How Efficacious is Danshen (Salvia miltiorrhiza) Dripping Pill in Treating Angina Pectoris? Evidence Assessment for Meta-Analysis of Randomized Controlled Trials.
Autor: | Yongliang Jia, Siu-wai Leung |
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Předmět: |
DRUG therapy for angina pectoris
PHYTOTHERAPY ISOSORBIDE dinitrate (Drug) CONFIDENCE intervals INFORMATION storage & retrieval systems MEDICAL databases MEDICAL information storage & retrieval systems MEDLINE META-analysis ONLINE information services REGRESSION analysis RESEARCH funding STATISTICS SYSTEMATIC reviews DATA analysis TREATMENT effectiveness PUBLICATION bias ODDS ratio MANN Whitney U Test THERAPEUTICS |
Zdroj: | Journal of Alternative & Complementary Medicine; Sep2017, Vol. 23 Issue 9, p676-684, 9p |
Abstrakt: | Background: More than 230 randomized controlled trials (RCTs) of danshen dripping pill (DSP) and isosorbide dinitrate (ISDN) in treating angina pectoris after the first preferred reporting items for systematic reviews and meta-analyses-compliant comprehensive meta-analysis were published in 2010. Other metaanalyses had flaws in study selection, statistical meta-analysis, and evidence assessment. This study completed the meta-analysis with an extensive assessment of the evidence. Methods: RCTs published from 1994 to 2016 on DSP and ISDN in treating angina pectoris for at least 4 weeks were included. The risk of bias (RoB) of included RCTs was assessed with the Cochrane's tool for assessing RoB. Meta-analyses based on a random-effects model were performed on two outcome measures: symptomatic (SYM) and electrocardiography (ECG) improvements. Subgroup analysis, sensitivity analysis, metaregression, and publication bias analysis were also conducted. The evidence strength was evaluated with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) method. Results: Among the included 109 RCTs with 11,973 participants, 49 RCTs and 5042 participants were new (after 2010). The RoB of included RCTs was high in randomization and blinding. Overall effect sizes in odds ratios for DSP over ISDN were 2.94 (95% confidence interval [CI]: 2.53-3.41) on SYM (n = 108) and 2.37 (95% CI: 2.08-2.69) by ECG (n = 81) with significant heterogeneities (I² = 41%, p < 0.0001 on SYM and I² = 44%, p < 0.0001 on ECG). Subgroup, sensitivity, and metaregression analyses showed consistent results without publication bias. However, the evidence strength was low in GRADE. Conclusion: The efficacy of DSP was still better than ISDN in treating angina pectoris, but the confidence decreased due to high RoB and heterogeneities. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
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