A Meta-analysis Of Clinical Efficacy About Tongxinluo Treatment Of Acute Myocardial Infarction In Patients

Objective: To evaluate the clinical value of Tongxinluo capsule in patients with acute myocardial infarction after reperfusion,and the purpose of thisstudy isto provide ideas and evidence for the use of traditional Chinese Medicine.Methods : Randomized controlled trials(RCT)on treatment of acute myocardial in-farction after reperfusiontreatment(thrombolysis or PCI)by Tongxinluo were ret-rieved from wan-fang database,CNKI,VIP database,PubMed database in 2005-2016.All collected RCTs were screened,extracted data,and assesed according to the Jadad scale.Eventually incorporate standards-compliant 31 RCTS,including a total of 2580 cases of acute myocardial infarction patients.Results: After screening,this study finally included 31 RCTS,a total of2580 casesof acute myocardial infarction patients after reperfusion.Interventions is Tong-xin-luo capsule combined with conventional western medicine,and the control group is conventional western medicine.Meta-analysis of the results by the various outcomes are shown :Major adverse cardiovascular events: After Tongxinluo capsule combined with conventional medicine after treatment,can reduce AMI in patients the incidence of all MACES than the control group[ OR=0.27,95% CI(0.17,0.43),P<0.00001],angina[OR=0.33,95% CI(0.16,0.68),P=0.003],heart failure [ OR=0.24,95% CI(0.10,0.63),P=0.004],no-reflow[OR=0.45,95% CI(0.29,0.70),P=0.0005],restenosis[OR=0.18,95% CI(0.05,0.72),P=0.02]and revascularization[ OR=0.15,95% CI(0.03,0.85),P=0.03].But in the thrombosisn in stent[OR=0.13,95% CI(0.02,1.06),P=0.06]re-infarction[ OR=0.15,95% CI(0.03,0.85),P=0.16],malignant arrhythmia[ OR=0.15,95% CI(0.03,0.85),P=0.15] and death[ OR=0.15,95% CI(0.03,0.85),P=0.08] there was no statistical significance.Heart function and left ventricular dimension: The results show Tongxinluo capsule combined with conventional western medicine treatment can improve the EF value liter levels[SD=4.11,95% CI(3.96,4.26),P<0.00001],reduce left ventricular dimension[ SMD=-0.84,95% CI(-1.16,0.52),P<0.00001]?Laboratory indexes: Reduce the level of CRP[ SMD=-1.42,95% CI(-1.88,-0.97),P<0.00001],IL-6[ SMD=-1.07,95% CI(-1.37,-0.78),P<0.00001],ET-1[ SMD=-3.16,95% CI(-4.60,-1.73),P<0.0001],TNF-?[ SMD=-1.27,95% CI(-1.55,-1.00),P<0.00001] and improve the NO levels.reduce TC[ MD=-0.39,95% CI(-0.62,-0.16),P=0.0007],LDL[ MD=-0.31,95% CI(-0.47,-0.16),P<0.00001] in the Blood Lipid.Conclusions: According to the literature included 31 by Meta analysis confirmedTongxinluo treatment of AMI after reperfusion in patients with conventional westernmedicine plus basis,can reduce the occurrence of major adverse cardiovascular events ?the level of inflammatory factors,the postoperative complications of the times,regulate blood lipids,improve left ventricular remodeling,Left ventricular ejection fractionand prognosis.