Effectiveness and Safety of Fufang Danshen Dripping Pill (Cardiotonic Pill) on Blood Viscosity and Hemorheological Factors for Cardiovascular Event Prevention in Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis

Figures

• 

  Figure 1. Compounded Danshen Dripping Pills (CDDPs). (A) CDDPs are a brown colored, round pill, usually 4.5 mm (0.18 inch) in size. (B) The three main herbal components of CDDP are Salvia miltiorrhiza, Dryobalanops aromatica, and Panax notoginseng.

• 

  Figure 2. Flowchart of this study.

• 

  Figure 3. Risk of bias assessment.

• 

  Figure 4. Risk of bias summary for the 18 studies analyzed. Green ‘+’ circles = Low risk of Bias; yellow ‘?’ circles = uncertainties about the risk of bias; red ‘–’ circles = high risk of bias. Reference: Bai 2008 [64]; Chen 2018 [53]; Gu 2020 [65]; Guo 2007 [60]; Huang 2005 [68]; Jia 2017 [63]; Jin 2015 [54]; Li 2015 [56]; Lin 2017 [66]; Lu 2017 [55]; Wang 2015 [58]; Wang 2016 [57]; Yang 2019 [62]; Ye 2016 [51]; Yin 2017 [67]; Yuan 2013 [61]; Zhang 2009 [59]; Zhao 2016 [52].

• 

  Figure 5. Meta-analysis of blood viscosity factors between treatment groups and control groups. (A) Low shear rate, (B) high shear rate, and (C) plasma viscosity. Green ‘+’ circles = Low risk of Bias; yellow ‘?’ circles = uncertainties about the risk of bias; red ‘−’ circles = high risk of bias. The black rectangle represents the mean difference; The green dot and bar represent the overall summary estimate of the treatment effect, especially, the bar represents the confidence interval for the summary estimate. Reference: Bai 2008 [64]; Huang 2005 [68]; Yuan 2013 [61]; Zhang 2009 [59]; Lin 2017 [66]; Yin 2017 [67]; Guo 2007 [60]; Yang 2019 [62]; Jia 2017 [63]; Gu 2020 [65].

• 

  Figure 6. Meta-analysis of homocysteine between treatment and control groups. Green ‘+’ circles = Low risk of Bias; yellow ‘?’ circles = uncertainties about the risk of bias; red ‘−’ circles = high risk of bias. The black rectangle represents the mean difference; The green dot and bar represent the overall summary estimate of the treatment effect, especially, the bar represents the confidence interval for the summary estimate. Reference: Chen 2018 [53]; Jin 2015 [54]; Li 2015 [56]; Lu 2017 [55]; Wang 2015 [58]; Wang 2016 [57]; Ye 2016 [51]; Zhao 2016 [52].

• 

  Figure 7. Meta-analysis of plasma adiponectin levels between treatment and control groups. Green ‘+’ circles = Low risk of Bias; yellow ‘?’ circles = uncertainties about the risk of bias; red ‘−’ circles = high risk of bias. The black rectangle represents the mean difference; The green dot and bar represent the overall summary estimate of the treatment effect, especially, the bar represents the confidence interval for the summary estimate. Reference: Chen 2018 [53]; Jin 2015 [54]; Li 2015 [56]; Wang 2015 [58]; Wang 2016 [57]; Ye 2016 [51]; Zhao 2016 [52].

• 

  Figure 8. Possible mechanistic pathway of CDDP for reducing blood viscosity.