Meta Analysis Of Traditional Chinese Medicine In Treating Angina Pectoris Of Coronary Heart Disease With Qi Stagnation And Blood Stasis

Objective:Adopt the method of evidence-based medicine to assess the clinical efficacy and safety of traditional Chinese medicine in the treatment of angina pectoris of coronary heart disease with qi stagnation and blood stasisto,provide a scientific basis for the treatment of coronary heart disease with syndrome differentiation of TCM.Methods:According to the search strategy of this study,CNKI,VIP,Wanfang date,Pub Med and other Chinese and English databases were searched by computer on the Internet.The clinical RCT literatures on the treatment of angina pectoris of coronary heart disease with qi stagnation and blood stasis by traditional Chinese Medicine published from the establishment of the database to October 2020 were searched and screened according to the inclusion and exclusion criteria,The "bias risk assessment tool" recommended by Cochrane Collaboration Network was used to evaluate the quality of literature,and the Review Manager 5.4 software was used to draw the forest map and funnel map.Results:In this study,30 eligible RCT literatures were included,with a total sample size of 2063 subjects,including 1036 cases in the traditional Chinese medicine combined with western medicine group and 1027 cases in the simple western medicine group.Six articles reported adverse reactions in clinical process.The top 10 commonly used traditional Chinese medicines were chuanxiong,Chaihu,Honghua,Danshen,Gancao,Danggui,Yuanhu,Zhihu,Sanqi and Xiangfu.The results of meta analysis showed that: The curative effect of angina pectoris was as follows:OR=3.23,95%CI=[2.48,4.21],Z=8.70,P < 0.00001;ECG improvement:OR=2.26,95%CI=[1.81,2.82],Z=7.17,P<0.00001;The cura-tive effect of TCM syndrome:OR=3.88,95%CI=[2.96,5.07],Z=9.87,P<0.00001;In terms of nitroglycerin withdrawal rate:OR=3.42,95%CI=[2.5 2,4.64],Z=7.91,P<0.00001;In-flammatory markers:SMD=-1.02,95%CI=[-1.56,-0.48],Z=3.71,P=0.0002;Blood lipids:TC:SMD=-1.20,95%CI=[-1.8,-0.60],Z=3.94,P<0.0001;TG:SMD=-0.72,95%CI=[-1.02,-0.42],Z=4.64,P<0.0001;LDL-C:SMD=-0.86,95%CI=[-1.21,-0.52],Z=4.84,P<0.00001;Meta-analysis showed that the above outcome index P values were all less than 0.05,which indicated statistical significance.Conclusion:1、Traditional Chinese medicine has a good effect on angina pectoris of coronary heart disease of qi stagnation and blood stasis type.It can improve the curative effect of angina pectoris,ECG,TCM syndrome,nitroglycerin reduction rate,inflammatory index and blood lipid level,and improve the overall clinical curative effect.2 、 There was no significant difference between the traditional Chinese medicine group and the western medicine group in improving HDL-C level.