Traditional Chinese Herbal Products for Coronary Heart Disease: An Overview of Cochrane Reviews

Q: What is the clinical evidence from this study?

Study design: Systematic Review. Population: Coronary heart disease (including angina pectoris, acute myocardial infarction, and heart failure caused by CHD). Intervention: Traditional Chinese herbal products (TCHPs) vs. Conventional western medicine (including isosorbide dinitrate) or other TCHPs. Primary outcome: Effectiveness and safety in treating coronary heart disease.

Q: What does this research mean for the field?

Definitive conclusions regarding the effectiveness of traditional Chinese herbal products for coronary heart disease cannot be established due to the weak methodological quality of existing trials. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Yu Qiu; Hao Xu; Dazhuo Shi

doi:10.1155/2012/417387

January 1, 2012Evidence-based Complementary and Alternative MedicineOpen Access

Traditional Chinese Herbal Products for Coronary Heart Disease: An Overview of Cochrane Reviews

View Full Paper

Ask AI

Bookmark

Share

Key result

Traditional Chinese herbal products showed no definite conclusion of effectiveness across 6 Cochrane reviews (69 primary studies) for coronary heart disease due to weak methodological quality.

Why the study?

Do traditional Chinese herbal products effectively treat coronary heart disease compared to conventional Western medicine or other herbal products?

Key Points

To evaluate and summarize Cochrane systematic reviews investigating the effectiveness and safety of traditional Chinese herbal products for coronary heart disease.
Searched the Cochrane Database of Systematic Reviews (September 2011) and the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 4, October 2011) for reviews and primary studies of herbal therapies for any coronary heart disease manifestation.
Extracted data through two independent reviewers using predefined criteria and evaluated methodological quality across six Cochrane risk-of-bias domains.
Included six Cochrane reviews published between 2006 and 2011 comprising 69 primary trials, covering angina pectoris (four reviews), heart failure (one review), and acute myocardial infarction (one review).
Four Cochrane reviews reported that herbal products may be or appear to be effective, while two found evidence insufficient; none drew definitive conclusions of effectiveness due to low methodological quality and potential publication bias.
Evaluation of eight newer primary randomized trials found ongoing quality concerns, with only four trials reporting blinding and one trial incorporating adequate allocation concealment.

Study Design

Type

Systematic Review

Structured PICO

Do traditional Chinese herbal products effectively treat coronary heart disease compared to conventional Western medicine or other herbal products?

P

Population

6 Cochrane reviews (comprising 69 primary studies) and 8 newly registered RCTs evaluating traditional Chinese herbal products in patients with coronary heart disease, primarily from China.

I

Intervention

Traditional Chinese herbal products (TCHPs), administered as injections (e.g., Shengmai Injection, Puerarin), oral Chinese patent medicines (e.g., Yi Xin Mai, Bao Xin Bao, Li Nao Xin, Shengmai Oral Liquid, Suxiao Jiuxin Wan, Tong Xin Luo, Danshen), or Chinese herbal decoctions, either added to conventional Western medicine or used alone.

C

Comparator

Conventional Western medicine (including isosorbide dinitrate) or other traditional Chinese herbal products.

O

Outcome

Clinical effectiveness and safety in treating coronary heart disease (definite conclusions across Cochrane reviews).

Current Cochrane systematic reviews do not provide definitive evidence to support the routine clinical use of traditional Chinese herbal products for coronary heart disease due to poor methodological quality of underlying trials.

Limitations

Very low methodological quality of included primary studies
Potential publication bias
Inadequate blinding and allocation concealment in primary trials
Heterogeneity of included RCTs in interventions, control treatments, and treatment durations
Reviews did not account for TCM syndrome differentiation
Very low methodological quality of primary studies included in the reviews
Inadequate reporting of randomization details, blinding, and allocation concealment in primary trials
High heterogeneity in TCHP formulations, control group treatments, and trial durations
Lack of consideration for TCM syndrome differentiation in the included reviews

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Insufficient evidence precludes recommending traditional Chinese herbal products for coronary heart disease; confirms need for rigorous randomized trials.

Abstract

Objective. The aim of this overview was to evaluate and summarize Cochrane reviews of traditional Chinese herbal products (TCHPs) as the treatment for coronary heart disease (CHD). Methods. We searched the Cochrane Database that was concerned with the effectiveness of TCHPs for CHD. We also searched the Cochrane Central Register of Controlled Trials. Reviews and primary studies of TCHP as the treatment of any type of CHD were included. Data were extracted according to predefined inclusion criteria by two independent reviewers. Results. Six Cochrane reviews were included. They related to a wide range of TCHPs for different types of CHD. Four reviews were concerned with angina pectoris (unstable or stable), one review was concerned with heart failure, and for acute myocardial infarction. No reviews concluded that TCHPs were definitely effective for CHD because of the weak evidence. Eight primary studies were TCHPs from CHD. These studies also maybe result in bias, but better than before. Conclusion. Several Cochrane reviews of TCHPs for the treatment of different types of CHD have recently been published. None of these reviews got definite conclusion favoring the effectiveness of TCHPs due to the weak evidence. With the improved quality of the new registered RCTs. The potential role of TCHPs in treating CHD is anticipated to be detected.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Qiu et al. (2012) conducted a systematic review in Coronary heart disease (including angina pectoris, acute myocardial infarction, and heart failure caused by CHD). Traditional Chinese herbal products (TCHPs) vs. Conventional western medicine (including isosorbide dinitrate) or other TCHPs was evaluated on Effectiveness and safety in treating coronary heart disease. Traditional Chinese herbal products showed no definite conclusion of effectiveness across 6 Cochrane reviews (69 primary studies) for coronary heart disease due to weak methodological quality.

synapsesocial.com/papers/6a845966002ab1506fb2af08 https://doi.org/10.1155/2012/417387

View Full Paper

Ask AI

Bookmark

Share

Traditional Chinese Herbal Products for Coronary Heart Disease: An Overview of Cochrane Reviews

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Traditional Chinese Herbal Products for Coronary Heart Disease: An Overview of Cochrane Reviews

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading