Systematic Reviews And Meta-analysis Of Long-term Prognosis About TCM Treatment Of Coronary Heart Disease In Patients After PCI

Objective To evaluate the clinical long-term prognosis of TCM therapy for coronary heart disease after PCI by systematic evaluation and meta-analysis method.And to investigate the therapeutic value of TCM treatment in patients with coronary heart disease after PCI,to provide treatment ideas and objective evidence for clinical Chinese medicine intervention in these patients.Methods All relevant article about the long-term prognosis of coronary heart disease after PCI by TCM treatment were collected from China Academic Journals Full-text Database(CJFD),Wan fang Med Online,Chinese Biomedical Literature Database(CMB dise),Pubmed,Embase,Cochrane Library,VIP Database(deadline for December 2017).And all the collected clinical control experiment were screened,extracted data,and assessed according to Bias risk assessment tool provided by Cochrane collaboration.Eventually 16 studies met the inclusion criteria,including 1676 patients with coronary heart disease after PCI.After assessing the risk of bias using Revman5.3 Meta-analysis software.Major cardiovascular events(recurrence of angina pectoris,postoperative restenosis rate,postoperative recurrence of myocardial infarction,PCI again,coronary artery bypass surgery,the incidence of death),cardiac function indexes(LVEF values),physical and chemical indicators(the change of blood lipid)are the main indicators.Results After rigorous screening and selecting,this study finally included 16 experimental study,a total of 1676 cases of coronary heart disease patients after PCI.Interventions in the treatment group is TCM treatment combined with conventional western medicine,and the control group is conventional western medicine.Meta-analysis of the results by the various outcomes are shown as follows:Relapse of angina pectoris:Compared with the control group,TCM treatment combined with conventional western medicine can significantly reduce the incidence the recurrence of angina pectoris in patients with coronary heart disease after PCI(OR=0.35,95%CI[0.25,0.50],P<0.00001).Coronary artery in-stent restenosis after PCI:the TCM treatment combined western routine medicine can significantly reduce occurrence of coronary artery in-stent restenosis after PCI(OR=0.40,95%CI[0.24,0.67],P=0.0005).Recurrence of myocardial infarction after PCI:After the combined treatments,the patient’s recurrence of myocardial infarction after PCI was reduced more than the control group(OR=0.38,95%CI[0.18,0.81],P=0.01).Cardiogenic death:there was no significant difference between the treatment group and the control group(OR=0.43,95%CI[0.14,1.32],P=0.14)in patients after PCI.Revascularization:TCM treatment combined with western medicine can reduce the risk of revascularization after PCI(OR=0.21,95%CI[0.09,0.50],P=0.0003).Left ventricular ejection fraction(LVEF):the combined treatments can significantly improve levels of the left ventricular ejection fractions in patients(SMD=1.03,95%CI[0.74,1.33],P<0.00001).Triglyceride:traditional Chinese medicine combined with western medicine can reduce the blood triglyceride(SMD=-0.54,95%CI[-0.85,-0.22],P=0.0008).Total cholesterol:the combined treatments can reduce total cholesterol(SMD=-0.55,95%CI[-0.86,-0.24],P=0.0006).Conclusion According to the results of this meta-analysis,we can find that TCM can not only reduce the recurrence of angina pectoris in patients after PCI,still can greatly reduce the incidence of major cardiovascular events,reduce the patients’ blood lipid and the related complications,so as to effectively improve the long-term prognosis of patients.