| Objective: To evaluate the efficacy and safety of Taohong SIWU decoction and its modified formula combined with conventional Western medicine in the treatment of angina pectoris of coronary heart disease.Methods: The two researchers used computers to conduct a comprehensive search of the databases of CNKI,WANFANG,VIP,CBM,Pubmed and the Cochrane Library,which were established until January 31,2006,and were 2023 to the database.To search the clinical studies of Taohong Siwu decoction and its addition and subtraction combined with conventional Western medicine in the treatment of angina pectoris of coronary heart disease,the retrieval results were imported into Note Express document management software for management,after de-weighting,the final included literature was identified according to inclusion criteria and exclusion criteria,and data were extracted.The quality of the literature was evaluated using the“Risk of bias assessment tool” recommended by the Cochrane Handbook,the outcome measures were analyzed by revman 5.4 software.Results: A total of 27 RCTs of Taohong Siwu decoction and its modified formula combined with Western medicine were included in this study.A total of 2338 patients were included,including 1175 in the trial group and 1163 in the control group.The control group was treated with routine Western medicine,and the test group was treated with Taohong SIWU decoction and its modified formula on the basis of the control group.A total of 13 articles were analyzed for the total effective rate.Meta-analysis showed:RR: 1.21,95%CI(1.15,1.27),P < 0.01,which indicated that the total effective rate of Taohong Siwu Decoction and its modified formula combined with western medicine in treating angina pectoris was better than that of conventional western medicine.A total of 10 articles analyzed the improvement of angina symptoms.Meta-analysis showed: RR: 1.23,95%CI(1.15,1.31),P < 0.01,which indicated that Taohong Siwu Decoction and its modified formula combined with western medicine were better than conventional western medicine in improving angina symptoms.A total of five articles analyzed the improvement of angina pectoris attack times.Meta-analysis showed: SMD:-4.07,95%CI(-5.58,-2.57),P < 0.01,which indicated that Taohong Siwu Decoction and its modified formula combined with western medicine were better than conventional western medicine in improving angina pectoris attack times.A total of 6 articles analyzed the improvement of the duration of angina pectoris attack.Meta-analysis showed that SMD:-4.38,95%CI(-5.96,-2.8),P < 0.01,which indicated that Taohong Siwu Decoction and its modified formula combined with western medicine were better than conventional western medicine in improving the duration of angina pectoris.A total of 10 articles analyzed the improvement of ECG.Meta-analysis showed that RR:1.27,95%CI(1.17,1.38),P < 0.01,which indicated that Taohong Siwu Decoction and its modified formula combined with western medicine were better than conventional western medicine in improving ECG.A total of 9 articles compared the improvement of TC.Meta-analysis showed that SMD:-1.64,95%CI(-2.4,-0.88),P < 0.01.A total of 9 articles compared the improvement of TG.Meta-analysis showed that SMD:-0.73,95%CI(-1.08,-0.37),P < 0.01.A total of 9 articles compared the improvement of LDL-C.Meta-analysis showed that SMD:-1.32,95%CI(-1.88,-0.76),P < 0.01.A total of 7 articles compared the improvement of HDL-C.After excluding Gancheng 2014,Meta-analysis showed that SMD:0.55,95%CI(0.38,0.72),P< 0.01,which indicated that Taohong Siwu Decoction and its modified formula combined with western medicine were better than conventional western medicine in improving blood lipid.A total of 6 articles compared the improvement of hs-CRP.Meta-analysis showed that SMD:-3.09,95%CI(-4.33,-1.84),P < 0.01,which indicated that Taohong Siwu Decoction and its modified formula combined with western medicine were better than conventional western medicine in improving hs-CRP.There were 7 articles describing the adverse drug reactions,4 of which showed no adverse drug reactions in the trial group,the other 3 groups in the trial of gastric discomfort,diarrhea,nausea,muscle soreness,no serious adverse reactions have not occurred,the safety is acceptable.The incidence of angina pectoris,duration of angina pectoris,LDL-C and hs-CRP were analyzed by subgroup analysis of different disease types and different intervention courses,the heterogeneity of TG and TG was analyzed by subgroup analysis of different disease types and different intervention courses,considering that different disease types might be the source of the heterogeneity of the two outcome measures.The sensitivity analysis showed that except the heterogeneity of HDL-C,the heterogeneity of other outcome measures did not change significantly,suggesting that the results were robust.A funnel plot was drawn to evaluate publication deviation for the total effective rate of outcome measures,the curative effect of angina pectoris,and the curative effect of ECG.The results showed that the inhomogeneous distribution of the points on both sides of the funnel plot line suggested that there might be a risk of deviation.Conclusion: This study evaluated the effect of Taohong Siwu decoction and its addition and subtraction combined with conventional western medicine on angina pectoris of coronary heart disease by Meta-analysis,and it could improve the total effective rate and the curative effect of angina pectoris,improving the times of angina pectoris,the duration of angina pectoris,the effective rate of ECG can significantly reduce the level of TC,TG,LDL-C,hs-CRP,and increase the level of HDL-C in patients with angina pectoris.Only a few studies have described adverse reactions,but the symptoms are mild,there are no serious adverse reactions,and the safety is acceptable. |
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