ObjectiveTo systematically review the efficacy of Chinese medicine injection (CMI) for treating heart failure (HF).MethodsCNKI, WanFang Data, VIP, The Cochrane Library, PubMed, and EMbase databases were electronically searched from inception to January 2021 to identify randomized controlled trials (RCTs) on CMI for treating HF. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Network meta-analysis was then performed by RevMan 5.2 software and Stata 16.0 software.ResultsA total of 47 studies were included involving 4 902 patients and 5 types of CMIs, including Shenmai, Shenfu, Yiqi Fumai (lyophilized), Shengmai, and Danhong injections. The results of network meta-analysis showed that the efficacy of combined CMIs was superior to conventional Western medicine alone. For the main efficacy, Shenmai, Shengmai, and Shenfu injections had significant advantages in improving the total clinical effectiveness. Shengmai, Shenmai, and Yiqi Fumai (lyophilized) injections were significantly more effective for reducing NT pro-BNP levels than other injections. Shenfu and Shengmai injections were significantly more effective for reducing BNP levels than other injections. Shenmai, Danhong and Shengmai injections were significantly more effective for improving the left ventricular ejection fraction than the other injections. These CMIs showed similar advantages for secondary efficacy indicators as for main efficacy indicators.ConclusionsThe combined 5 types of CMIs for treating HF can improve the clinical efficacy when compared with conventional Western medicine treatment. Shenmai injection, Yiqi Fumai injection (lyophilized), and Shengmai injection, which is part of Sheng Mai San, have clear advantages in terms of the overall curative effect or on individual indices.
中药临床试验是中医药研究中发展较快的一个领域，临床研究协调员（CRC）在中药临床试验中有重要作用，其工作范围涉及到中药临床试验的各个方面。由于中药临床试验有着不同于西药临床试验的特点，CRC在中药临床试验中的作用也有其特殊性，对提高临床试验的安全性、科学性及试验数据的可信度方面起重要作用。
目的:观察艾灸联合芦荟、红花、当归酒精提取液治疗输液并发静脉炎的临床疗效。方法:将60例静脉炎患者随机分为两组,观察组采用艾灸联合芦荟、红花、当归酒精提取液治疗,对照组采用50%硫酸镁治疗,并进行疗效对比。结果: 观察组痊愈22例、显效6例、有效2例、无效0例,有效率100%;对照组痊愈13例、显效8例、有效3例、无效6例,有效率80%;两组相比差异有统计学意义(Plt;0005)。结论:艾灸联合芦荟、红花、当归酒精提取液具有活血化瘀、散结止痛、抗炎解毒、促进损伤组织细胞修复作用。
Objective To evaluate the efficacy and safety of Chinese herb compared with an analgesic drug in the treatment of cancer pain. Methods We electronically searched CBM (1990 to 2008), CNKI (1990 to 2008), VIP (1990 to 2008), The Cochrane Library (Issue 3, 2008), and MEDLINE (1990 to 2008). Relevant journals and conference proceedings were also handsearched. The quality of the included trials was assessed according to the criteria recommended by the Cochrane Handbook for systematic reviews of interventions and meta-analyses were performed for homogeneous studies using the Cochrane collaboration’s review manager 4.2.2 software. Results Five randomized controlled trails (RCTs), all published in Chinese, involving 590 participants, were included. The quality of all RCTs was graded C (low). Meta-analyses were not performed due to heterogeneity. Instead, descriptive analyses were conducted. The results showed that as for the total effective rate in pain-relieving, Zhentongsan (RR=1.11, 95%CI 1.00 to 1.24, P=0.05) and Xiaozhengzhitong paste (RR=1.35, 95%CI 1.02 to 1.78, P=0.04) were more effective than Indometacin, with significant differences. There were no significant differences between Duyiwei capsule and Indometacin, and so were between Huajianbadumo as well as Shebingzhitong paste and Tramado. In terms of early potency, there were significant differences between Zhentongsan (SMD= –?9.87, 95%CI –10.84 to –8.89, Plt;0.000 01) as well as Xiaozhengzhitong paste (SMD= –8.74, 95%CI –10.164 to –7.32, Plt;0.000?01) and Indometacin, and so were between Shebingzhitong paste and Tramadol (SMD= –2.24, 95%CI –3.00 to –1.49, Plt;0.000?01). There were no significant differences between Huajianbadumo and Tramodo. With regard to the durative effect on pain-relieving, there were significant differences between Xiaozhengzhitong paste and Indometacin (WMD=4.78, 95%CI 2.99 to 6.57, Plt;0.00001), but not between Shebingzhitong paste and Tramadol. Conclusion Because of low quality of the existing studies, the current evidence is insufficient to define the efficacy and safety of compound Chinese herb, and further large-scale and high-quality RCTs are needed.
ObjectiveTo systematically review the clinical effect and safety of traditional Chinese medicine (TCM) in the treatment of cough variant asthma (CVA). MethodsWe searched MEDLINE (Ovid), PubMed, EMbase, The Cochrane Library, VIP, WanFang Data, CNKI and CBM databases to collect randomized controlled trials (RCTs) about TCM for CVA from inception to May 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by RevMan 5.2 software. ResultsA total of 17 RCTs were included. The results of qualitative analysis showed that:in improving cough symptom, three of four RCTs showed that TCM was superior to western medicine alone. In improving airway hyper responsiveness and overall treatment effect, the difference between TCM and western medicine alone remained uncertain. No serious adverse reactions related to TCM was reported in 17 RCTs. ConclusionBased on the current evidence, some trials suggest the TCM is superior to western medicine alone in improving cough symptom, however in the improvement of airway hyper responsiveness and overall efficacy, the difference between TCM and western medicine alone remains uncertain. Due to the variety of TCM and western medicine as well as limited methodological quality and different intervention of the included studies, more high-quality RCTs with large scale are needed to verify the above conclusion.
ObjectivesTo evaluate the methodological quality and the reliability of the conclusions of systematic reviews (SRs) on traditional Chinese medicine (TCM) treatment for essential hypertension. MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were searched to collect the SRs which focused on the TCM for essential hypertension from January 2015 to June 2019. PRISMA statement, AMSTAR 2 tool and GRADE system were respectively applied to evaluate report quality, methodological quality and evidence quality assessment of included outcomes of SRs.ResultsA total of 25 SRs involving 65 outcomes were included. PRISMA evaluation results showed that the quality of 25 SRs reports was good. However, all studies did not report item 5 " Was an ‘a prior’ design provided?”. AMSTAR 2 tool evaluation results showed that the 25 SRs of quality levels were markedly low, where most problems concerned item 2 " If there is ‘a prior’ published in advance”, item 3 " Were reasons about selection of the study designs explained”, item 7 " Were the list of exclude of studies and justify the exclusions provided”, item 10 " Were the sources of funding for the studies reported”, and item 12 " If meta-analysis was performed, whether the author assesses the potential impact of risk of bias”. The results of grading showed that most outcomes were graded as " low” or " very low” quality. The main factors contributing to downgrading evidence quality were limitations, followed by inconsistencies, inaccuracies and publication bias.ConclusionsCurrent evidences shows that the treatment of essential hypertension by TCM has been supported by low quality evidence-based medical evidence. However, the SRs methodology for the treatment of essential hypertension by TCM is generally poor in quality and the standardization still require improvement.
ObjectiveTo study the clinical effect of the combination of glucosamine hydrochloride with exercise therapy and traditional Chinese medicine hot compress in the treatment of early patellofemoral osteoarthritis. MethodsA total of 126 patients with early patellofemoral osteoarthritis treated between June 2013 and April 2015 were divided into group A (n=43), B (n=42) and C (n=41) with the method of random number table. Oral administration of glucosamine hydrochloride tablets, exercise therapy of knee joints and traditional Chinese medicine hot compress were applied for the 43 patients in group A. Oral administration of glucosamine hydrochloride tablets and exercise therapy of knee joints were applied for the 42 patients in group B. Exercise therapy of knee joints and traditional Chinese medicine hot compress were applied for the 41 patients in group C. Chen's Scoring was applied before the treatment and 2, 4, 12 and 24 weeks after the treatment. ResultsThe differences of Chen's scores at the time points after treatment and those before treatment of the same group had statistical significance (P<0.05). The differences of Chen's scores at the time points after treatment in group A and those in group B and C had statistical significance (P<0.05). There were no obvious adverse effects due to administration of glucosamine hydrochloride tablets in group A and B. Five patients in group A and 4 patients in group C suffered from the symptoms of local erythema, light cutaneous pruritus and other contact dermatitis after traditional Chinese medicine hot compress. Those symptoms disappeared automatically several hours later without any special treatment. ConclusionThe treatment of early patellofemoral osteoarthritis by the combination of glucosamine hydrochloride tablets with exercise therapy and traditional Chinese medicine hot compress can rapidly relieve joint pain, and maintain efficacy for a long time.