of symptom stability dimension.③The score of Primary TCM syndrome in the experimental group was significantly lower than that in the control group at the 6th month follow-up,and the difference was statistically significant.④Triglyceride levels in the experimental group showed a decreasing trend compared with the control group at the 6th month follow-up,and the difference was not statistically significant.Total cholesterol,high-density lipoprotein,and low-density lipoprotein at all follow-up time point showed no decreasing trend at each follow-up time.⑤There was no significant difference in fasting blood glucose and high-sensitivity CRP between the experimental group and the control group at each follow-up time.⑥The LVPW of UCG test in the experimental group was significantly lower than that in the control group at the sixth month follow-up,and the difference was statistically significant.There was no significant difference in EF and LVEDd between the two groups.⑦The result of ultrasonic examination of endothelial function indicated that the FMD level in the experimental group was higher than that in the control group at 6 months of follow-up,and the difference was statistically significant.⑧There was no significant difference in the safety indicators between the experimental group and the control group at each follow-up time.Conclusion:In patients with coronary heart disease,using Yugengtongyu Granules on the basis of standardized treatment routine may improve the quality of life,reduce the incidence of cardiovascular adverse events and improve clinical prognosis,the possible mechanism of which is the protection of endothelial function. |
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