Outcome Measures of Chinese Herbal Medicine for Coronary Heart Disease: An Overview of Systematic Reviews

Abstract

Objective. The aim of this overview was to summarize the outcome measures of Chinese herbal medicine (CHM) as the treatment of coronary heart disease (CHD) based on available systematic reviews (SRs), so as to display the current situation and evaluate the potential benefits and advantages of CHM on CHD. Methods. An extensive search included the Cochrane Database of Systematic Reviews, MEDLINE, and 4 databases in Chinese. SRs of CHM for CHD were included. Besides evaluating and summarizing the outcome measures, we also estimated the quality of the included reviews by PRISMA (preferred reporting items for systematic reviews and meta-analyses). Data were extracted according to predefined inclusion criteria by two independent reviewers. Results. 46 articles were included. 20 kinds of CHM were reviewed. 7 SRs were concerned with myocardial infarction (MI), 38 SRs were related to angina pectoris. 11 SRs had primary endpoints, while others focused on secondary endpoints to evaluate CHM for CHD such as angina pectoris and electrocardiogram (ECG). One SR reported more adverse effects of CHM for CHD and of the SRs analyzed quality of life. Many CHM appeared to have significant effect on improving symptoms, ECG, biomarkers and so on. However, most SRs failed to make a definite conclusion for the effectiveness of CHM in CHD patients due specifically to the poor evidence. And according to PRISMA we found most of the trials in the SRs were of low quality. Conclusion. Primary endpoints were not used widely. The benefits of CHM for CHD need to be confirmed in the future with RCTs of more persuasive primary endpoints and high-quality SRs.

Traditional Formula, Modern Application: Chinese Medicine Formula Sini Tang Improves Early Ventricular Remodeling and Cardiac Function after Myocardial Infarction in Rats

“…In recent years, an increasing number of studies provide scientific evidence to support the use of TCM for preventing and treating cardiovascular diseases [6–11] including SNT [15, 16]. Nevertheless, the role of TCM in cardiovascular diseases still requires further experimental evidence [39].…”

“…Previous studies provided scientific evidence to support the use of Chinese herbal medicine (CHM) for treating MI and HF [6–11]. …”

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“…For 7 days, CDDP (117 mg/kg/d) was given by gastric tube to rabbits in groups 2 and 4, and saline (5 mL/d ) was given by gastric tube to rabbits in groups 1 and 3, as previously described. 11 There were 3 additional rabbits added to the study to replace 3 rabbits that died during the experiments (cause of death: postoperative pleural infection, 2 rabbits; iatrogenic pneumothorax, 1 rabbit).…”

Integrative Western and Chinese Medicine on Coronary Heart Disease: Where Is the Orientation?

“…For most intervention studies, RCT including explanatory randomized controlled trial (ERCT) and pragmatic randomized controlled trial (PRCT) is usually the first choice. Recently, real-world study (RWS) [39], which is applicable to explore the effectiveness of complex intervention with integrative medicine [40] and the reevaluation of postmarketing drugs, has been drawn and is worthy of more attention, while researchers need to strengthen the control of confounding factors, to which modern statistical analysis methods involving instrumental variable and propensity scores can be introduced.Outcome measures should be appropriate [41]. Avoid merely using subjective outcome measures like angina score and TCM syndrome score.…”

“…Outcome measures should be appropriate [41]. Avoid merely using subjective outcome measures like angina score and TCM syndrome score.…”