Shexiang Baoxin Pills as an Adjuvant Treatment for Chronic Heart Failure: A System Review and Meta‐Analysis

Abstract

Background Shexiang Baoxin pills (SXBXP), as a Traditional Chinese Medicine, are widely used for chronic heart failure in China. It is essential to systematically assess the efficacy and safety of SXBXP as an adjuvant treatment for chronic heart failure. Methods Seven English and Chinese electronic databases (PubMed, Embase, Cochrane Library, CBM, Wanfang, VMIS, and CNKI) were searched from inception to July 2017. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of eligible studies. Meta-analysis was performed by Review Manager 5.3. Results A total of 27 RCTs with 2637 participants were included in this review. Compared to conventional treatment, SXBXP combined with conventional treatment showed potent efficacy when it came to the total efficacy rate (OR, 3.88; 95% CI, 2.87, 5.26; P < 0.00001), B-type natriuretic peptide (BNP) (MD = −66.95; 95% CI, −108.57, −25.34; P = 0.002), N-terminal pro-brain natriuretic peptide (NT-ProBNP) (MD = −0.15; 95% CI, −0.21, −0.09; P < 0.00001), six-minute walking distance (6-MWD) (MD = 38.57; 95% CI, 28.47, 48.67; P < 0.00001), cardiac output (CO) (MD = 0.84; 95% CI, 0.68, 0.99; P < 0.00001), and Stroke Volume (SV) (MD = 7.43; 95% CI, 4.42, 10.44, P < 0.00001). The pooled subgroup analysis indicated that there was a significant difference between SXBXP plus conventional treatment and conventional treatment alone in short term course (OR = 3.51; 95% CI, 2.28, 5.40; P < 0.00001), in middle period of treatment (OR = 5.01; 95% CI, 2.61, 9.60; P < 0.00001), and in long-term course (OR = 3.77; 95% CI, 2.13, 6.67; P < 0.00001). No serious adverse events or reactions were mentioned in these RCTs. Conclusions As an adjuvant drug, this study suggested that SXBXP provide an obvious efficacy for the treatment of CHF. However, due to small samples and generally low quality studies being applied in this study, more rigorous and well-designed RCTs are needed to confirm these findings.

Effect and safety of oral Chinese patent medicine for heart failure

“…Previous systematic reviews and meta analyses on Qili Qiangxin capsules, Qishen Yiqi dripping pills, Shexiang Baoxin pills, Wenxin granules, and other oral PCMs show good efficacy and safety in the treatment of HF. [ 16 , 23 – 25 ]…”

“…Perform iterative operations based on preset model parameters. [ 16 , 17 ] After the statistical analysis, the convergence needs to be measured by the potential scale reduction factors (PSRE). The closer the PSRE is to 1, the better the convergence.…”

“…If the points on both sides are the same, it means the publication bias does not exist; otherwise, there is publication bias. [ 16 ]…”

Shexiang Baoxin Pill, Derived From the Traditional Chinese Medicine, Provides Protective Roles Against Cardiovascular Diseases

“…Shexiang Baoxin Pill (SBP), a classic patent medicine derived from the TCM formula Suhexiang Pill of Song Dynasty in China, has been extensively used for the prevention and treatment of CVDs, such as unstable angina, myocardial infarction (MI), and heart failure (HF) ( Zhou et al, 2016 ; Dong T. et al, 2018 ). There are seven TCM materials contained in the SBP: Artificial Moschus, Radix Ginseng (Root of Panax ginseng C.A.Mey.…”

“…From the perspective of preclinical studies, SBP has demonstrated therapeutic effects on CVDs via various beneficial mechanisms including regulating angiogenesis and coronary artery dilation, repressing inflammation and oxidation stress, improving lipid metabolism, and protecting vascular endothelium ( Ning et al, 2011 ; Xu et al, 2011 ; Zhang et al, 2017 ; Wei et al, 2018 ). Additionally, in terms of clinical practice, the cardiovascular protective roles of SBP have been proven by several randomized controlled trials and expert consensuses on SBP treatment of CVDs ( Zhou et al, 2016 ; Dong T. et al, 2018 ; Fan et al, 2018 ). In the following sections, we provide an overview of basic experiments and clinical studies on the cardiovascular effects of SBP and the underlying mechanism profiles.…”