AUTHOR=Huang Peiying , Li Zhishang , Chen Li , Zeng Jing , Zhao Shuai , Tang Yong , Huang Bixuan , Guan Hansu , Chen Yan , Feng Yuchao , Lei Sisi , Wu Qihua , Zhang Haobo , Huang Xiaoyan , Zeng Linsheng , Liu Yuxiang , Zeng Zhongyi , Chen Bojun 

TITLE=The comparative effects of oral Chinese patent medicines combined with western medicine in stable angina: A systematic review and network meta-analysis of 179 trials

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.918689

DOI=10.3389/fphar.2022.918689

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> Stable angina is a common condition with high morbidity and mortality rates. It has been reported that combining oral Chinese patent medicines (OCPMs) and Western medicine (WM) could potentially achieve a better effect than WM alone. However, the optimal OCPMs for stable angina remain controversial and merit further empirical research.</p><p><bold>Methods:</bold> PubMed, Embase, Web of Science, Cochrane Library, Ovid-Medline, Clinical <ext-link ext-link-type="uri" xlink:href="http://Trials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">Trials.gov</ext-link>, China National Knowledge Infrastructure, Wanfang Database, Weipu Journal Database, and Chinese Biomedical Literature Database were all searched from inception to 13 March 2022. We employed Version 2 of the Cochrane risk-of-bias tool (ROB2) to assess the overall quality of the selected studies. We also used R 4.1.2 and STATA 14.0 software applications to perform network meta-analysis, followed by sensitivity and subgroup analysis.</p><p><bold>Results:</bold> A total of 179 randomized controlled trials with 16,789 patients were included. The selected trials were all assessed as some concerns. OCPMs combined with WM had a better treatment effect than WM alone. In terms of the effective clinical rate, a significant increase was detected for Qishen Yiqi dripping pill (QSYQ)+WM as compared with Shensong Yangxin capsule (SSYX)+WM, Shexiang Baoxin pill (SXBX)+WM, Tongxinluo capsule (TXL)+WM, Xuefu Zhuyu capsule (XFZY)+WM, Qiliqiangxin capsule (QLQX)+WM, Naoxintong capsule (NXT)+WM, Fufang Danshen dripping pill (FFDS)+WM, and Danlou tablet (DL)+WM. QSYQ + WM had the highest-ranking probability (98.12%). Regarding the effective rate in ECG, QSYQ + WM was superior to SXBX + WM, TXL + WM, DL + WM, FFDS + WM, and NXT + WM. QSYQ + WM ranked first (94.21%). In terms of weekly frequency of angina, QLQX + WM obtained a better effect than FFDS + WM, Kuanxiong aerosol (KXQW)+WM, NXT + WM, QLQX + WM, SSYX + WM, SXBX + WM, and TXL + WM. QLQX + WM ranked first (100.00%). Regarding the duration of an angina attack, KXQW + WM was superior to SSYX + WM; KXQW + WM ranked first (95.71%). Adverting to weekly nitroglycerin usage, TXL + WM had the highest-ranking probability (82.12%). Referring to cardiovascular event rate, DL + WM had the highest effect (73.94%). Additionally, SSYX + WM had the lowest rate of adverse drug reactions (1.14%).</p><p><bold>Conclusion:</bold> OCPMs combined with WM had a higher efficacy. QSYQ + WM, QLQX + WM, KXQW + WM, TXL + WM, DL + WM, SSYX + WM, and SXBX + WM merit further investigation. SXBX + WM is presumably the optimal treatment prescription for both clinically effective and cardiovascular event rates. Further high-quality empirical research is needed to confirm the current results.</p><p><bold>Systematic Review Registration:</bold> URL = <ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316534" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316534</ext-link>, CRD 42022316534</p>