Meta-analysis Of Clinical Efficacy Of Buyang Huanwu Decoction Combined With Conventional Western Medicine In The Treatment Of Stable Angina Pectoris (Qi Deficiency And Blood Stasis Type)

Objective: The effectiveness of buyang Huanwu Decoction combined with conventional Western medicine in the treatment of stable angina pectoris(qi deficiency and blood stasis type)was evaluated by means of Meta analysis,in order to provide objective evidence-based medical evidence and new research direction for clinical application of this prescription.Methods: According to the established retrieval strategy,relevant literatures on buyanghuanwu Decoction combined with conventional Western medicine in the treatment of stable angina were systematically searched in Pub Med,EMbase,Corchane Library,CNKI,Wan Fang,VIP and other databases.The search period is up to February 28,2022.The retrieved literatures were exported to Note Express3.2 software,and the final included literatures were determined by software de-weighting and manual screening,and their data extraction and quality assessment were carried out.Stata12.0software was used for statistical analysis of outcome indicators and corresponding forest maps were drawn.Publication bias was evaluated by drawing funnel plot and calculating Egger’s value for outcome indexes with more than 10 articles.Results:According to the developed retrieval strategy,a total of 1552 Chinese randomized controlled trials were included,including 777 patients in the treatment group and 775 patients in the control group.A total of 5literatures reported adverse reactions in this study,among which 4 literatures only described that no adverse reactions such as liver and kidney function damage,nausea and vomiting occurred in all subjects.One study reported the changes of ALT,AST,BUN and CR levels before and after treatment,and the results showed that there was no statistical difference between the treatment group and the control group(P>0.05),suggesting that the two treatment methods were safe.Meta-analysis results of other outcome indicators were as follows:(1)Angina efficiency: a total of 14 literatures were included.The combined effect size I2=0.0%<50%,RR=1.264,95%CI[1.201,1.329],P=0.000,the difference was statistically significant(P<0.01),suggesting that the treatment group was superior to the control group in improving the effective rate of angina pectoris.(2)ECG efficiency: a total of 7 literatures were included.The combined effect size I2=45.3%<50%,RR=1.328,95%CI[1.197,1.475],P=0.000,the difference was statistically significant(P<0.01),suggesting that the treatment group was better than the control group in improving ECG efficiency.(3)Efficacy of TCM syndromes: a total of 5 literatures were included.The combined effect size I2=28.1%<50%,RR=1.256,95%CI[1.146,1.377],P=0.000,the difference was statistically significant(P<0.01),suggesting that the treatment group was superior to the control group in improving the curative effect of TCM syndrome.(4)Hypersensitive C-reactive protein(hs-CRP): a total of 4 references were included.The combined effect size I2=92.6%,after sensitivity analysis excluding literature,I2=50.5%,SMD=-1.924,95%CI[-2.401,-1.447],P=0.000,the difference was statistically significant(P<0.01),suggesting that the treatment group was better than the control group in improving hs-CRP.(5)The frequency and duration of angina pectoris attacks were included in 5 literatures.The heterogeneity was I2=98.7% and 96.7%>75%,respectively.The source of heterogeneity of the above indicators could not be found by subgroup analysis and sensitivity analysis,and reliable conclusions could not be drawn.(6)Blood lipids: Changes in TC,TG and LDL-C levels were observed in7 literatures,with heterogeneity of I2=88.9%,I2=97.6%,I2=95.1%>75%,respectively.Changes in HDL-C levels were observed in 6 studies,I2=88.4%.Subgroup analysis and sensitivity analysis failed to find the source of heterogeneity of the above indicators,and reliable conclusions could not be drawn.Conclusion:1.The combination of Buyang Huanwu Decoction and conventional Western medicine in the treatment of stable angina pectoris(qi deficiency and blood stasis type)is superior to western medicine alone in improving the effective rate of angina pectoris,the effective rate of electrocardiogram,the curative effect of TCM syndrome and the reduction of hs-CRP level.2.In the treatment of stable angina pectoris(qi deficiency and blood stasis type),Buyang Huanwu Decoction combined with conventional Western medicine showed significant heterogeneity in the improvement of angina pectoris attack times,duration of angina pectoris attack and blood lipid,and reliable conclusions could not be reached.