Meta-analysis Of Shuxuening Injection Combined With Trimetazidine In Treatment Of Angina Pectoris Of Coronary Heart Disease

Objective:To systemically evaluate the clinical efficacy and safety of Shuxuening injection combined with trimetazidine and conventional western medicine in treating angina pectoris in coronary heart disease.Methods:Randomized controlled trials(RCTs)about Shuxuening injection combined with trimetazine in the treatment of angina pectoris of coronary heart disease.Cochrane Library,Pub Med,Web of Science,CNKI,VIP,Wanfang,and Sino Med databases were retrieved on computer.The search time was from the establishment of the database to October 2022.Two researchers independently screened the literature,extracted the data and evaluated the methodological quality of included studies using the Cochrane bias risk assessment tool.Literature screening,data extraction and quality evaluation were conducted independently by two researchers,literature methodology quality evaluation was conducted with use of the Cochrane bias risk assessment tool.Meta-analysis was performed with Rev Man 5.4 software.Results:A total of 25 studies were included,involving 2301 patients.Meta-analysis showed that,compared with conventional western medicine treatment alone,the application of Shuxuening injection combined with trimetazine significantly improved angina pectoris efficacy(RR=1.22,95%CI[1.18,1.27],P<0.00001)and electrocardiogram efficacy(RR=1.37,95%CI[1.24,1.52],P<0.00001).There were statistically significant differences in the number of angina attacks(MD=-1.96,95%CI[-2.63,-1.29],P<0.00001)and the duration of each angina pectoris(MD=-1.23,95%CI[-1.62,-0.84],P<0.00001).The serum levels of low density lipoprotein cholesterol(MD=-0.51,95%CI[-0.77,-0.25],P<0.00001),total cholesterol(MD=-0.81,95%CI[-1.04,-0.58],P<0.00001),triglyceride(MD=-0.70,95%CI[-0.96,-0.44],P<0.00001)were lower than the control group,and high density lipoprotein cholesterol(MD=0.30,95%CI[0.04,0.55],P=0.02)was higher than the control group.There was no significant difference in the incidence of adverse reactions between two groups(RR=0.57,95%CI[0.32,1.03],P=0.06).The GRADE evidence quality rating results showed that angina pectoris efficacy and electrocardiogram efficacy were medium quality evidence,and the TC,TG,LDL-C,HDL-C,the number of angina attacks,the duration of angina pectoris,and the incidence of adverse reactions were low quality evidence.Conclusions:Shuxuening injection combined with trimetazidine has significant effect in the treatment of angina pectoris,which is obviously superior to conventional western medicine in improving the symptoms of angina pectoris and electrocardiogram performance.The effect of improving triglyceride,total cholesterol,low density lipoprotein cholesterol and high density lipoprotein cholesterol in blood lipids is better than the western medicine alone.However,there was no significant difference in the incidence of adverse reactions between the two groups.