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Chinese Medicine

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Open Access 01-12-2023 | Coronary Heart Disease | Review

Efficacy and safety of oral Chinese patent medicines in the treatment of coronary heart disease combined with hyperlipidemia: a systematic review and network meta-analysis of 78 trials

Authors: Zhenyu Yang, Jixin Li, Bogeng Zhou, Xuan Ji, Jianying Yuan, Junchen Yan, Xilei Nan, Dandan Guo

Published in: Chinese Medicine | Issue 1/2023

Abstract

Aim of the study

To evaluate the clinical efficacy and safety of commonly used oral Chinese patent medicines for the treatment of coronary heart disease combined with hyperlipidemia in clinical practice through a network meta-analysis.

Materials and methods

PubMed, Embase, Cochrane Library, Web of Science, Wanfang, VIP, SinoMed, and CNKI databases were searched for all published randomized controlled trials (RCTs) on the treatment of coronary heart disease combined with hyperlipidemia using Chinese patent medicines. NoteExpress software was used to screen the literature obtained from the databases according to the inclusion and exclusion criteria. The Cochrane risk of bias assessment tool was used to evaluate the quality of the included studies. A network meta-analysis was performed using R 4.2.1. Subgroup analyses of outcome indicators were made based on conventional treatment (CT) methods. The incidence of adverse events in the included RCTs was statistically analyzed. A funnel plot was drawn using RevMan 5.4.1 software for the assessment of bias in the total clinical effectiveness rate. Finally, the quality of evidence for interventions with statistically significant differences was evaluated using the GRADE system.

Results

A total of 78 RCTs were included, involving 7,955 cases and 8 types of Chinese patent medicines, which were Tongxinluo Capsule, Naoxintong Capsule, Compound Danshen Dripping Pill, Shexiangbaoxin Pill, Songling Xuemaikang Capsule, Xuezhikang Capsule, Yindan Xinnaotong Capsule, and Zhibitai Capsule. A total of 24 RCTs reported the incidence of adverse events, but no statistically significant difference in the incidence of adverse events was found between the experimental and control groups in each study (P > 0.05). There was no obvious publication bias in all studies, but the overall quality of evidence in the included RCTs was low. Comparison of different intervention measures showed that Naoxintong Capsule + CT improved the cardiac index and cardiac output, and lowered the low-density lipoprotein cholesterol and total cholesterol levels. Tongxinluo Capsule + CT raised high-density lipoprotein cholesterol levels and reduced triglyceride levels. Xuezhikang Capsule + CT improved the total clinical effectiveness rate. Subgroup analyses showed that differences in CT did not cause heterogeneity in the results.

Conclusion

Compared with the use of CT alone, the combined use of Chinese patent medicines with CT can effectively improve the symptoms in patients with both coronary heart disease and hyperlipidemia.

Available only for authorised users

Lu Y, Jiang X, Dai W. The roles of a novel inflammatory neopterin in subjects with coronary atherosclerotic heart disease. Int Immunopharmacol. 2015;24(2):169–72. https://doi.org/10.1016/j.intimp.2014.11.013.CrossRef

Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis. Nature. 2011;473(7347):317–25. https://doi.org/10.1038/nature10146.CrossRefPubMed

Hira RS, Gosch KL, Kazi DS, Yeh RW, Kataruka A, Maddox TM, et al. Potential impact of the 2019 ACC/AHA guidelines on the primary prevention of cardiovascular disease recommendations on the inappropriate routine use of aspirin and aspirin use without a recommended indication for primary prevention of cardiovascular disease in cardiology practices: insights from the NCDR pinnacle registry. Circ Cardiovasc Qual Outcomes. 2022;15(3):238–46. https://doi.org/10.1161/CIRCOUTCOMES.121.007979.CrossRef

Okopień B, Bułdak A, Bołdys A. Current and future trends in the lipid lowering therapy. Pharmacol Rep. 2016;68(4):737–47. https://doi.org/10.1016/j.pharep.2016.03.016.CrossRefPubMed

Fan Y, Jin L, Wu Y, Fan Y, Wei Q. Effects of metoprolol on serum inflammatory factors and myocardial ischemia in rats modeled with coronary heart disease. Am J Transl Res. 2021;13(4):2518–27.PubMedPubMedCentral

Lu Y, Wang F, Ni H, Sun Y, Shi H. Observation of curative effect of trimetazidine combined with metoprolol in elderly patients with coronary heart disease complicated with heart failure and the effect of myocardial remodeling by integrated traditional Chinese and western medicine. Biomed Res Int. 2022;30(9):609–19. https://doi.org/10.1155/2022/6098799.CrossRef

Singh S, Zahoor I, Sharma N, Behl T, Kanojia N, Sehgal A, et al. Insights into the pivotal role of statins and its nanoformulations in hyperlipidemia. Environ Sci Pollut Res Int. 2022;29(51):76514–31.PubMedCrossRef

Mukhtar RY, Reckless JP. Statin-induced myositis: a commonly encountered or rare side effect? Curr Opin Lipidol. 2005;16(6):640–7. https://doi.org/10.1097/01.mol.0000188414.90528.71.CrossRefPubMed

Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, et al. The Prisma extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015;162(11):777–84. https://doi.org/10.7326/M14-2385.CrossRefPubMed

10.

Yan HB. US Guidelines for the diagnosis and treatment of coronary artery disease. Beijing: China Environmental Science Press; 2004.

11.

Zheng G. New guidelines to guide clinical practice—2007 guidelines for the diagnosis and treatment of coronary heart disease. Acta Med Sin. 2008;21(3):575–7.

12.

Chinese MA, Chinese MJPH, Chinese SOGP, Practitioners EBOT, Diseases EGOT. Guideline for primary care of stable coronary artery disease (2020). Chin J Gen Practition. 2021;20(3):265–73. https://doi.org/10.3760/cma.j.cn114798-20210120-00079. (in Chinese).CrossRef

13.

Chen Y, Chen YB, Tao RF. Interpretation of “guideline for prevention and treatment of dyslipidemia in Chinese adults in 2016.” Chin J Pract Intern Med. 2017;37(S1):38–42 (in Chinese).

14.

Xiang H, Qiu L, Zhao H, Li H, Xie TH, Yang T, et al. Implementation of Bayesian network meta-analysis with bugsnet package in r software. Chin J Evidence-Based Med. 2022;22(05):600–8 (in Chinese).

15.

Chen C. Clinical efficacy of compound DANSHEN dropping pills combined with atorvastatin in treatment of coronary heart disease complicated with hyperlipidemia and its effect on serum trail. Fuji J Tradit Chin Med. 2022;53(5):7–09 (in Chinese).

16.

Chen ST, Shi PJ, Huang DB. Observation on curative effect of compound Danshen drop pills for coronary heart disease combined with hyperlipemia. J Med Theo Pract. 2007;19(07):750–2. https://doi.org/10.19381/j.issn.1001-7585.2007.07.004. (in Chinese).CrossRef

17.

Chen XZ. Effect of Danshen dripping pills combined with atorvastatin on elderly patients with coronary heart disease combined with abnormal lipid metabolism. Inn Mong J Tradit Chin Med. 2019;38(10):22–3 (in Chinese).

18.

Deng CL. Clinical efficacy of coronary heart disease combined hyperlipidemia CSDP joint alto-generation statin therapy. Mod Diagn Treat. 2015;26(08):1754–5 (in Chinese).

19.

Dong ZQ. Analysis of the efficacy of combined Chinese and western medicine in the treatment of coronary artery disease combined with hyperlipidemia. J front Med. 2017;7(27):99–100. https://doi.org/10.3969/j.issn.2095-1752.2017.27.081. (in Chinese).CrossRef

20.

Gao TW. Effect of compound Danshen dripping pills combined with atorvastatin on coronary heart disease combined with hyperlipidemia and serum trail. Wmn Health Res. 2021;8(2):19–20 (in Chinese).

21.

Guo HM. Clinical observation on the treatment of coronary heart disease combined with hyperlipidemia by combining compound Danshin drops with simvastatin. J North Pharm. 2016;13(07):47 (in Chinese).

22.

Jin JB, Xie JD. Study the clinical 64 cases efficacy of treatment of coronary heart disease with hyperlipidemia using simvastatin with compound Danshen dripping pills. Sma Healthc. 2019;5(02):106–8. https://doi.org/10.19335/j.cnki.2096-1219.2019.02.045. (in Chinese).CrossRef

23.

Li J. Clinical observation on the treatment of coronary heart disease combined with hyperlipidemia by combining compound Danshin drops with rosuvastatin. Guangming J Chin Med. 2018;33(14):2102–3 (in Chinese).

24.

Li SJ. Clinical efficacy of compound salvia drops in combination with resulvastatin or resulvastatin alone in the treatment of patients with coronary artery disease combined with hyperlipidemia. J Math Med. 2017;30(11):1663–4 (in Chinese).

25.

Li SS, Zhang Y, Zhang M. Clinical analysis of salvia miltiorrhiza combined with rosuvastatin calcium in the treatment of coronary heart disease complicated with hyperlipidemia. J N Sichuan Med Coll. 2019;34(4):448–51.

26.

Li T. A comparative study of combination therapy with Fufang Danshen drop pill and simvastatin and simvastatin alone oncoronary artery disease with hyperlipidemia. Chin Res Hosp. 2017;4(3):20–3 (in Chinese).

27.

Liu YC. Clinical efficacy analysis of compound salvia drops combined with resulvastatin calcium in the treatment of coronary artery disease combined with hyperlipidemia. Chin Pract Med. 2014;9(22):183–4. https://doi.org/10.14163/j.cnki.11-5547/r.2014.22.016. (in Chinese).CrossRef

28.

Rong CL. The clinical efficacy of compound Danshen dropping pilltreatment on 80 cases with angina pectoris complicated with hyperlipidemia. Chin Med Pharm. 2014;4(19):86–7, 97 (in Chinese).

29.

Shen SX. Clinical analysis of compound Danshin drops combined with resulvastatin in the treatment of coronary artery disease combined with hyperlipidemia. Diet Health. 2020;7(12):93 (in Chinese).

30.

Wang HX, Hu JX. Efficacy analysis of compound Danshen dripping pills and atorvastatin in elderly patients with coronary heart disease complicated with abnormal blood lipid metabolism. Wld Chin Med. 2018;13(10):2433–6 (in Chinese).

31.

Wang L. Clinical effects of combined Chinese and western medicine treatment (compound danshin drops combined with rosuvastatin) in patients with coronary artery disease combined with hyperlipidemia. Chin Health Food. 2021;20(12):170–1 (in Chinese).

32.

Wang LM, Xu JF, Chen WJ, Wang RX, Zhang N. Efficacy of Fufang Danshen dripping pills combined with atorvastatin on coronary heart disease with hyperlipidemia and its influence on hemorheology. Chin J Clin Healthc. 2015;18(05):489–92 (in Chinese).

33.

Wu WJ. Analysis of the efficacy of the combination of rosuvastatin and compound Danshin drops in the treatment of coronary heart disease combined with hyperlipidemia. China Health C Nutr. 2020;30(21):250 (in Chinese).

34.

Wu ZC. Clinical efficacy of compound Danshin drops combined with rosuvastatin calcium in the treatment of coronary artery disease combined with hyperlipidemia. Chin J Clin Ration Drug Use. 2020;13(34):32–3 (in Chinese).

35.

Xie K, Zeng SZ, Lai XW, Xia DN, Huang LJ, Yang F, et al. Effect of compound Danshen dripping pill combined with atorvastatin on coronary heart disease and hyperlipidemia in patients with heart function. J Front Med. 2018;8(25):20–1. https://doi.org/10.3969/j.issn.2095-1752.2018.25.016. (in Chinese).CrossRef

36.

Xie SM, Wei NN, Wei J, Chen B. Effect of compound Danshen dripping pills combined with western medicine on coronary disease with abnormal blood lipid metabolism and its influence on blood viscosity and vascular endothelial function. Chin Arch Tradit Chin Med. 2020;38(4):162–5 (in Chinese).

37.

Xu L. Curative effect of Fufang Danshen gutta pills combining rosuvastatin on coronary heart disease complicating hyperlipidemia. Chin J Evidence-Based Med. 2014;6(1):99–101 (in Chinese).

38.

Xu YX. Analysis of the efficacy of combined Chinese and western medicine in the treatment of coronary artery disease combined with hyperlipidemia. Cardiovasc Dis Electron J Integr Tradit Chin West Med. 2014;2(17):114–5. https://doi.org/10.16282/j.cnki.cn11-9336/r.2014.17.089. (in Chinese).CrossRef

39.

Zhang HL, Zhao BC, Liu YP. Therapeutic effect of compound Danshen dripping pills combined atorvastatin on coronary heart diseasecomplicated hyperlipidemia and its influence on serum trail level. Chin J Cardiovasc Rehabil Med. 2019;28(03):360–4 (in Chinese).

40.

Zhang Y. Clinical efficacy of lovastatin combined with compound salvia drops in the treatment of hyperlipidemia combined with coronary artery disease. Natl Med Front Chin. 2013;8(16):97–8 (in Chinese).

41.

Zhao M. Clinical efficacy of compound Danshin drops in combination with rosuvastatin in the treatment of patients with coronary artery disease combined with hyperlipidemia. Wld Lat Med Inf. 2018;18(93):147–8. https://doi.org/10.19613/j.cnki.1671-3141.2018.93.123. (in Chinese).CrossRef

42.

Bai L. Effects of Buchangnaoxintong capsule in the treatment of coronary heart disease elderly pa-tients with hyperlipidemia. J Hainan Med Univ. 2012;18(11):1599–601 (in Chinese).

43.

Chen HS, Chen XY, Hou XL, Hong JK. Effect of Bu Chang brain and heart capsules on blood lipids and blood sedimentation rate in patients with angina pectoris combined with hyperlipidemia in coronary heart disease. Hunan J Tradit Chin Med. 2016;32(01):40–1. https://doi.org/10.16808/j.cnki.issn1003-7705.2016.01.022. (in Chinese).CrossRef

44.

Duan XF, Zhang H, Zhang SR. Clinical study on the treatment of coronary heart disease combined with dyslipidemia with brain heart capsules. J Tod Health. 2015;14(2):234 (in Chinese).

45.

Gao AB, Wang LL, Wang JH. Effects of Buchangnaoxintongjiaonang (bcnxt) on blood lipid and plasma endothelin in patients with coronary artery disease. Chin J Integr Med Cardio-Cerebrovasc Dis. 2007;23(06):482–3 (in Chinese).

46.

Gao LX, Wang GQ, Liu KK. Efficacy of brain heart capsules combined with isosorbide nitrate tablets in the treatment of coronary heart disease with dyslipidemia. Ppl Milit Surg. 2011;54(04):307–8 (in Chinese).

47.

Hao YX, Wei FG, Lou JT. Clinical efficacy of Bu Chang brain and heart capsules in patients with coronary heart disease combined with hyperlipidemia. Wld Lat Med Inf. 2016;16(84):168 (in Chinese).

48.

Li Q. Efficacy observation on treatment of coronary heart disease with hyperlipoproteinemia by naoxintong capsules combined with simvastatin. Clin J Chin Med. 2016;8(03):36–8 (in Chinese).

49.

Li XM, Yan L. Clinical efficacy of Bu Chang brain heart tong on 32 cases of coronary heart disease combined with dyslipidemia in the elderly. Yunnan J Tradit Chin Med Mater Med. 2008;28(02):9–10. https://doi.org/10.16254/j.cnki.53-1120/r.2008.02.003. (in Chinese).CrossRef

50.

Lu ZY. Clinical study on the treatment of coronary heart disease combined with dyslipidemia with brain heart capsules. J Front Med. 2014;35(36):184. https://doi.org/10.3969/j.issn.2095-1752.2014.36.181. (in Chinese).CrossRef

51.

Wan MY, Lu Y, Luo YH. Clinical observation of Naoxintong capsules combined with simvastatin for treating coronary heart disease complicated with hyperlipidemia. Chin Pharm. 2018;27(04):47–9 (in Chinese).

52.

Wang QJ. Analysis of the efficacy of cerebroxin on coronary heart disease combined with dyslipidemia. Asia-Pac Tradit Med. 2015;11(3):124–5 (in Chinese).

53.

Wu JH. Clinical effect of Buchangnaoxintong capsule in the treatment of coronary heart disease patients with hyperlipidemia. Chin Med Her. 2011;8(34):186–7 (in Chinese).

54.

Zhang FJ, Chen L, Wang ZX, Fan XY, Ju MF. Clinical study on the treatment of coronary heart disease combined with dyslipidemia with brain heart capsules. Hebei Med. 2014;20(12):2048–9 (in Chinese).

55.

Zhang GT, Zhang H, Yang G. Influence of Naoxintong capsule on adiponectin and endothelial function of coronary heart disease patients with hyperlipidemia. Chin J Exp Tradit Med Formulae. 2013;19(22):295–8 (in Chinese).

56.

Cao QH. Effects of muscovy heart pill combined with simvastatin on lipid levels and endothelial function in patients with coronary heart disease with hyperlipidemia. Med Forum. 2020;24(7):1027–8 (in Chinese).

57.

Hu F. Effects of Shexiang Baoxin pills combined with simvastatin in treatment of coronary heart disease and hyperlipidemia. Med J Chin Ppl Health. 2021;33(24):89–92 (in Chinese).

58.

Hu YM, Cai HJ, Mao XQ. Clinical research of Shexiang Baoxin pill in treating angina pectoris with hyperlipoidemia. China J Chin Med. 2012;27(12):1637–8. https://doi.org/10.16368/j.issn.1674-8999.2012.12.050. (in Chinese).CrossRef

59.

Peng YY, Yan XM. Efficacy of Shexiang Baoxin pills combined with atorvastatin in the treatment of coronary heart disease with hyperlipidemia. Shanghai Med Pharm J. 2021;42(17):37–9, 52 (in Chinese).

60.

Song W, Lin ZJ, Cai HP, Xu YS. A comparative study of combination therapy with Shexiang Baoxin pill and simvastatin and simvastatin alone on coronary artery disease with hyperlipidemia. Chin J Gen Pract. 2017;15(4):617–9, 633 (in Chinese).

61.

Zhang YJ. Clinical study of muscovado heart pill combined with rosuvastatin in the treatment of coronary heart disease combined with hyperlipidemia. Mod Diagn Treat. 2019;30(17):2989–91 (in Chinese).

62.

Cai ZQ, Yuan HY, Yu Y. Effect of Songlingxuemaikang capsule combined with simvastatin for treating coronary heart disease angina and hyperlipidemia in 48 cases. China Pharm. 2015;24(17):29–30 (in Chinese).

63.

Li CF. 40 cases of stable coronary artery disease with hyperlipidemia treated with songling blood vascular health capsules. Pract Clin J Integr Tradit Chin West Med. 2018;18(5):7–09 (in Chinese).

64.

Yang J. Clinical observation of 35 cases of coronary artery disease with hyperlipidemia treated with songling blood vascular health capsule. Chin J Trauma Disabil Med. 2014;22(13):141–2 (in Chinese).

65.

Cai HJ. Clinical observation of Tongxinluo capsule in the treatment of angina pectoris with hyperlipidemia in coronary atherosclerotic heart disease. Hebei J Traditi Chin Med. 2006;12(03):216–7 (in Chinese).

66.

Chen XH. Efficacy of Tongxinluo in the treatment of exertional angina pectoris with hyperlipidemia. J Guangdong Pharm Univ. 2004;19(01):81–2. https://doi.org/10.16809/j.cnki.1006-8783.2004.01.032. (in Chinese).CrossRef

67.

He Y. Observation of Tongxinluo capsule in ’treatment of coronary artery disease complicated with hyperlipemia. J Emerg Tradit Chin Med. 2008;16(08):1082–3 (in Chinese).

68.

Hu YM. Clinical observation on the treatment of angina due to coronary heart disease and hyperlipemia with integrated tcm and wm, a report of 56 cases. Shanxi J Tradit Chin Med. 2005;20(01):24–5 (in Chinese).

69.

Jiang Y. Clinical effect of Tongxinluo capsule combined with atorvastatin calcium tablets in the treatment of coronary heart disease combined with hyperlipidemia. J Community Med. 2016;14(03):29–31 (in Chinese).

70.

Kou TC. Clinical value of Tongxinluo capsule combined with atorvastatin calcium tablets in the treatment of coronary artery disease combined with hyperlipidemia. China Health Vis. 2022;29(2):153–4 (in Chinese).

71.

Li QY. 60 cases of coronary heart disease and angina combined with hyperlipidemia treated with Tongxinluo capsule. J Heze Med Coll. 2004;15(02):19–21 (in Chinese).

72.

Li XS, Zhu XM. Clinical study of Tongxinluo capsule for the treatment of angina pectoris with hyperhomocysteinemia in coronary heart disease. Clin Med (Lond). 2016;36(12):124–5 (in Chinese).

73.

Ni JB. Efficacy of Tongxinluo in the treatment of angina pectoris combined with hyperlipidemia in coronary heart disease. Med Inf. 2014;56(27):252 (in Chinese).

74.

Sun HW. Effectiveness of trimetazidine combined with tongxinluo capsule in the treatment of angina pectoris with dyslipidemia in coronary heart disease. Henan Med Res. 2018;27(11):2026–7 (in Chinese).

75.

Wang ZT. Efficacy of Tongxinluo capsule in the treatment of angina pectoris with hyperhomocysteinemia in coronary heart disease. Chin J Integr Med Cardio-Cerebrovasc Dis. 2016;14(2):166–8. https://doi.org/10.3969/j.issn.1672-1349.2016.02.019. (in Chinese).CrossRef

76.

Zhang QD, Zhang YQ, Wang XL. Effect of Tongxinluo capsule on blood lipid and plasma endothelin in patients with coronary artery disease. J Heze Med Coll. 2005;16(04):15–7 (in Chinese).

77.

Zhang YX. Efficacy of trimetazidine combined with Tongxinluo capsule in the treatment of angina pectoris with dyslipidemia in coronary artery disease. Henan Med Res. 2017;26(3):537–8 (in Chinese).

78.

Zhang YQ, Zhang X. Clinical observation of 60 cases of angina pectoris with hyperlipidemia in coronary heart disease treated with Tongxinluo capsule. Chin J Integr Med Cardio-Cerebrovasc Dis. 2005;21(11):71–2 (in Chinese).

79.

Zhou T. Clinical effects of Tongxinluo capsule combined with atorvastatin calcium tablets in the treatment of coronary artery disease combined with hyperlipidemia. Chin J Clin Ration Drug Use. 2021;14(29):32–4 (in Chinese).

80.

Zhou YJ. Efficacy of the combination of rosuvastatin and Tongxinluo capsule in the treatment of coronary heart disease combined with hyperlipidemia. China Health C Nutr. 2017;27(35):100. https://doi.org/10.3969/j.issn.1004-7484.2017.35.129. (in Chinese).CrossRef

81.

Huang SX, Yin JZ, Pan M, Liang QL. Efficacy of lipocon in the treatment of angina pectoris and dyslipidemia in the elderly with coronary artery disease. Contemp Med. 2009;15(13):128–9 (in Chinese).

82.

Li XM, Yan L, Huang H. Clinical observation of lipid-regulating treatment with Chinese medicine blood lipid kang. J Clin Exp Med. 2009;8(07):114–5 (in Chinese).

83.

Qu H. Clinical evaluation of Xuezhikang capsule treatment of coronary heart disease with dyslipidemia. Mod Diagn Treat. 2015;26(22):5081–3 (in Chinese).

84.

Qu J, Ren YY, Zhang XY. Effect of Xuezhikang capsule combined with pitavastatin in the treatment of coronary heart disease complicated with hyperlipidemia and its influences on glucose and lipid metabolism and cardiac function. Clin Res Pract. 2020;5(33):28–30. https://doi.org/10.19347/j.cnki.2096-1413.202033011. (in Chinese).CrossRef

85.

Zhao YC, Li XR, Zeng DH. Effects of Xuezhikang treatment of coronary heart disease and high blood lipid. West China Med J. 2008;22(05):1053–4 (in Chinese).

86.

Dong Y, Chen B, Wang WL, Qi XY, He L, Yang XX. Efficacy of yin dan xin nong tong soft capsule in the treatment of cardiovascular diseases with hyperlipidemia. Chin J Integr Med Cardio-Cerebrovasc Dis. 2012;10(05):615–6 (in Chinese).

87.

He F, Shi X, Han Y, Chen A, Sun Y. Efficacy of yin dan xin nong tong soft capsule in the treatment of coronary heart disease and hyperlipidemia. Proc Clin Med. 2008;1(17):823–4 (in Chinese).

88.

Pang N, Deng MH, Ou JX, Chen K. Effect of yin dan xin nong tong soft capsule on blood lipid and hcy level in patients with coronary heart disease with dyslipidemia. Chin J Integr Med Cardio-Cerebrovasc Dis. 2018;16(3):337–8 (in Chinese).

89.

Qu LL, Tao JJ, Dai YQ, Chen F. Efficacy of the combination of Yindan Xinnaotong soft capsules and rosuvastatin calcium in patients with coronary heart disease and hyperlipidemia. Northwest Pharm J. 2017;6:775–9 (in Chinese).

90.

Chen J. Evaluation of the lipid lowering ability and clinical safety of the joint using of Zhibitai capsule with atorvastatin [硕士]. Wuhu, Wannan Medical College; 2013. (in Chinese).

91.

Liu J, Tao T, Wang ND, Cai R. Effect of Zhibitai combined with rosuvastatin on patients with dyslipidemia of coronary heart disease. Clin Res Pract. 2019;4(24):29–30, 33 (in Chinese).

92.

Shi M. Efficacy of lipitor in the treatment of coronary artery disease combined with hyperlipidemia. J Mod Med Health. 2008;7(15):2257–8 (in Chinese).

93.

Wang SQ. New strategies for the study of the molecular mechanism of action of Chinese medicine. Chin J Pharm Toxicol. 2019;33(09):647 (in Chinese).

94.

Geng HJ, Xie YM, Wang ZF. clinical comprehensive evaluation of Naoxintong capsules in treatment of cerebral infarction with qi deficiency and blood stasis syndrome and coronary heart disease angina pectoris. Zhongguo Zhong Yao Za Zhi. 2021;46(23):6087–95. https://doi.org/10.19540/j.cnki.cjcmm.20210930.504.CrossRefPubMed

95.

Han J, Tan H, Duan Y, Chen Y, Zhu Y, Zhao B, et al. The cardioprotective properties and the involved mechanisms of Naoxintong capsule. Pharmacol Res. 2019;141:409–17. https://doi.org/10.1016/j.phrs.2019.01.024.CrossRefPubMed

96.

Li WX, Zhang SQ, Zhao YD, Tang JF, Li CX, Wang XY, et al. Study progress on chemical compounds, pharmacological action and clinical application of Naoxintong capsule. Zhongguo Zhong Yao Za Zhi. 2018;43(10):1998–2005.PubMed

97.

Wang J, Zhao T, Li J, Dong Y, Yang XC, Zhao C, et al. Overview of clinical efficacy and mechanism of action of brain heart capsules in the treatment of coronary heart disease. J Tradit Chin Med. 2020;61(09):814–7. https://doi.org/10.13288/j.11-2166/r.2020.09.019. (in Chinese).CrossRef

98.

Li QN, Shang JF, Jiang TY, Bi L, Jiao JK, Lu YH, et al. Exploration of mechanism of “simultaneous treatment of brain and heart” of Naoxintong capsules based on toll-like receptor signaling pathway. China J Chin Mater Med. 2022;47(15):4110–8. https://doi.org/10.19540/j.cnki.cjcmm.20220211.401. (in Chinese).CrossRef

99.

Krüger-Genge A, Blocki A, Franke RP, Jung F. Vascular endothelial cell biology: an update. Int J Mol Sci. 2019;20(18):1335–42. https://doi.org/10.3390/ijms20184411.CrossRef

100.

Samarakoon R, Higgins SP, Higgins CE, Higgins PJ. The tgf-β1/p53/pai-1 signaling axis in vascular senescence: role of caveolin-1. Biomolecules. 2019;9(8):1225–36. https://doi.org/10.3390/biom9080341.CrossRef

101.

Li WX, Li MM, Niu L, Zhang SQ, Zhang H, Wang XY, et al. Study on the mechanism of activating blood and removing stasis of Naoxintong capsule based on plasma metabolomics and network pharmacology. Chin J Integr Tradit West Med. 2022;41(6):1–08 (in Chinese).

102.

Liu Q, Dong T, Xi M, Gou L, Bai Y, Hou L, et al. Tongxinluo capsule combined with atorvastatin for coronary heart disease: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2021;2021:9413704.PubMedPubMedCentral

103.

Hui J, Yuan R, Li P, Xin Q, Miao Y, Shen X, et al. Efficacy and safety of different courses of Tongxinluo capsule as adjuvant therapy for coronary heart disease after percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials. J Clin Med. 2022. https://doi.org/10.3390/jcm11112991.CrossRefPubMedPubMedCentral

104.

Lv J, Liu S, Guo S, Gao J, Song Q, Cui X. Tongxinluo capsule as supplementation and cardiovascular endpoint events in patients with coronary heart disease: a systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials. J Ethnopharmacol. 2022;289: 115033. https://doi.org/10.1016/j.jep.2022.115033.CrossRefPubMed

105.

Li JY, Guo ZG. The efficacy of Tongxinluo capsule on patients with coronary heart disease after intervention and its effect on vascular endothelial function and inflammatory factors. Chin Tradit Pat Med. 2019;41(05):1202–4 (in Chinese).

106.

Jiang XJ, Li JX, Zhang QY, Zong WJ. Effect of Tongxinluo capsules on inflammation in apoe-/- atherosclerotic mice based on wnt/β-catenin pathway. J Emerg Tradit Chin Med. 2023;32(01):43–6 (in Chinese).

107.

Zhang M, Liu Y, Xu M, Zhang L, Liu Y, Liu X, et al. Carotid artery plaque intervention with Tongxinluo capsule (capital): a multicenter randomized double-blind parallel-group placebo-controlled study. Sci Rep. 2019;9(1):4545. https://doi.org/10.1038/s41598-019-41118-z.CrossRefPubMedPubMedCentral

108.

Wang Y, Chen ZH, Liu GH, Zhang F, Zhang Z, Guan XF, et al. Adjunctive therapy of Xuezhikang capsule for coronary heart disease: a systematic review and meta-analysis of randomized controlled trials. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2014;34(10):1182–91.PubMed

109.

Shang Q, Liu Z, Chen K, Xu H, Liu J. A systematic review of Xuezhikang, an extract from red yeast rice, for coronary heart disease complicated by dyslipidemia. Evid Based Complement Alternat Med. 2012;2012: 636547. https://doi.org/10.1155/2012/636547.CrossRefPubMedPubMedCentral

110.

Feng SJ, Tang XY, Wang Y, Kuang ZM. Beyond lipid-lowering: progress in researches for Xuezhikang in cardiovascular protection and its mechanisms. Chin J New Drugs. 2019;28(10):1192–6 (in Chinese).

111.

Lin CH, Lin TH, Pan TM. Alleviation of metabolic syndrome by monascin and ankaflavin: the perspective of monascus functional foods. Food Funct. 2017;8(6):2102–9. https://doi.org/10.1039/c7fo00406k.CrossRefPubMed

112.

Sun L, Zhang YN. Compound Danshen dripping pills in treating with coronary heart disease: a protocol for systematic review and meta-analysis. Medicine (Baltimore). 2022;101(7): e28927. https://doi.org/10.1097/MD.0000000000028927.CrossRefPubMed

113.

Lv L, Yuan X, Jiang L. Effects of compound Danshen dropping pills on adverse cardiovascular events and quality of life after percutaneous coronary intervention in patients with coronary heart disease: a protocol for systematic review and meta-analysis. Medicine (Baltimore). 2022;101(8): e28994. https://doi.org/10.1097/MD.0000000000028994.CrossRefPubMed

114.

Luo J, Song W, Yang G, Xu H, Chen K. Compound Danshen (salvia miltiorrhiza) dripping pill for coronary heart disease: an overview of systematic reviews. Am J Chin Med. 2015;43(1):25–43. https://doi.org/10.1142/S0192415X15500020.CrossRefPubMed

115.

Wang M, Shan Y, Sun W, Han J, Tong H, Fan M, et al. Effects of Shexiang Baoxin pill for coronary microvascular function: a systematic review and meta-analysis. Front Pharmacol. 2021;12: 751050. https://doi.org/10.3389/fphar.2021.751050.CrossRefPubMedPubMedCentral

116.

Wei J, Liu S, Wang X, Li B, Qiao L, Wang Y, et al. Efficacy and safety of Shexiang Baoxin pill for coronary heart disease after percutaneous coronary intervention: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2021;2021:2672516. https://doi.org/10.1155/2021/2672516.CrossRefPubMedPubMedCentral

117.

Wei J, Ma T, Zhou C, Hao P, Li B, Wang X, et al. Efficacy and safety of Shexiang Baoxin pill for stable coronary artery disease: a systematic review and meta-analysis of 42 randomized controlled trials. Front Pharmacol. 2022;13:1002713. https://doi.org/10.3389/fphar.2022.1002713.CrossRefPubMedPubMedCentral

118.

Chen M, Li Y, Men L, Zhang Z, Zhong X, Yang S, et al. Efficacy and safety of Zhibitai in treating coronary heart disease patients with hyperlipemia: a protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020;99(36): e21991. https://doi.org/10.1097/MD.0000000000021991.CrossRefPubMed

119.

Li MH, Li Y, Chen MT, Lin HD, Wu YH, Zhang Z. Meta-analysis of Zhibitai capsules combined with statin in reducing blood lipid levels in patients with coronary heart disease. Zhongguo Zhong Yao Za Zhi. 2020;45(12):2966–74. https://doi.org/10.19540/j.cnki.cjcmm.20200211.502.CrossRefPubMed

Title: Efficacy and safety of oral Chinese patent medicines in the treatment of coronary heart disease combined with hyperlipidemia: a systematic review and network meta-analysis of 78 trials
Authors: Zhenyu Yang
Jixin Li
Bogeng Zhou
Xuan Ji
Jianying Yuan
Junchen Yan
Xilei Nan
Dandan Guo
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Coronary Heart Disease
Published in: Chinese Medicine / Issue 1/2023
Electronic ISSN: 1749-8546
DOI: https://doi.org/10.1186/s13020-023-00866-x

At a glance: The STEP trials

Springer Medicine

Efficacy and safety of oral Chinese patent medicines in the treatment of coronary heart disease combined with hyperlipidemia: a systematic review and network meta-analysis of 78 trials

Abstract

Aim of the study

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Aim of the study

Materials and methods

Results

Conclusion

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