Systematic Review Of The Effectiveness And Safety Of Yindanxinnaotong In Angina

Objective: To evaluate the effectiveness and safety of Yindan Xinnaotong Capsule forangina pectoris by systematic review.Methods：Randomized controlled trials (RCT) on treatment of angina pectoris by YindanXinnaotong Capsule were retrieved from electronic databases including Cochrane Database ofSystematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CCTR),MEDLINE, EMBASE, SinoMed, CNKI, Wanfang Med Online, VIP, China Proceedings ofConference Database and China Core Newspapers Database and China Masters’ ThesesDatabase. Study selection, data extraction and methodological quality assessment wasperformed by two researchers independently in accordance with RTCs quality evaluationcriteria designed by the Cochrane Collaboration; Review Manager Software (RevMan5.2)was applied for meta-analysis.Results: Thirteen RTCs involving1,264patients diagnosed with angina pectoris wereincluded. The majority of the included RTCs was those with small sample size andcompromised methodological quality. According to the result of Meta-analysis, as comparedwith control group, Yindan Xinnaotong Capsule could lower the patients’ level of serum totalcholesterol (TC), triglycerides (TG) and LDL while on the contrary increase that of HDL;besides, it could reduce the symptoms of angina pectoris while improve clinical cure rates andpatients’ ECG performance. Side effects: Side effects were mentioned specifically in oneincluded study; seven other included RTCs reported negative observations on significant sideeffects; still five others were silent on severe adverse reactions. Therefore, no analysis onsevere adverse reactions was conducted. Sensitivity analysis: Sensitivity analyses wereconducted on clinical cure rates and patients’ ECG performances by multiple statisticalmethods (fixed-effects model and random-effects model) with no significant statisticaldifference found between groups, suggesting fairly reliable results derived from themeta-analysis. Publication bias: Test for funnel plot asymmetry showed positive, indicatingpossible publication bias and low quality in methodology; publication bias also showed thattrials with negative results might not have been published.Conclusions: The application of a standard treatment by western medicine alone, a combinational approach with Yindan Xinnaotong Capsule and standard western medicinecould achieve a better result in reducing the symptoms of angina pectoris. Due to theinadequacy in adverse reaction report by some of the included studies, as well as in the timespan for treatment and follow-up, any effort to offer determinative conclusions on side effectsremains elusive.