Meta analysis on efficacy of Compound Danshen Dropping Pills in treating angina based on syndrome differentiation / 中草药

ABSTRACT

Objective: To evaluate the efficacy and safety of the combination therapy of Compound Danshen Dropping Pills and conventional chemical drugs in the treatment of the angina by Meta-analysis. Methods: Databases including CNKI, WanFang, CBM, VIP, PubMed, and Cochrane Library were searched to collect qualified researches, and the quality of articles was evaluated according to Cochrane Handbook. Meta-analysis including subgroup analysis was performed by using Stata 13.1 and RevMan 5.3 software. All these methods were used to systematically evaluate the safety and clinical efficacy of Compound Danshen Dropping Pills in the treatment of angina pectoris under two circumstances (with or without syndrome differentiation). Results: A total of 39 studies involving 3 941 patients were studied, including 1 991 patients in the experimental group and 1 950 in the control group. The results of Meta analysis showed that the clinical efficacy [RR = 1.24, 95%CI (1.20, 1.28), P < 0.000 01], ECG efficacy [RR = 1.29, 95%CI (1.21, 1.37), P < 0.000 01], angina attack frequency [WMD = -1.82, 95%CI (-3.28, -0.36), P = 0.01], duration of angina attack [WMD = -2.09, 95%CI (-2.67, -1.50), P < 0.000 01], hs-CRP [WMD = -2.63, 95%CI (-4.39, -0.86), P = 0.003], ET [WMD = -16.22, 95%CI (-19.37, -13.06), P < 0.000 01], platelet aggregation [WMD=-7.46, 95%CI (-11.15, -3.78), P < 0.000 1], GMP-140 [WMD=-5.64, 95%CI (-6.88, -4.39), P < 0.000 01] and fibrinogen [WMD = -0.73, 95%CI (-1.00, -0.46), P < 0.000 01] of routine western medicine treatment combine with Compound Danshen Dripping Pills group had significant difference compared with the control group; In terms of clinical efficacy, the combination effect of dialectical medication group and non dialectical medication group had no significant difference (P = 0.55, I2 = 0). A total of 15 studies described adverse reactions, with 43 cases in the experimental group and 65 cases in the control group. There was no significant publication bias on funnel plot and Egger's test. Conclusion: It is safe and effective to use Compound Danshen Dropping Pills in patients with coronary heart disease and angina, which can further improve the clinical effect compared with the simple routine treatment. There is no significant difference between the therapeutic effect of Compound Danshen Dropping Pills and that of non-syndrome differentiation. However, these conclusions still need to be verified with more high-quality and large-sample literature.