Pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Chengyu , ZHANG Xiaoyu , TANG Xiaoyi , LI Min , YANG Xinyu ,  SHANG Hongcai

Kay Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, P.R.China;

Corresponding?author：

SHANG Hongcai, Email: shanghongcai@126.com

Keywords：

Pericarpium trichosanthis injection; Angina pectoris; ECG; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201703032

Video：

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ObjectiveTo systematically review the efficacy and safety of pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris.MethodsDatabases including CBM, CNKI, WanFang Data, VIP, PubMed, The Cochrane Library and Web of Science were searched from inception to February 20^th 2017 to collect randomized controlled trials (RCTs) about pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs involving 1 004 patients were included. The results of meta-analysis showed that: the effective rate of angina symptoms (RR=1.24, 95%CI 1.15 to 1.33, P<0.000 01) and resting ECG (RR=1.30, 95%CI 1.15 to 1.45, P<0.000 1) in pericarpium trichosanthis injection combined with conventional western medicine group were superior to the conventional western medicine group. And the adverse reaction was rare and could be more tolerated in pericarpium trichosanthis injection combined with conventional western medicine group.ConclusionPericarpium trichosanthis injection combined with conventional western medicine can improve the symptoms of angina pectoris and objective indicator of ECG. However, due to the low quality of included studies and lack of evidence, the above results are needed to be validated by further well-designed multicenter, large scale, double blind RCTs.

Citation： LI Chengyu, ZHANG Xiaoyu, TANG Xiaoyi, LI Min, YANG Xinyu, SHANG Hongcai. Pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(9): 1072-1078. doi: 10.7507/1672-2531.201703032 Copy

1.	陳偉偉, 高潤霖, 劉力生, 等. 《中國心血管病報告 2015》概要. 中國循環雜志, 2016, 31(6): 521-528.
2.	Roger VL, Go AS, Lloydjones DM, et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation, 2013, 127(1): 29-322.
3.	任勝男, 許龍, 張冬梅, 等. 老年人群心絞痛患病率: 醫生診斷與 Rose 問卷診斷之比較. 中國老年學, 2015, 35(24): 7070-7072.
4.	Mancini GBJ, Gosselin G, Chow B, et al. Canadian cardiovascular society guidelines for the diagnosis and management of stable ischemic heart disease. Can J Cardiol, 2014, 30(8): 837-849.
5.	Krasopoulos G, Brister SJ, Beattie WS, et al. Aspirin " resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis. BMJ, 2008, 336(7637): 195-198.
6.	Liu L, Gao YH, Cao J, et al. High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome. J Geriatr Cardiol, 2016, 13(6): 531-536.
7.	Xiong XJ, Wang Z, Wang J. Innovative strategy in treating angina pectoris with Chinese patent medicines by promoting blood circulation and removing blood stasis: experience from combination therapy in Chinese medicine. Curr Vasc Pharmacol, 2005, 13(4): 540-553.
8.	張勇. 中藥注射劑治療冠心病心絞痛近況. 北京: 北京中醫藥大學, 2007: 1-27.
9.	Xiong XJ, Borrelli F, de Sá Ferreira A, et al. Herbal medicines for cardiovascular diseases. Evid Based Complement Alternat Med, 2014, 2014: 809741.
10.	王姍姍. 瓜蔞皮的藥理作用及其臨床應用. 山西醫藥雜志, 2009, 38(1): 67-68.
11.	吳嘉瑞. 基于文獻數據庫和傳統藥物警戒思想的中藥注射劑安全性研究. 北京: 北京中醫藥大學, 2007: 1-172.
12.	[No authors listed]. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation, 1979, 59(3): 607-609.
13.	Anderson JL, Adams CD, Antman EM, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-st-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 2011, 123(18): e426-579.
14.	Fraker TD Jr, Fihn SD, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines writing group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. Circulation, 2007, 116(23): 2762-2772.
15.	中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 慢性穩定型心絞痛診斷與治療指南. 中華心血管病雜志, 2007, 35(3): 195-206.
16.	中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 不穩定型心絞痛和非 ST 段抬高心肌梗死診斷與治療指南. 中華心血管病雜志, 2007, 35(3): 295-304.
17.	鄭筱萸. 中藥新藥臨床研究指導原則. 北京: 中國醫藥科技出版社, 2002: 68-73.
18.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: http://handbook. cochrane.org.
19.	劉莉, 牛新萍. 瓜蔞皮注射液對穩定型心絞痛痰瘀互結證血管內皮功能的影響. 中西醫結合心腦血管病雜志, 2014, 12(1): 3-5.
20.	劉頒, 石振東. 瓜蔞皮注射液聯合阿司匹林治療高齡不穩定型心絞痛的臨床效果及對血小板聚集率的影響. 中國療養醫學, 2016, 25(2): 188-190.
21.	史永堂. 新通注射液聯合低分子肝素治療不穩定型心絞痛及對血脂的療效觀察. 中華中醫藥雜志, 2007, 22(11): 804-805.
22.	姜丹. 瓜蔞皮注射液聯合西藥治療不穩定型心絞痛 (痰濁血瘀證) 隨機平行對照研究. 實用中醫內科雜志, 2013, 27(6): 65-67.
23.	張衛三, 劉入源, 洪秀芳. 瓜蔞皮注射液對冠心病穩定型心絞痛的治療. 中華現代內科學雜志, 2006, 3(8): 893-894.
24.	楊麗君. 瓜蔞皮注射液聯合西藥治療痰瘀互結冠心病心絞痛隨機平行對照研究. 實用中醫內科雜志, 2016, 30(12): 61-63.
25.	梅發光, 王忠良, 張義勤, 等. 瓜蔞皮注射液對不穩定型心絞痛患者斑塊穩定性的影響. 河南中醫, 2016, 36(11): 1913-1915.
26.	王群群, 張忠輝. 瓜蔞皮注射液治療冠心病的臨床觀察. 心血管病防治知識 (學術版), 2016, 6(5): 60-62.
27.	趙海燕, 張秉戟. 瓜蔞皮注射液聯用阿司匹林對不穩定性心絞痛患者血小板聚集功能的影響. 中國社區醫師 (醫學專業), 2010, 27(12): 140-141.
28.	黃緒兵. 瓜蔞皮注射液治療冠心病心絞痛 50 例. 醫藥前沿, 2014, 22(8): 165.
29.	趙先, 寧澤瓊, 王婧雯, 等. 瓜蔞皮注射液治療心絞痛安全性和有效性的 Meta 分析. 西北藥學雜志, 2016, 31(1): 86-91.
30.	Xiong XJ. Integrating traditional Chinese medicine into western cardiovascular medicine: an evidence-based approach. Nat Rev Cardiol, 2015, 12(6): e374.

1. 陳偉偉, 高潤霖, 劉力生, 等. 《中國心血管病報告 2015》概要. 中國循環雜志, 2016, 31(6): 521-528.
2. Roger VL, Go AS, Lloydjones DM, et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation, 2013, 127(1): 29-322.
3. 任勝男, 許龍, 張冬梅, 等. 老年人群心絞痛患病率: 醫生診斷與 Rose 問卷診斷之比較. 中國老年學, 2015, 35(24): 7070-7072.
4. Mancini GBJ, Gosselin G, Chow B, et al. Canadian cardiovascular society guidelines for the diagnosis and management of stable ischemic heart disease. Can J Cardiol, 2014, 30(8): 837-849.
5. Krasopoulos G, Brister SJ, Beattie WS, et al. Aspirin " resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis. BMJ, 2008, 336(7637): 195-198.
6. Liu L, Gao YH, Cao J, et al. High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome. J Geriatr Cardiol, 2016, 13(6): 531-536.
7. Xiong XJ, Wang Z, Wang J. Innovative strategy in treating angina pectoris with Chinese patent medicines by promoting blood circulation and removing blood stasis: experience from combination therapy in Chinese medicine. Curr Vasc Pharmacol, 2005, 13(4): 540-553.
8. 張勇. 中藥注射劑治療冠心病心絞痛近況. 北京: 北京中醫藥大學, 2007: 1-27.
9. Xiong XJ, Borrelli F, de Sá Ferreira A, et al. Herbal medicines for cardiovascular diseases. Evid Based Complement Alternat Med, 2014, 2014: 809741.
10. 王姍姍. 瓜蔞皮的藥理作用及其臨床應用. 山西醫藥雜志, 2009, 38(1): 67-68.
11. 吳嘉瑞. 基于文獻數據庫和傳統藥物警戒思想的中藥注射劑安全性研究. 北京: 北京中醫藥大學, 2007: 1-172.
12. [No authors listed]. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation, 1979, 59(3): 607-609.
13. Anderson JL, Adams CD, Antman EM, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-st-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 2011, 123(18): e426-579.
14. Fraker TD Jr, Fihn SD, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines writing group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. Circulation, 2007, 116(23): 2762-2772.
15. 中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 慢性穩定型心絞痛診斷與治療指南. 中華心血管病雜志, 2007, 35(3): 195-206.
16. 中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 不穩定型心絞痛和非 ST 段抬高心肌梗死診斷與治療指南. 中華心血管病雜志, 2007, 35(3): 295-304.
17. 鄭筱萸. 中藥新藥臨床研究指導原則. 北京: 中國醫藥科技出版社, 2002: 68-73.
18. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: http://handbook. cochrane.org.
19. 劉莉, 牛新萍. 瓜蔞皮注射液對穩定型心絞痛痰瘀互結證血管內皮功能的影響. 中西醫結合心腦血管病雜志, 2014, 12(1): 3-5.
20. 劉頒, 石振東. 瓜蔞皮注射液聯合阿司匹林治療高齡不穩定型心絞痛的臨床效果及對血小板聚集率的影響. 中國療養醫學, 2016, 25(2): 188-190.
21. 史永堂. 新通注射液聯合低分子肝素治療不穩定型心絞痛及對血脂的療效觀察. 中華中醫藥雜志, 2007, 22(11): 804-805.
22. 姜丹. 瓜蔞皮注射液聯合西藥治療不穩定型心絞痛 (痰濁血瘀證) 隨機平行對照研究. 實用中醫內科雜志, 2013, 27(6): 65-67.
23. 張衛三, 劉入源, 洪秀芳. 瓜蔞皮注射液對冠心病穩定型心絞痛的治療. 中華現代內科學雜志, 2006, 3(8): 893-894.
24. 楊麗君. 瓜蔞皮注射液聯合西藥治療痰瘀互結冠心病心絞痛隨機平行對照研究. 實用中醫內科雜志, 2016, 30(12): 61-63.
25. 梅發光, 王忠良, 張義勤, 等. 瓜蔞皮注射液對不穩定型心絞痛患者斑塊穩定性的影響. 河南中醫, 2016, 36(11): 1913-1915.
26. 王群群, 張忠輝. 瓜蔞皮注射液治療冠心病的臨床觀察. 心血管病防治知識 (學術版), 2016, 6(5): 60-62.
27. 趙海燕, 張秉戟. 瓜蔞皮注射液聯用阿司匹林對不穩定性心絞痛患者血小板聚集功能的影響. 中國社區醫師 (醫學專業), 2010, 27(12): 140-141.
28. 黃緒兵. 瓜蔞皮注射液治療冠心病心絞痛 50 例. 醫藥前沿, 2014, 22(8): 165.
29. 趙先, 寧澤瓊, 王婧雯, 等. 瓜蔞皮注射液治療心絞痛安全性和有效性的 Meta 分析. 西北藥學雜志, 2016, 31(1): 86-91.
30. Xiong XJ. Integrating traditional Chinese medicine into western cardiovascular medicine: an evidence-based approach. Nat Rev Cardiol, 2015, 12(6): e374.

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Pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris: a meta-analysis

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