Meta-Analysis Of Clinical Efficacy Of Modified Gualou Xiebai Banxia Decoction Combined With Western Medicine In The Treatment Of Stable Angina Pectoris (Phlegm Turbidity Blocking Syndrome)

Objective:In this study,the Meta-analysis method was used to evaluate the clinical efficacy and safety of modified Gualou Xiebai Banxia Decoction combined with western medicine in the treatment of stable angina(phlegm turbidity blocking syndrome),and to provide evidence-based evidence for the better application of traditional Chinese medicine combined with Western medicine in the treatment of stable angina pectoris.Methods:According to reasonable criteria for inclusion and exclusion of literature based on research,and medical databases such as CNKI,Wanfang Database,VIP Database,and Pubmed were searched in turn.The search scope was from the establishment of the database to January 2022 for all clinical randomized controlled trials of modified Gualou Xiebai Banxia decoction combined with western medicine in the treatment of stable angina pectoris.The literatures that met the requirements were strictly screened,the basic information and research data were extracted,and the quality of the included literatures was evaluated.Relevant data were systematically sorted and summarized,and RevMan5.4 software was used for meta-analysis of the included studies,and a conclusion was finally drawn.Results:In this study,a total of 3179 literatures were searched for the first time,and 19 literatures were included after strict screening,Including 1593 patients,there were 814 patients in the experimental group(modified Gualou Xiebai Banxia Decoction combined with western medicine treatment),and 779 patients in the control group(conventional western medicine treatment);there are 10 studies that mentioned adverse reactions,but only described that some patients had diarrhea,rash and other adverse reactions that disappeared after drug withdrawal,but no statistical analysis was performed,Meta-analysis results of other observation indicators are as follows:(1)Clinical total effective rate: A total of 11 articles were included,with a total of 1013 patients.The analysis results showed that I~2 =0%,OR=3.91,95%CI [2.57,5.96],Z=6.35,(P<0.000001),the difference was statistically significant,indicating that the observation group was better than the control group in improving the total clinical efficiency.(2)Efficacy of angina pectoris: A total of 7 articles were included,with a total of 515 patients.The analysis results showed that I~2 =0%,OR=3.51,95%CI [2.27,5.47],Z=5.62,(P<0.00001),the difference was statistically significant,indicating that the observation group is better than the control group in improving the efficacy of angina pectoris.(3)Improvement of ECG: A total of 10 articles were included,with a total of 731 patients.The analysis results showed that I~2 =0%,OR=2.59,95%CI [1.87,3.59],Z=5.75,(P<0.00001),the difference was statistically significant,indicating that the ECG improvement of the observation group was significantly better than that of the control group.(4)Nitroglycerin cessation rate: A total of 5 articles were included,with a total of 401 patients.The analysis results showed that I~2 =30%<50%,OR=3.63,95%CI[2.16,6.12],Z=4.85,(P<0.00001),the difference was statistically significant,indicating that the observation group had a higher rate of nitroglycerin stopping and reducing significantly better than the control group.(5)TCM syndrome points: A total of 6 articles were included,with a total of 434 patients.The analysis results show that P<0.00001 and I~2=92%>50%,indicating that the included studies are highly heterogeneous,and the literatures with sources of heterogeneity are excluded by sensitive analysis,I~2 =0%,and the fixed effect model can be used to combine the effect size,obtained MD=-3.53,95%CI[-4.14,-2.92],Z=11.36,(P<0.00001),the difference was statistically significant,indicating that the observation group was significantly better than the control group in terms of TCM syndrome scores.(6)The analysis results of total cholesterol(TC)and low-density lipoprotein(LDL-C)found that the heterogeneity was large.After finding the source of heterogeneity through sensitive analysis,it was eliminated and the effect size was combined,and the results showed the difference was statistically significant,indicating that the observation group was better than the control group in reducing total cholesterol(TC)and low-density lipopro-tein(LDL-C)levels.(7)The results of triglyceride(TG)analysis showed that the heterogene-ity was large,and the source of heterogeneity was not detected by subgroup analysis and sensitivity analysis.Speculation that differences in the geograp-hy and circumstances of the study subjects,and different manufacturers of intervention options can cause heterogeneity,so no reliable conclusions can be drawn.Conclusions:1.Modified Gualou Xiebai Banxia Decoction combined with western medicine in the treatment of stable angina pectoris(phlegm turbidity blocking syndrome)can improve the total clinical efficiency of SAP,improve electroc-ardiogram,angina pectoris efficacy,TCM syndrome score,nitroglycerin cessation rate,reduce Total cholesterol(TC)and low-density lipoprotein(LDL-C)levels were superior to conventional western medicine treatment.2.Modified Gualou Xiebai Banxia Decoction combined with western medicine in the treatment of stable angina(phlegm turbidity blocking syndrome)in reducing triglyceride(TG)levels has great heterogeneity and no source of heterogeneity has been found.Therefore no reliable conclusions can be drawn.