0
selected
-
1.
Effect of levothyroxine on the progression of carotid intima-media thickness in subclinical hypothyroidism patients: a meta-analysis.
Zhao, T, Chen, B, Zhou, Y, Wang, X, Zhang, Y, Wang, H, Shan, Z
BMJ open. 2017;(10):e016053
Abstract
BACKGROUND Subclinical hypothyroidism (SCH) has been associated with increased carotid intima-media thickness (C-IMT) in recent studies, but the effects of levothyroxine (L-T4) therapy on C-IMT in SCH patients are still controversial. AIM: To evaluate the effect of L-T4 therapy on endothelial function as determined by C-IMT in patients with SCH. METHODS BeforeJuly 2016, we searched the PubMed, Embase, Cochrane Library and Google Scholar databases, selecting published randomised controlled trials (RCTs) and self-controlled trials for the meta-analysis. RESULTS Three RCTs with 117 patients were considered appropriate for the meta-analysis. The results of the meta-analysis indicated that L-T4 significantly decreased the development of C-IMT (weighted mean difference (WMD) -0.05 mm, 95% CI -0.08 to -0.01 mm; p=0.025). We also analysed nine studies (self-controlled trials) with 247 patients and extracted the IMT of SCH patients before and after L-T4 treatment. After L-T4 therapy, the pooled estimate of the WMD of decreased C-IMT was -0.04 mm (95% CI -0.07 to -0.02 mm; p=0.05). Subgroup analysis showed that L-T4 therapy was associated with a decrease in C-IMT among patients of mixed genders (WMD -0.03 mm, 95% CI -0.06 to -0.01 mm; p=0.145). L-T4 therapy was associated with a decrease in C-IMT among female patients (WMD -0.07 mm, 95% CI -0.14 to -0.01; p=0.186). Longer treatment (>6 months) also resulted in a significant decrease in C-IMT (WMD -0.05 mm, 95% CI -0.08 to -0.02; p=0.335). CONCLUSION This meta-analysis indicates that L-T4 treatment of SCH patients can reduce C-IMT, possibly as a result of the reduction of total cholesterol, triglyceride, low density lipoprotein, systolic blood pressure, diastolic blood pressure, lipoprotein(a), and flow-mediated dilatation. Decreased C-IMT was observed in SCH patients after long-term (>6 months) L-T4 treatment. RCTs with larger samples are needed to verify these observations.
-
2.
The effect of Chinese herbal medicine Jian Ling Decoction for the treatment of essential hypertension: a systematic review.
Xiong, X, Wang, P, Li, X, Zhang, Y
BMJ open. 2015;(2):e006502
Abstract
OBJECTIVES Jian Ling Decoction (JLD) is often prescribed to improve hypertension-related symptoms in China. However, this treatment has not been systematically reviewed for its efficacy against essential hypertension (EH). This review aims to assess the current clinical evidence of JLD in the treatment of EH. DESIGN Seven electronic databases, including the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database (VIP), the Chinese Biomedical Literature Database (CBM) and the Wanfang Database, were searched up to March 2014. Randomised control trials (RCTs) comparing JLD or combined with antihypertensive drugs versus antihypertensive drugs were included. We assessed the methodological quality, extracted the valid data and conducted the meta-analysis according to criteria from the Cochrane group. The primary outcome was categorical or continuous blood pressure (BP), and the secondary outcome was quality of life (QOL). RESULTS Ten trials (655 patients) with unclear-to-high risk of bias were identified. Meta-analysis showed that JLD used alone showed no BP reduction effect; however, improvement on QOL was found in the JLD group compared to antihypertensive drugs. A significant reduction in systolic and diastolic BP was observed for JLD plus antihypertensive drugs when compared with antihypertensive drugs alone. No serious adverse effects were reported. CONCLUSIONS Owing to insufficient clinical data, it is difficult to draw a definite conclusion regarding the effectiveness and safety of JLD for EH, and better trials are needed.
-
3.
Effect of Baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials.
Xiong, X, Wang, P, Li, S, Zhang, Y, Li, X
Maturitas. 2015;(4):370-8
Abstract
This study aims to evaluate the efficacy of Baduanjin exercise for hypertension. Cochrane Library, PubMed, EMBASE, CNKI, VIP, CBM and Wanfang databases were searched. Eight randomized controlled trials (RCTs) were identified. Baduanjin significantly lowered systolic blood pressure (SBP) (WMD=-13.00 mmHg; 95% CI: -21.24 to -4.77; P=0.002), diastolic blood pressure (DBP) (WMD=-6.13 mmHg; 95% CI: -11.20 to -1.07; P=0.02), body mass index, blood glucose, triglyceride, and low-density lipoprotein-cholesterol, and improved high-density lipoprotein-cholesterol and quality of life compared to no intervention. No significant difference between Baduanjin and antihypertensive drugs on SBP (WMD=1.05 mmHg; 95% CI: -2.07 to 4.17; P=0.51) or DBP (WMD=1.90 mmHg; 95% CI: -1.22 to 5.02; P=0.23) was identified. Baduanjin plus antihypertensive drugs significantly reduced SBP (WMD=-7.49 mmHg; 95% CI: -11.39 to -3.59; P=0.0002), DBP (WMD=-3.55 mmHg; 95% CI: -5.25 to -1.85; P<0.0001), blood glucose, and total cholesterol compared to antihypertensive drugs. Baduanjin is an effective therapy for hypertension. However, further rigorously designed RCTs are still warranted.
-
4.
Shenqi pill, a traditional Chinese herbal formula, for the treatment of hypertension: A systematic review.
Xiong, X, Wang, P, Li, X, Zhang, Y
Complementary therapies in medicine. 2015;(3):484-93
Abstract
BACKGROUND Shenqi pill, a traditional Chinese herbal formula, is widely prescribed for hypertensive patients with kidney yang deficiency syndrome in China. This study aims to examine the efficacy and safety of Shenqi pill for the treatment of hypertension. METHODS A systematic search of the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, the Chinese National Knowledge Infrastructure, the Chinese Scientific Journal Database, the Chinese Biomedical Literature Database, and the Wanfang Database was conducted from their inception up to October 7, 2014. All randomized controlled trials (RCTs) testing Shenqi pill alone or combined with western medicine against placebo, no intervention or western medicine in hypertensive patients were included. RESULTS A total of 4 RCTs comparing Shenqi pill plus western medicine with western medicine were included. Shenqi pill as complementary therapy exhibited a relatively small with no significant reduction on blood pressure, and showed remarkable improvement on sexual function, lipid profile and some biochemical indicators of hypertensive renal damage compared to western medicine used alone. The safety of Shenqi pill is still unknown. CONCLUSIONS This systematic review firstly provided no definite evidence for the efficacy and safety of Shenqi pill for hypertension based on the insufficient data. More rigorously designed RCTs focusing on sexual dysfunction and hypertensive renal damage are warranted to give high level of evidence.
-
5.
Chinese herbal formulas for treating hypertension in traditional Chinese medicine: perspective of modern science.
Xiong, X, Yang, X, Liu, Y, Zhang, Y, Wang, P, Wang, J
Hypertension research : official journal of the Japanese Society of Hypertension. 2013;(7):570-9
Abstract
Hypertension, which directly threatens quality of life, is a major contributor to cardiovascular and cerebrovascular events. Over the past two decades, domestic and foreign scholars have agreed upon various standards in the treatment of hypertension, and considerable progress has been made in the field of antihypertensive drugs. Oral antihypertensive drugs represent a milestone in hypertension therapy. However, the blood pressure standard for patients with hypertension is far from satisfactory. The study of Chinese herbal formulas for treating hypertension has received much research attention. These studies seek to integrate traditional and Western medicine in China. Currently, Chinese herbal formulas are known to have an outstanding advantage with regard to bodily regulation. Research shows that Chinese medicine has many protective mechanisms. This paper addresses the process of the antihypertensive mechanisms in Chinese herbal formulas for treating hypertension. These mechanisms are to be discussed in future research.