Network Meta-analysis of Traditional Chinese Medicine Injections Combined with Conventional Therapy for Acute Myocardial Infarction
Objective:To evaluate and analyze the clinical efficacy and safety of six popular traditional Chinese medicine injections combined with conventional Western medicine therapy for the treatment of acute myocardial infarction using network meta-analysis.Methods:A computer search was conducted on 7 Chinese and English databases,including CNKI,WanFang,VIP,SinoMed,PubMed,the Cochrane Library,and Web of Science were searched.Randomized controlled trials(RCTs)of traditional Chinese medicine injection for the treatment of acute myocardial infarction from the establishment of the database to January 2023 were searched.Stata13 and RevMan5.3 were used for data statistical analysis.Results:A total of 75 RCTs involving 6 977 patients with acute myocardial infarction were included,including 3 506 patients in the experimental group and 3 471 patients in the control group,involving 7 intervention measures(6 traditional Chinese medicine injections):Shenmai injection combined with conventional Western medicine therapy(SM+CT),Danhong injection combined with conventional Western medicine therapy(DH+CT),Shuxuetong injection combined with conventional Western medicine therapy(SXT+CT),Shenfu injection combined with Western conventional therapy(SF+CT),Shengmai injection combined with Western conventional therapy(SGM+CT),tanshinone Ⅱ A sulfonic acid sodium injection combined with Western conventional therapy(DST+CT),and Western conventional therapy(CT).The results of the mesh meta-analysis showed that the cumulative probability ranking of the clinical total effective rate was as follows:SXT+CT(70.8％)＞DH+CT(70.5％)＞SGM+CT(69.2％)＞SF+CT(65.8％)＞SM+CT(42.2％)＞DST+CT(31.4％)＞CT(0.0％).The cumulative probability ranking for troponin improvement was as follows:SF+CT(83.4％)＞SXT+CT(74.5％)＞DH+CT(71.5％)＞SM+CT(32.8％)＞DST+CT(27.3％)＞CT(10.5％).The cumulative probability ranking for improvement in left ventricular ejection fraction was as follows:SF+CT(89.3％)＞DH+CT(85.8％)＞SXT+CT(51.7％)＞SGM+CT(44.8％)＞DST+CT(43.0％)＞SM+CT(35.4％)＞CT(0.0％).In terms of the incidence of major adverse cardiovascular events(MACE)events,SF+CT(70.0％)＞DST+CT(68.4％)＞SXT+CT(66.5％)＞SM+CT(52.2％)＞DH+CT(39.1％)＞CT(3.7％).In terms of brain natriuretic peptide(BNP)improvement,SGM+CT(99.0％)＞SF+CT(58.6％)＞DH+CT(54.8％)＞SM+CT(46.3％)＞SXT+CT(40.3％)＞CT(0.9％).Conclusion:SXT+CT focuses on improving the overall clinical response rate of patients,SF+CT shows certain advantages in improving troponin,ejection fraction,and MACE,while SGM+CT focuses on reducing patients'BNP levels.In terms of safety,there was no significant difference between different traditional Chinese medicine injections combined with conventional Western medicine therapy and conventional Western medicine therapy alone.
acute myocardial infarctionTraditional Chinese medicine injectiontroponin Ⅰleft ventricular ejection fractionbrain natriuretic peptidenetwork Meta-analysis
万方数据
维普
