Key result
Chinese herbal medicines boost cardiac function response ~28% when added to conventional therapy.
Why the study?
Combination therapy with Chinese herbal medicines and conventional medical treatment was proposed for chronic heart failure complicated with depression, but its effects required systematic assessment.
Does the combination of Chinese herbal medicines and conventional medical treatment improve cardiac function and depressive symptoms in patients with chronic heart failure complicated with depression?
Meta-Analysis (n=1,022)
Does the combination of Chinese herbal medicines and conventional medical treatment improve cardiac function and depressive symptoms in patients with chronic heart failure complicated with depression?
Answers are grounded in this paper and cite their sources.
The combination of Chinese herbal medicines and conventional medical treatment may improve cardiac function, depressive symptoms, and quality of life in patients with chronic heart failure and depression, though the evidence is limited by low methodological quality.
BACKGROUND: Combination therapy with Chinese herbal medicines (CHMs) and conventional medical treatment (CMT) was proposed as a therapeutic strategy for chronic heart failure (CHF) patients complicated with depression. Therefore, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess effects of this combination therapy on CHF complicated with depression. METHODS: RCTs comparing the combination of CHMs and CMT to CMT were retrieved in seven electrical databases till March 30, 2019. The effective rate of cardiac function and Hamilton depression scale (HAMD) were marked as the primary outcomes. Left ventricular ejection fraction (LVEF) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were marked as the secondary outcomes. The methodological quality of eligible RCTs used the Cochrane bias risk assessment tool. Stata 13.0 and Review Manager 5.3 were preferred for synthesizing the results if the results were appropriate. RESULTS: Thirteen RCTs enrolling 1022 subjects met the inclusion criteria. The majority of the retrieved RCTs were evaluated to be of low methodological quality. The pooled results of the meta-analysis showed that CHMs plus CMT group created better outcomes compared to CMT alone therapy, as evidenced by the fact that the overall effects of combination therapy strategy were significantly greater than the control group in increasing effective rate of cardiac function (risk ratio (RR) = 1.28; 95% CI: 1.16 to 1.42), in improving depressive symptoms (HAMD) (standard mean difference (SMD) = -1.31; 95% CI: -1.68 to -0.95) and quality of life (MLHFQ) (weighted mean difference (WMD) = -8.42; 95% CI: -10.08 to -6.76), in increasing LVEF scores (WMD = 5.33; 95% CI: 4.30 to 6.35). CONCLUSION: The combination of CHMs and CMT increased the effective rate of cardiac function and LVEF scores and reduced HAMD and MLHFQ scale scores, which was a potential therapeutic strategy that improved the management of CHF patients complicated with depression. Future trials were needed to verify the above results since abnormal heterogeneity and poor quality of literature have existed in the included studies.
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Yang et al. (2020) conducted a meta-analysis in Chronic heart failure complicated with depression (n=1,022). Chinese herbal medicines (CHMs) plus conventional medical treatment (CMT) vs. Conventional medical treatment (CMT) alone was evaluated on Effective rate of cardiac function (RR 1.28, 95% CI 1.16 to 1.42, p=<0.001). Chinese herbal medicines plus conventional treatment increased the effective rate of cardiac function and improved depressive symptoms versus conventional treatment alone.
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