| Objective:To systematically evaluate the clinical efficacy and safety of Zhishi Xiebai guizhi decoction and its modification in the treatment of angina pectoris in coronary heart disease.Methods:Search 7 Chinese and English databases including Pubmed 、Embase 、 Cochrane Library,CNKI 、 Wanfang database 、 VIP 、 Chinese Biomedical Literature Database(CBM),all Randomized Controlled Trials(RCT)of Zhishi Xiebai Guizhi decoction in the treatment of coronary heart disease angina pectoris published from the establishment of the database to January 1,2022 were collected.Strictly follow the inclusion and exclusion criteria to screen the retrieved research literature,and used Note Express and Excel to organize research and collect data.Finally,usde the Cochrane handbook to evaluate the quality of the article,and used Rev Man5.3to perform a meta-analysis of the studied outcome data.Result:1.Contained literature information : A total of 422 literatures were retrieved from the selected database,and 14 RCT literatures were obtained after inclusion and screening criteria.A total of 1308 patients were included,including 653 patients in the experimental(modified Zhishi Xiebai Guizhi decoction combined with conventional western medicine treatment)group and655 in the control(conventional western medicine treatment)group.2.Quality assessment:The risk of bias assessment determines that the quality of the contained literature is averagege.3.Results of meta-analysis:A total of 14 indicators were analyzed.(1)The Clinical Total Effective Rate:The 11 included literatures and1018 patients were analyzed.The results:OR=3.52,95%CI[2.45,5.08],Z=6.76,P<0.00001,the difference was statistically significant.(2)TCM symptom score:The 2 included literatures and 138 patients were analyzed.The results: MD =-2.06,95% CI [-4.72,0.61],Z = 1.51,P =0.13,the results showed no statistical significance.(3)Therapeutic effects of TCM symptoms: The 2 included literatures and168 patients were analyzed..The results:OR=3.34,95%CI[1.24,9.01],Z=2.38,P=0.02,the difference was statistically significant.(4)Duration of angina:After excluding a highly heterogeneous literature,The 3 included literatures and 277 patients were analyzed.The results:MD=-2.05,95%CI[-2.34,-1.77],Z=14.02,P< 0.00001,,the difference was statistically significan.(5)Frequency of angina:The 4 included literatures and 377 patients were analyzed..The results:MD=-2.49,95%CI[-3.35,-1.64],Z=5.74,P< 0.00001,the difference was statistically significant.(6)Nitroglycerin:The 2 included literatures and 263 patients were analyzed.The results:MD=-2.95,95%CI[-4.37,-1.53],Z=4.07,P <0.00001,the difference was statistically significant.(7)EKG efficacy:The 2 included literatures and 176 patients were analyzed..The results:OR=2.25,95%CI[1.10,4.60],Z=2.23,P=0.03< 0.05,the difference was statistically significant.(8)TC:The 5 included literatures and 424 patients were analyzed.The results:MD=-1.46,95%CI[-2.15,-0.77],Z=4.14,P< 0.0001,the difference was statistically significant.(9)TG:The 5 included literatures and 424 patients were analyzed.The results:MD=-0.64,95%CI[-0.88,-0.41],Z=5.33,P< 0.00001,the difference was statistically significant.(10)LDL-C:After excluding a highly heterogeneous literature,The 4included literatures and 277 patients were analyzed.The results:MD=-1.12,95%CI[-1.39,-0.86],Z=8.32,P< 0.00001,the difference was statistically significant.(11)ET:The 3 included literatures and 383 patients were analyzed..The results:MD=-14.36,95%CI[-21.57,-7.16],Z=3.91,P< 0.00001,the difference was statistically significant.(12)NO:The 3 included literatures and 383 patients were analyzed..The results:MD=8.77,95%CI[7.58,9.95],Z=14.52,P< 0.00001,the difference was statistically significant.(13)HCY:After excluding a highly heterogeneous literature,the 2 included literatures and 209 patients were analyzed.The results:MD=-8.43,95%CI[-9.76,-7.10],Z=12.34,P< 0.00001,the difference was statistically significant.(14)hs-CRP:The 3 included literatures and 248 patients were analyzed.The results:MD=-3.03,95%CI[-5.01,-1.06],Z=3.01,P< 0.003,the difference was statistically significant.4.Safety assessment:A total of 5 clinical trials were conducted for safety evaluation,of which 2 patients had no adverse reactions,and 3 patients had abdominal pain,diarrhea,rash and other adverse reactions during the trial,furthermore,the incidence of adverse reactions was not statistically significant.5.Conclusion:1 Routine western medicine combined with Zhishi Xiebai Guizhi decoction in the treatment of coronary heart disease angina pectoris,it can effectively improve the total clinical efficiency,the efficacy of TCM symptoms and TCM symptom score,reduce angina attack frequency,duration and nitroglycerin usage,improve the efficiency of EKG,increase NO content,reduce the content of TC,TG,LDL,HCY,hs-CRP in blood.2 Due to the high heterogeneity of angina attack frequency,angina duration,nitroglycerin usage,TC,TG,LDL,and hs-CRP,the reliability of the results still needs to be further proved.3 Zhishi Xiebai Guizhi decoction treating coronary heart disease angina pectoris less adverse reactions. |
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