A Meta analysis on clinical therapeutic effects of integrated traditional Chinese and western medicine for treatment of patients with acute heart failure / 中国中西医结合急救杂志

ABSTRACT

Objective To systemically evaluate the clinical therapeutic effect of combined traditional Chinese medicine (TCM) and western medicine for treatment of acute heart failure by Meta analysis. Methods The America National Library PubMed and China Biomedical Literature Data System (SinoMed), China National Knowledge Infrastructure (CNKI), VIP Data Resource, Wanfang Data Resource, Chinese TCM Database Retrieval System were searched from 1990 to May 2014 to identify the formally published randomized controlled trials (RCTs) in which the effects of combined TCM and western medicine (experiment group) or simple western medicine (control group) for treatment of patients with acute heart failure were reported. The Cochrane system 4.2.2 quality evaluation standard in Evaluation Handbook was applied to assess the methodological quality of literature. The Cochrane Collaboration's RevMan 5.2 software was used to seek the literatures consistent to the criteria of enrolling into the study for Meta analysis. Results There were 18 RCTs, and all together 1 374 cases were included in the data. The grade of methodological quality of the enrolled studies was of high migration. Meta analysis showed compared with the control group, the clinical efficacy in experimental group was significantly higher [odds ratio (OR) = 5.04, 95% confidence interval (95%CI) 3.31 - 7.69, P < 0.000 01]; the level of type B natriuretic peptide (BNP) was significantly reduced [standardized mean difference (SMD) = -1.31, 95%CI -1.78 to -0.83, P<0.000 01];left ventricular ejection fraction (LVEF) was significantly increased (SMD=0.79, 95%CI0.52-1.07, P < 0.000 01); the therapeutic effect on TCM syndrome was significantly elevated [categorical variables relative risk (RR) = 1.30, 95%CI 1.06 - 1.59, P = 0.01; quantitative variables mean difference (MD) = -1.67, 95%CI -2.48 to-0.86, P<0.000 1] and cardiac diastolic function was significantly improved (SMD=0.64, 95%CI0.05-1.24, P<0.05). Conclusions The clinical therapeutic effects of combined TCM and western medicine are significantly higher than those of simple western medicine for treatment of patients with acute heart failure. However, the low quality of the reports involved in this study limits the reliability of this conclusion.