[Analysis of evidence map of clinical research on Chinese patent medicines in treatment of chronic pulmonary heart disease]

Zhongguo Zhong Yao Za Zhi. 2024 Oct;49(19):5354-5364. doi: 10.19540/j.cnki.cjcmm.20240611.501.
[Article in Chinese]

Abstract

Chinese patent medicines play a crucial role in the treatment of chronic pulmonary heart disease(CPHD). Nowadays, there is still a lack of comprehensive control over clinical research evidence in this field. This study aims to summarize the clinical research on the treatment of CPHD with Chinese patent medicines using an evidence map, in order to understand the current status and deficiencies of evidence in this area. Systematic searches were conducted across various databases including CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Web of Science and Cochrane Library for clinical studies on Chinese patent medicines in treatment of CPHD. The distribution characteristics of evidence are presented numerically and graphically. Finally, 397 RCTs, 1 observational study, 14 systematic reviews/Meta-analysis, 1 network Meta-analysis and 3 guidelines/expert consensus were included in this analysis. Over the past decade, there has been a decline in the number of published documents related to this topic. Amongst the included literature, particular attention was given to CPHD caused by chronic obstructive pulmonary disease, and a total of 42 Chinese patent medicines were involved, with Danhong Injection, Danshen Chuanxiongqin Injection and Shenmai Injection being most commonly used. The typical course of treatment ranged from 2-4 weeks. The outcome measures paid more attention to the total effective rate, cardiac function indicators and blood gas analysis, while paid less attention to the economic indicators, prognosis/endpoint indicators, quality of life indicators, clinical symptoms/signs and traditional Chinese medicine(TCM) indicators. The overall quality of RCT and systematic review/Meta-analysis was generally low, and the process of formulating guidelines/expert consensus lacked standardization, which resulted in a low evidence quality grade. The findings indicated that despite the quantitative advantages observed in clinical studies on the treatment of chronic pulmonary heart disease with proprietary Chinese medicine, the overall quality of evidence was generally low. In the future, it is still necessary to carry out large-sample, multi-center and long-period clinical studies, standardize the process of systematic review/Meta-analysis, guidelines/expert consensus formulation, and actively construct the core indicator set of TCM treatment of pulmonary heart disease, so as to promote the high-quality development of TCM clinical research.

Keywords: Chinese patent medicine; chronic pulmonary heart disease; clinical research; evidence map.

Publication types

  • English Abstract

MeSH terms

  • Chronic Disease / drug therapy
  • Drugs, Chinese Herbal* / therapeutic use
  • Humans
  • Medicine, Chinese Traditional
  • Nonprescription Drugs / therapeutic use
  • Pulmonary Heart Disease* / drug therapy
  • Randomized Controlled Trials as Topic

Substances

  • Drugs, Chinese Herbal
  • Nonprescription Drugs