Shenmai injection as an adjuvant treatment for chronic cor pulmonale heart failure: a systematic review and meta-analysis of randomized controlled trialsReport as inadecuate




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BMC Complementary and Alternative Medicine

, 15:418

First Online: 24 November 2015Received: 10 June 2015Accepted: 17 November 2015

Abstract

BackgroundShenmai injection SM, as a traditional Chinese medicine injection, is widely used for chronic cor pulmonale heart failure in mainland China. It is essential to systematically assess the efficacy and safety of SM as an adjuvant treatment for chronic cor pulmonale heart failure.

MethodsEight English and Chinese electronic databases were searched, from inception to December 2014, to identify randomized controlled trials RCTs of SM for chronic cor pulmonale heart failure. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of eligible studies. Meta-analysis was performed by Review Manager 5.2.

ResultsTwenty-seven RCTs with 2045 participants were identified. The methodological quality of the included studies was generally low. Only one trial reported data on death. None of the included trials reported quality of life. The meta-analysis indicated that compared to conventional treatment, the combination of SM and conventional treatment was more effective in terms of the New York Heart Association classification RR, 1.26; 95 % CI, 1.20–1.32; P < 0.00001, Left Ventricular Ejection Fraction MD, 11.33; 95 % CI, 8.59–14.07; p < 0.00001, partial pressure of oxygen MD, 1.00; 95 % CI, 0.64–1.36; P < 0.00001 and partial pressure of carbon dioxide MD, 0.83; 95 % CI, 0.58–1.08; p < 0.00001. In addition, two trials reported that SM plus conventional treatment was superior to the conventional treatment alone to reduce B-type natriuretic peptide. No serious adverse drug events or reactions were reported.

ConclusionsSM plus conventional treatment appeared to be effective and relatively safe for chronic cor pulmonale heart failure. However, due to the generally low methodological quality and small sample size, this review didn’t find evidence to support routine use of SM as an adjuvant treatment for chronic cor pulmonale heart failure.

KeywordsShenmai injection SM Chronic cor pulmonale heart failure Systematic review Meta-analysis AbbreviationsSMShenmai injection

RCTsRandomized controlled trials

COPDChronic obstructive pulmonary disease

CFDAChina Food and Drug Administration

NYHA classificationNew York Heart Association classification

LVEFLeft Ventricular Ejection Fraction

BNPB-type natriuretic peptide

PaO2Partial pressure of oxygen

PaCO2Partial pressure of carbon dioxide

ADEsAdverse drug events

ADRsAdverse drug reactions

PRISMAPreferred Reporting Items for Systematic Reviews and Meta-Analyses

CBMChinese Biomedical Literature Database

VIPChinese Scientific Journal Database

CNKIChinese National Knowledge Infrastructure

TCMTraditional Chinese Medicine

MDMean difference

RRRisk ratio

CIConfidence interval

II-square

CONSORTConsolidated Standards of Reporting Trials

Electronic supplementary materialThe online version of this article doi:10.1186-s12906-015-0939-2 contains supplementary material, which is available to authorized users.

An erratum to this article can be found at http:-dx.doi.org-10.1186-s12906-015-0953-4.

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Author: Liwei Shi - Yanming Xie - Xing Liao - Yan Chai - Yanhua Luo

Source: https://link.springer.com/







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