[Current status of randomized controlled trials of traditional Chinese medicine in treating coronary heart disease with angina pectoris after percutaneous coronary intervention]

Zhongguo Zhong Yao Za Zhi. 2024 Nov;49(22):6224-6234. doi: 10.19540/j.cnki.cjcmm.20240815.503.
[Article in Chinese]

Abstract

This study systematically reviewed the randomized controlled trial(RCT) of traditional Chinese medicine(TCM) treatment of coronary heart disease patients with angina pectoris after percutaneous coronary intervention(PCI). The basic elements of these RCTs, including sample size and estimation method, randomizing scheme, allocation concealment, blind method implementation, data integrity, statistical method, TCM syndrome, intervention measures, treatment course, follow-up time, and outcome indicators, were analyzed to provide reference for the design of future RCT and the clinical application of TCM in treating angina pectoris after PCI. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, Web of Science, ClinicalTrials.gov, and Chinese Clinical Trial Registry were searched for the RCT about TCM treatment of coronary heart disease patients with angina pectoris after PCI according to pre-defined criteria, with the time interval from inception to January 31, 2024. A total of 188 RCTs were included, of which 184 were clinical research articles and 4 were clinical trial registration schemes. These RCTs involved a total of 15 521 patients, with an average sample size of 83 patients and a maximum sample size of 248 patients. Among them, 126 RCTs reported TCM syndromes, the top three of which were Qi deficiency and blood stasis(38.89%), phlegm combined with stasis(17.46%), and Qi stagnation and blood stasis(9.52%). The control group received guideline-directed medical therapy(GDMT) or GDMT combined with placebo, and the treatment group received GDMT combined with TCM. The treatment mainly lasted for 4-8 weeks, most of the RCTs did not set the follow-up period or the follow-up period was unknown. A total of 160 outcome indicators were used, with the total frequency of 1 348. According to functional attributes, the outcome indicators can be categorized into 6 groups: symptoms/signs(403, 29.90%), TCM syndromes/symptoms(182, 13.50%), physical and chemical examination(468, 34.72%), quality of life(89, 6.60%), long-term prognosis(5, 0.37%), and safety evaluation(201, 14.91%). The clinical trial design of TCM intervention in angina pectoris after PCI of coronary heart disease is becoming more and more rigorous, while it remains to be improved. It is expected that more clinical trial schemes with rigorous design and taking into account the TCM advantages can be adopted in the future to provide a basis for the TCM treatment of angina pectoris after PCI of coronary heart disease.

Keywords: angina pectoris after percutaneous coronary intervention; coronary heart disease; randomized controlled trial; research status; traditional Chinese medicine.

Publication types

  • English Abstract

MeSH terms

  • Angina Pectoris* / drug therapy
  • Angina Pectoris* / therapy
  • Coronary Disease* / drug therapy
  • Coronary Disease* / therapy
  • Drugs, Chinese Herbal* / administration & dosage
  • Drugs, Chinese Herbal* / therapeutic use
  • Female
  • Humans
  • Male
  • Medicine, Chinese Traditional*
  • Percutaneous Coronary Intervention*
  • Randomized Controlled Trials as Topic*
  • Treatment Outcome

Substances

  • Drugs, Chinese Herbal