Dualbenefits of traditional Chinese medicine for glycemic control and cardiovascular protection in type 2 diabetes mellitus and coronary heart disease: A multidimensional systematic review and network meta-analysis of efficacy and safety

Objective: To systematically evaluate the efficacy and safety of adjunctive Traditional Chinese Medicine (TCM) therapy in improving cardiovascular outcomes and metabolic control for patients with type 2 diabetes mellitus (T2DM) complicated by coronary heart disease (CHD), providing evidence for integrated TCM-Western medicine management strategies. Methods: Randomized controlled trials (RCTs) published since 2020 were retrieved from PubMed, Cochrane Library, Embase, CNKI, Wanfang, and VIP databases. Twenty-five RCTs involving 2,468 patients and 18 TCM formulations were analyzed. Methodological quality was assessed using the Cochrane Risk of Bias tool; meta-analyses were performed using RevMan 5.4 and Stata 18. Results: Adjunctive TCM therapy demonstrated statistically superior outcomes versus conventional Western medicine(CT) alone: Glycemic Control: Significant reductions in glycated Hemoglobin A1c(HbA1c)(+87.1% efficacy with Fufang Danshen Drops(FFDSD)), fasting plasma glucose (FPG; +78.6% with Qishen Yiqi Dripping Pills (QSYS), and 2-hour postprandial glucose (2hPBG; +82.8% with Jiawei Gegen Honghua Decoction (JWGH)). Lipid Profile: Notable improvements in triglycerides (TG; +91.8% with Shenxiang Suhe Pills (SXSH)), total cholesterol (TC; +99.0% with Shenmai Powder (SMS)), and low-density lipoprotein cholesterol (LDL-C) (+95.0% with JWGH). Cardiovascular Outcomes: Enhanced left ventricular ejection fraction (LVEF; +99.7% with Tongxinluo Capsules(TXL)), angina efficacy (+83.7%), and reduced angina duration (+94.2% with Yindan Xinnaotong Soft Capsules(YDTX)). Safety: Lower cumulative adverse event rates versus conventional therapy (78.1% for controls, P >0.05 for pooled analysis). Conclusion: Integrated TCM therapy significantly improves glycemic stability, lipid metabolism, cardiac function, and angina symptoms in T2DM-CHD patients, demonstrating multi-target synergy with favorable safety. Methodological heterogeneity in existing trials necessitates higher-quality RCTs with long-term follow-up to optimize clinical protocol standardization.