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      The Clinical Efficacy of Phytochemical Medicines Containing Tanshinol and Ligustrazine in the Treatment of Stable Angina: A Systematic Review and Meta-Analysis

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          Abstract

          Background

          Phytochemical medicines containing tanshinol and ligustrazine are commonly used in the treatment of stable angina in China, but their clinical effectiveness and risk have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the clinical efficacy.

          Methods

          Relevant randomized controlled trials (RCTs) of phytochemical medicines containing tanshinol and ligustrazine in the treatment of stable angina were searched in electronic databases. The search date was up to March 31, 2020, and the languages of the RCTs were limited to English and Chinese.

          Results

          A total of 28 studies, including 2518 patients, were included in the meta-analysis. It was shown that the adjunctive therapy of phytochemical medicines containing tanshinol and ligustrazine was better than the conventional therapies in the improvement of stable angina according to the clinical efficacy in symptoms ( n = 2518, RR = 1.24, 95% CI: 1.20 to 1.29, P < 0.01) and clinical efficacy in electrocardiography ( n = 1766, RR = 1.29, 95% CI: 1.19 to 1.40, P < 0.01).

          Conclusion

          The meta-analysis supported the use of phytochemical medicines containing tanshinol and ligustrazine in the treatment of stable angina. However, quality of the evidence for this finding was low due to a high risk of bias in the included studies. Therefore, well-designed RCTs are still needed to further evaluate the efficacy.

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          Most cited references88

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          The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

          Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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            Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial

            The Lancet, 391(10115), 31-40
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              Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus: A Scientific Statement From the American Heart Association

              Although cardiologists have long treated patients with coronary artery disease (CAD) and concomitant type 2 diabetes mellitus (T2DM), T2DM has traditionally been considered just a comorbidity that affected the development and progression of the disease. Over the past decade, a number of factors have shifted that have forced the cardiology community to reconsider the role of T2DM in CAD. First, in addition to being associated with increased cardiovascular risk, T2DM has the potential to affect a number of treatment choices for CAD. In this document, we discuss the role that T2DM has in the selection of testing for CAD, in medical management (both secondary prevention strategies and treatment of stable angina), and in the selection of revascularization strategy. Second, although glycemic control has been recommended as a part of comprehensive risk factor management in patients with CAD, there is mounting evidence that the mechanism by which glucose is managed can have a substantial impact on cardiovascular outcomes. In this document, we discuss the role of glycemic management (both in intensity of control and choice of medications) in cardiovascular outcomes. It is becoming clear that the cardiologist needs both to consider T2DM in cardiovascular treatment decisions and potentially to help guide the selection of glucose-lowering medications. Our statement provides a comprehensive summary of effective, patient-centered management of CAD in patients with T2DM, with emphasis on the emerging evidence. Given the increasing prevalence of T2DM and the accumulating evidence of the need to consider T2DM in treatment decisions, this knowledge will become ever more important to optimize our patients’ cardiovascular outcomes.
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                Author and article information

                Contributors
                Journal
                Evid Based Complement Alternat Med
                Evid Based Complement Alternat Med
                ECAM
                Evidence-based Complementary and Alternative Medicine : eCAM
                Hindawi
                1741-427X
                1741-4288
                2021
                2 February 2021
                2 February 2021
                : 2021
                : 8616413
                Affiliations
                1School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
                2St Michael's Hospital, University of Toronto, Toronto, M5B 1W8, Canada
                Author notes

                Academic Editor: Sai-Wang Seto

                Author information
                https://orcid.org/0000-0002-7119-4397
                https://orcid.org/0000-0003-2731-8433
                https://orcid.org/0000-0002-3413-5291
                https://orcid.org/0000-0002-4808-5790
                https://orcid.org/0000-0003-0532-551X
                https://orcid.org/0000-0001-5401-3331
                Article
                10.1155/2021/8616413
                7875616
                c99ddb4b-b6ce-4ff6-8f4a-fc6027f24095
                Copyright © 2021 Li Gao et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 May 2020
                : 22 November 2020
                : 21 January 2021
                Funding
                Funded by: China Postdoctoral Science Foundation
                Award ID: 2019M650598
                Funded by: Fundamental Research Funds for the Central Universities
                Award ID: 2019-JYB-JS-005
                Funded by: National Natural Science Foundation of China
                Award ID: 81874514
                Funded by: National Key Research and Development Program of China
                Award ID: 2017YFC1700102
                Categories
                Research Article

                Complementary & Alternative medicine
                Complementary & Alternative medicine

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