Shenmai injection as an adjuvant treatment for chronic cor pulmonale heart failure: a systematic review and meta-analysis of randomized controlled trials

Abstract

BackgroundShenmai injection (SM), as a traditional Chinese medicine injection, is widely used for chronic cor pulmonale heart failure in mainland China. It is essential to systematically assess the efficacy and safety of SM as an adjuvant treatment for chronic cor pulmonale heart failure.MethodsEight English and Chinese electronic databases were searched, from inception to December 2014, to identify randomized controlled trials (RCTs) of SM for chronic cor pulmonale heart failure. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of eligible studies. Meta-analysis was performed by Review Manager 5.2.ResultsTwenty-seven RCTs with 2045 participants were identified. The methodological quality of the included studies was generally low. Only one trial reported data on death. None of the included trials reported quality of life. The meta-analysis indicated that compared to conventional treatment, the combination of SM and conventional treatment was more effective in terms of the New York Heart Association classification (RR, 1.26; 95 % CI, 1.20–1.32; P < 0.00001), Left Ventricular Ejection Fraction (MD, 11.33; 95 % CI, 8.59–14.07; p < 0.00001), partial pressure of oxygen (MD, 1.00; 95 % CI, 0.64–1.36; P < 0.00001) and partial pressure of carbon dioxide (MD, 0.83; 95 % CI, 0.58–1.08; p < 0.00001). In addition, two trials reported that SM plus conventional treatment was superior to the conventional treatment alone to reduce B-type natriuretic peptide. No serious adverse drug events or reactions were reported.ConclusionsSM plus conventional treatment appeared to be effective and relatively safe for chronic cor pulmonale heart failure. However, due to the generally low methodological quality and small sample size, this review didn’t find evidence to support routine use of SM as an adjuvant treatment for chronic cor pulmonale heart failure.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-015-0939-2) contains supplementary material, which is available to authorized users.

Ginkgo leaf extract and dipyridamole injection for chronic cor pulmonale: a PRISMA-compliant meta-analysis of randomized controlled trials

“…Chronic cor pulmonale (CCP), a common type of heart disease, has become a rising major public problem that threatens people's health and quality of life around the world [1]. Although the term "cor pulmonale" is popular in the medical literature, there is presently no consensual definition [1][2][3].…”

“…Chronic cor pulmonale (CCP), a common type of heart disease, has become a rising major public problem that threatens people's health and quality of life around the world [1]. Although the term "cor pulmonale" is popular in the medical literature, there is presently no consensual definition [1][2][3]. World Health Organization (WHO) defined CCP as "hypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs, and may further leading to heart failure" [4].…”

“…World Health Organization (WHO) defined CCP as "hypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs, and may further leading to heart failure" [4]. Pulmonary hypertension resulting from disorders of the respiratory system and/or from chronic hypoxaemia is the main pathological mechanism of CCP [1,5,6]. Currently, the conventional treatment, including antibiotics, vasodilators, expectorants, antiasthmatic drugs, diuretics and antiarrhythic drugs etc.…”

“…Currently, the conventional treatment, including antibiotics, vasodilators, expectorants, antiasthmatic drugs, diuretics and antiarrhythic drugs etc. is the main clinical therapy for CCP [1]. However, it is universally acknowledged that long-time use of western medicine sometimes may cause drug resistance and toxic side effects, and therefore its clinical efficacy is still unsatisfactory [1,2].…”

“…is the main clinical therapy for CCP [1]. However, it is universally acknowledged that long-time use of western medicine sometimes may cause drug resistance and toxic side effects, and therefore its clinical efficacy is still unsatisfactory [1,2]. Many researchers in China and some other Asian countries indicated that the combination of Chinese and Western medicine for CCP might be the potential trend of clinical treatment development in future [7][8][9][10][11][12].…”