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Comparative efficacy of Chinese herbal injections for angina pectoris: A Bayesian network meta-analysis of randomized controlled trials.
Wang, K, Wu, J, Duan, X, Zhang, D, Lin, X, Zhang, S, Ni, M, Liu, S, Meng, Z, Gao, X, et al
Complementary therapies in medicine. 2019;:208-217
Abstract
OBJECTIVE The severity of angina pectoris has been recognized. It is believed that Chinese herbal injections have an outstanding clinical effect on this condition. This network meta-analysis was devised to investigate the comparative efficacy of eight Chinese herbal injections (Ciwujia injection, Dazhuhongjingtan injection, Huangqi injection, Shenfu injection, Shengmai injection, Shenmai injection, Shenqi Fuzheng injection, Yiqifumai injection) in the treatment of angina pectoris. METHODS A literature search was performed in PubMed, Embase, and the Cochrane Library, Chinese Biological Medicine Database, China National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journal Database from their inception to June 25, 2018. A pre-designed eligibility criterion was utilized in this network meta-analysis, and a methodological quality analysis was conducted. Data analysis was performed by WinGUGS 1.4.3, Stata 13.0 and TSA software, and the odds ratio or mean difference with the 95% credible interval was reported for symptomatic improvement, electrocardiography improvement, fibrinogen, triglyceride and cholesterol. The ranking probability of interventions in various outcomes was also utilized. RESULTS A total of 73 randomized controlled trials with 6639 patients were identified. Integrating network meta-analysis results, Shenqi Fuzheng injection plus western medicine therapy and Shenmai injection plus western medicine therapy were shown to be more efficacious than other therapies. In addition, Huangqi injection plus western medicine therapy and Shenmai injection plus western medicine therapy performed well in improving the haemorheology index and serum lipid parameters. CONCLUSIONS Eligible Chinese herbal injections plus western medicine therapy might have a better impact on angina pectoris patients than western medicine therapy alone. While this study had limitations, the findings should be interpreted with caution. In addition, more high-quality randomized controlled trials with a large sample must be conducted to support this study.
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Network meta-analysis of Chinese herbal injections combined with the chemotherapy for the treatment of pancreatic cancer.
Zhang, D, Wu, J, Liu, S, Zhang, X, Zhang, B
Medicine. 2017;(21):e7005
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Abstract
BACKGROUND This study sought to use a network meta-analysis to assess the effectiveness and safety of Chinese herbal injections (CHIs) combined with the chemotherapy for the treatment of pancreatic cancer. METHODS Randomized controlled trials (RCTs) regarding CHIs to treat pancreatic cancer were searched in PubMed, the Cochrane library, Embase, the China National Knowledge Infrastructure Database (CNKI), the Wan-Fang Database, the Chinese Scientific Journals Full-text Database (VIP), and the Chinese Biomedical Literature Database (SinoMed) up to November 2016. The quality assessment was conducted by the Cochrane risk of bias tool and network meta-analysis was performed to compare the effectiveness and safety of different CHIs combined with the chemotherapy. Data were analyzed using STATA 12.0 and Win-BUGS 1.4 software. RESULTS A total of 278 records were searched, and 22 eligible RCTs involving 1329 patients and 9 CHIs were included. The results of the network meta-analysis demonstrated that compared with the chemotherapy alone, Compound Kushen, Kangai or Kanglaite injection combined with chemotherapy yielded significantly higher probability of improving performance status. Aidi injection combined with chemotherapy was more effective in relieving leucopenia than using chemotherapy single. And these between-group differences were statistically significant. However, CHIs combined with chemotherapy could not achieve a better effect in the total clinical effect, nausea and vomiting. As for the cluster analysis for the adverse reactions (ADRs), the chemotherapy alone and Huachansu injection combined with the chemotherapy were inferior to relieve ADRs than the other CHIs plus chemotherapy for patients with pancreatic cancer. CONCLUSIONS The current evidence showed that using CHIs on the basis of the chemotherapy could be beneficial for patients with pancreatic cancer in improving performance status and reducing the ADRs.
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Dang shen [Codonopsis pilosula (Franch.) Nannf] herbal formulae for chronic obstructive pulmonary disease: a systematic review and meta-analysis.
Shergis, JL, Liu, S, Chen, X, Zhang, AL, Guo, X, Lu, C, Xue, CC
Phytotherapy research : PTR. 2015;(2):167-86
Abstract
This systematic review and meta-analysis assessed the efficacy and safety of Dang shen [Codonopsis pilosula (Franch.) Nannf., root] formulae for the treatment of chronic obstructive pulmonary disease (COPD). English and Chinese databases were searched, and 48 randomized controlled trials were included. Dang shen formulae improved lung function forced expiratory volume in 1 s compared with conventional pharmacotherapy (CP) [mean difference (MD) 0.22 L, 95% confidence interval (CI) 0.13-0.31, p < 0.001, I(2) = 5%] and quality of life (St. Georges Respiratory Questionnaire) compared with placebo (MD -7.19, 95% CI -10.82 to -3.56, p < 0.001, I(2) = 0%) and when combined with CP versus CP (MD -9.05, 95% CI -12.72 to -5.38, p < 0.001, I(2) = 89%). Dang shen formulae also increased distance walked in 6 min when combined with CP versus CP alone (MD 51.43 m, 95% CI 30.06-72.80, p < 0.001, I(2) = 27%) and reduced frequency/days with COPD exacerbations. Risk of bias was evaluated using the Cochrane tool. Methodological shortfalls were identified. Adverse events were low and not different between intervention and control groups. Thirty-three events were reported, including gastrointestinal upset, dry mouth, and insomnia. Dang shen formulae appear to improve some aspects of the included COPD outcomes. However, owing to methodological flaws, the current evidence is inadequate to support the routine use of Dang shen formulae outside of Chinese medicine practice. However, these results justify further investigation.
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Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke: a systematic review and meta-analysis.
Ni, X, Ni, X, Liu, S, Guo, X
Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan. 2013;(6):715-20
Abstract
OBJECTIVE To evaluate the medium- to long-term efficacy of ligustrazine plus conventional medicine treating ischemic stroke. METHODS Randomized controlled trials (RCTs) testing ligustrazine in the treatment of acute ischemic stroke were retrieved from Cochrane Library, PubMed, Excerpta Medica Database, Chinese Medical Journal Database, Chinese Biomedical Database, China National Knowledge Infrastructure Database, and Chinese Clinical Trial Register, and then identified by the inclusive and exclusive criteria. The quality of trials was assessed with the Cochrane Handbook 5.1, a risk of bias assessment tool. RevMan 5.1 was used for meta-analysis. RESULTS Three RCTs involving 643 patients were included. Compared to conventional medicine treatment alone, ligustrazine plus conventional medicine treatment showed significant difference in reduction of stroke recurrence either at the end of 1-year follow-up [RR = 0.42, 95% CI (0.18, 0.94), P < 0.05] or 3-years observation [RR = 0.48, 95% CI (0.27, 0.83), P < 0.05]. The ligustrazine group also showed higher survival rate [RR =1.67, 95% II (1.02, 0.2.71), P <0.05] and significantly better effective rate [R R= 1.28, 95% II (1.10, 1.50), P <0.05] than that of the control group at the end of 1 year visit. Only one trial conducted safety assessment and no adverse events were reported. The methodological quality of all the trials included was generally poor. CONCLUSION The findings provided evidence that the combination of ligustrazine and conventional medication was medium- and long-term beneficial to the patients suffering ischemic stroke. But more RCTs of high quality are needed to further prove the efficacy and safety of using ligustrazine for ischemic stroke.