Systematic Review And Meta-analysis Of Oral Chinese Patent Medicine For Nourishing Qi And Activating Blood In The Treatment Of Unstable Angina Pectoris Of Coronary Heart Disease

Objective:To systematically review the efficacy and safety of oral traditional Chinese medicine for invigorating qi and activating blood circulation combined with conventional western medicine in the treatment of unstable angina,and to provide the evidence of evidence-based medicine about the efficacy and safety of oral traditional chinese medicine for invigorating qi and activating blood circulation for the treatment of unstable angina.Method:Randomized controlled trials on the treatment of unstable angina with oral traditional Chinese medicine for invigorating qi and activating blood circulation from seven databases including CNKI,Wanfang Database,VIP,CBM,PubMed,Embase and Cochrane Library database,were searched by computer.Two evaluators independently screened the literatures according to the inclusion and exclusion criteria,and extracted the data and evaluated the quality of the finally included literatures.In case of any disagreement during the process,the two evaluators shall negotiate or seek the assistance of a third party to solve the problem.RevMan5.3 and STATA SE 12 software was used to analyze the data of the included literatures,and the results were presented in the form of forest plots.Funnel plots were used to detect publication bias,and sensitivity analysis was used to verify whether the results were credible.Results:39 RCTs for the treatment of unstable angina with oral traditional chinese medicine for invigorating qi and activating blood circulation were included finally,including 3956 patients with unstable angina.Among them,2112 patients were in the experimental group and 1844 patients were in the control group.The intervention measures of the experimental group were oral traditional chinese medicine for invigorating qi and activating blood circulation combined with conventional western medicine,while the in tervention measures of the control group were conventional western medicine.12 literatures reported the angina frequency in the unit of times/week,meta-analysis results:SMD=-2.76,95%CI[-3.79,-1.72],P<0.00001,the difference was statistically significant;17 literatures reported the duration of angina attack,meta-analysis results:SMD=-2.03,95%CI[-2.77,-1.29],P<0.00001,the difference was statistically significant;16 literatures reported the ECG efficiency,meta-analysis results:RR=1.21,95%CI[1.14,1.28],P<0.00001,the difference was statistically significant;6 literatures reported the dosage of nitroglycerin daily,meta-analysis results:MD=-0.78,95%CI[-1.00,-0.56],P<0.00001,the difference was statistically significant;2 literatures reported the rate of nitroglycerin stopped reduction,meta-analysis results:RR=1.23,95%CI[1.05,1.45],P=0.01,the difference was statistically significant.4 literatures reported the occurrence of MACE events,meta analysis results:RR=0.38,95%CI[0.22,0.66],P=0.0005,the difference was statistically significant.24 literatures reported the adverse events,meta analysis results:RR=3.01,95%CI[1.71,5.30],P=0.0001,the difference was statistically significant.Conclusion:Oral traditional chinese medicine for invigorating qi and activating blood circulation with conventional western medicine therapy compared with conventional western medicine treatment,have a good curative effect,can improve the ECG efficiency,reduce the dosage of nitroglycerin daily,increase the rate of nitroglycerin stopped reduction,reducing the occurrence of MACE events;It has certain advantages in reducing the unstable angina patients with the angina frequency in the unit of times/week and the duration of angina attack;security can be ok.