Meta Analysis Of Xuefu Zhuyu Decoction In Treating Angina Pectoris Of Coronary Heart Disease

Objective:Objective to evaluate the efficacy and safety of Xuefu Zhuyu Decoction in the treatment of angina pectoris of coronary heart disease(CHD).Methods:According to the key words,the retrieval strategy was formulated.Electronic database and manual literature retrieval were used to search the literatures in CNKI,Wanfang database,VIP,Pub Med and Cochrane Library.The retrieval scope was set from the establishment of the database to December 2020.The literature type was clinical randomized controlled trials of Xuefu Zhuyu Decoction in the treatment of coronary heart disease and angina pectoris,The retrieved literature titles were imported into Noteexpress to eliminate duplicate literatures,the remaining literatures were read with titles and abstracts,the non-conforming literatures were excluded,and then the remaining literatures were read in full text.The literatures meeting the inclusion and exclusion criteria were extracted for data extraction,and the quality of literatures was evaluated by using Cochrane risk bias assessment tool,Review managers.5.4 software was used for metaanalysis of related outcome indicators,and forest map and funnel chart were drawn.Results:(1)A total of 41 studies were included,including 3395 patients(2)Meta analysis showed that Xuefu Zhuyu Decoction Combined with conventional western medicine had significant advantages in the treatment of angina pectoris.After treatment,the clinical total effective rate,ECG effective rate,HDL-C,as,AF,TS,DS and LVEF in the treatment group were higher than those in the control group(P < 0.00001,P < 0.00001,P = 0.0002,P < 0.0001,P < 0.0001,P < 0.0001,P < 0.0001,P < 0.0001,P < 0.00001);TC,TG,LDL-C,frequency and duration of angina pectoris,plasma viscosity,whole blood viscosity low shear,whole blood viscosity high shear,BNP treatment group were lower than control group(P < 0.00001,P < 0.00001,P< 0.00001,P < 0.00001,P < 0.00001,P < 0.00001,P = 0.00008,P < 0.00001,P < 0.00001,P < 0.00001,P < 0.00001);There was no significant difference between the treatment group and the control group in terms of PL and incidence of adverse reactions(P = 0.05,P = 0.12).(3)According to the type of patients with angina pectoris,subgroup analysis found that for patients with stable angina pectoris,the clinical total effective rate,HDL-C,LVEF in the treatment group were higher than those in the control group(P < 0.00001,P < 0.00001,P < 0.00001);The frequency,duration,TC,TG,LDL-C,plasma viscosity,whole blood viscosity high shear,whole blood viscosity low shear in the treatment group were lower than those in the control group(P < 0.00001,P = 0.00004,P < 0.00001,P <0.00001,P < 0.00001,P < 0.00001,P = 0.005);There was no significant difference in ECG effective rate and adverse reactions between the treatment group and the control group(P = 0.04,P = 0.83).For patients with unstable angina pectoris,after treatment,the clinical total effective rate,ECG effective rate,HDL-C,LVEF in the treatment group were higher than those in the control group(P < 0.00001,P = 0.0003,P = 0.004,P < 0.00001),the attack frequency,duration,TC,TG,LDL-C,plasma viscosity,whole blood viscosity high shear,whole blood viscosity low shear,BNP in the treatment group were lower than those in the control group(P < 0.00001,P < 0.00001)P < 0.00001 、 P < 0.00001 、 P < 0.00001 、 P < 0.00001 、 P < 0.00001 、P=0.0006、P<0.00001、P=0.002);There was no significant difference in adverse reactions between the treatment group and the control group(P =0.30).(4)Sensitivity analysis showed that the heterogeneity and stability of the results were affected by the types of angina pectoris,treatment regimens and course of disease.(5)Funnel plot suggested that there was publication bias in all the results,which had an impact on the research results.Conclusion:(1)Xuefu Zhuyu Decoction in the treatment of angina pectoris of coronary heart disease can improve the clinical total effective rate,improve the symptoms of angina pectoris,reduce blood lipid level,reduce blood viscosity,and improve myocardial contractile function;(2)There was no significant difference in the adverse reactions of Xuefu Zhuyu Decoction in the treatment of angina pectoris;(3)Xuefu Zhuyu Decoction can benefit both SAP and UA patients in the adjuvant treatment of angina pectoris of coronary heart disease.It can improve the clinical total effective rate,reduce blood lipid level,reduce blood viscosity,improve myocardial systolic function,and improve the ECG effective rate for UA patients.