Key result
Shexiang Baoxin pills combined with conventional treatment significantly improved the total efficacy rate for chronic heart failure compared to conventional treatment alone (OR 3.88; 95% CI 2.87-5.26; P<0.00001).
Why the study?
Does Shexiang Baoxin pills added to conventional treatment improve efficacy and surrogate markers in patients with chronic heart failure?
Meta-Analysis (n=2,637)
Does Shexiang Baoxin pills added to conventional treatment improve efficacy and surrogate markers in patients with chronic heart failure?
Shexiang Baoxin pills as an adjuvant to conventional therapy may improve clinical efficacy and cardiac function in chronic heart failure, though evidence is limited by low study quality.
Background. Shexiang Baoxin pills (SXBXP), as a Traditional Chinese Medicine, are widely used for chronic heart failure in China. It is essential to systematically assess the efficacy and safety of SXBXP as an adjuvant treatment for chronic heart failure. Methods. Seven English and Chinese electronic databases (PubMed, Embase, Cochrane Library, CBM, Wanfang, VMIS, and CNKI) were searched from inception to July 2017. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of eligible studies. Meta‐analysis was performed by Review Manager 5.3. Results. A total of 27 RCTs with 2637 participants were included in this review. Compared to conventional treatment, SXBXP combined with conventional treatment showed potent efficacy when it came to the total efficacy rate (OR, 3.88; 95% CI, 2.87, 5.26; P < 0.00001), B‐type natriuretic peptide (BNP) (MD = −66.95; 95% CI, −108.57, −25.34; P = 0.002), N‐terminal pro‐brain natriuretic peptide (NT‐ProBNP) (MD = −0.15; 95% CI, −0.21, −0.09; P < 0.00001), six‐minute walking distance (6‐MWD) (MD = 38.57; 95% CI, 28.47, 48.67; P < 0.00001), cardiac output (CO) (MD = 0.84; 95% CI, 0.68, 0.99; P < 0.00001), and Stroke Volume (SV) (MD = 7.43; 95% CI, 4.42, 10.44, P < 0.00001). The pooled subgroup analysis indicated that there was a significant difference between SXBXP plus conventional treatment and conventional treatment alone in short term course (OR = 3.51; 95% CI, 2.28, 5.40; P < 0.00001), in middle period of treatment (OR = 5.01; 95% CI, 2.61, 9.60; P < 0.00001), and in long‐term course (OR = 3.77; 95% CI, 2.13, 6.67; P < 0.00001). No serious adverse events or reactions were mentioned in these RCTs. Conclusions. As an adjuvant drug, this study suggested that SXBXP provide an obvious efficacy for the treatment of CHF. However, due to small samples and generally low quality studies being applied in this study, more rigorous and well‐designed RCTs are needed to confirm these findings.
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Dong et al. (2018) conducted a meta-analysis in chronic heart failure (n=2,637). Shexiang Baoxin pills (SXBXP) vs. conventional treatment was evaluated on total efficacy rate (OR 3.88, 95% CI 2.87-5.26, p=< 0.00001). Shexiang Baoxin pills combined with conventional treatment significantly improved the total efficacy rate for chronic heart failure compared to conventional treatment alone (OR 3.88; 95% CI 2.87-5.26; P<0.00001).
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