Background
Methods
Search strategy
Selection of reviews
Data extraction
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Basic information including publication year, retrieval strategy, inclusion criteria, quality assessment methods, and conclusions
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Number of included studies and participants
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Drug used, dose, and formulation (if formulation was available)
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Outcomes (including desirable outcomes and adverse events)
Assessment of methodological quality and quality of evidence
Methodological quality
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Was a priori design provided?
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Was there duplicate study selection and data extraction?
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Was a comprehensive literature search performed?
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Were published and unpublished studies included irrespective of language of publication?
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Was a list of studies (included and excluded) provided?
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Were the characteristics of the included studies provided?
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Was the scientific quality of the included studies assessed and documented?
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Was the scientific quality of the included studies used appropriately in formulating conclusions?
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Were the methods used to combine the findings of studies appropriate?
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Was the likelihood of publication bias assessed?
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Was a conflict of interest stated?
Quality of evidence
Quality level | Definition |
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High | We are very confident that the true effect lies close to that of the estimate of the effect |
Moderate | We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different |
Low | Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect |
Very low | We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect |
Data analysis
Results
Description of the included reviews
Researchers and publication time | Types of included studies | Number of studies (total sample) | Age | Interventions | Follow-up time | Evaluation criteria of methodology | Conclusions | |
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Treatment group | Control group | |||||||
Chen 2014 [11] | RCT | 12 (1001) | 39–80 | Banxia baizhu tianma tang + conventional medicine | Conventional medicine | – | Jadad | As compared with conventional medicine banxia baizhu tianma tang combined with it can improve the clinical curative effect in treating high blood pressure |
Wang 2012 [12] | RCT | 11 (981) | 36–86 | Danshen injection + control group | Hemostatic agents、dehydrator, regulation of blood pressure, brain cell protective agent | 6 months | Jadad | Danshen injection has a certain treatment effect in treating hypertensive cerebral hemorrhage, and the earlier the better |
Guo 2013 [13] | RCT | 14 (1364) | – | Liuwei dihuang pill + conventional medicine | Conventional medicine | – | Jadad | The whole therapy effect of liuwei dihuang pill combined with conventional medicine is better than that of single conventional medicine, and so do the SBP and DBP |
Zhou 2012 [22] | RCT | 8 (554) | – | Tianma gouteng yin + captopril | Captopril | – | Jadad | Compared with single captopril, the clinical efficacy of tianma gouteng yin combined with captopril is more better, which can improve symptoms with better blood pressure effect |
Dong 2011 [23] | RCT | 6 (543) | – | Tianma gouteng yin + captopril | Captopril | – | Jadad | Tianma gouteng yin may obtain better treatment result and more security than enalapril in treatment of essential hypertension |
Ren 2006 [24] | RCT | 11 (1010) | – | TCM combination therapy including Chinese herb medicine, Chinese patent medicines, acupuncture, etc.) + conventional medicine | Conventional medicine | – | Jadad | Traditional Chinese medicine may have similar effect with conventional medicine in primary hypertension therapy |
Dai 2010 [25] | RCT | 9 (655) | – | Therapied by Chinese herb medicine or combined with conventional medicine | Conventional medicine | – | Jadad | Traditional Chinese medicine can reduce the SBP and DBP effectively, improve efficiency, integrated Chinese and Western treatment is more better |
Du 2014 [26] | RCT | 10 (1777) | – | Yangxue qingnao granules + conventional medicine | Conventional medicine | – | Risk of bias | Yangxue qingnao granules can significantly improve headache, dizziness, insomnia symptoms of high blood pressure |
Li 2012 [27] | RCT | 17 (1323) | – | TCM combination therapy including Chinese herb medicine compound, Chinese patent medicines, acupuncture, etc.) + conventional medicine | Conventional medicine | – | Jadad | Traditional Chinese medicine has a certain effect in treatment of elderly hypertension patients and reduced pulse pressure with symptoms reduced |
Xiong 2012 [28] | RCT | 16 (1424) | 19–78 | Banxia baizhu tianma tang + blood pressure drugs | Blood pressure drugs or placebo | – | Risk of bias | Banxia baizhu tianma tang has better antihypertensive effect |
Wang 2013 [29] | RCT | 22 (1808) | 30–74 | Tianma gouteng yin + blood pressure drugs | Blood pressure drugs | – | Risk of bias | The efficacy and safety evidence of tianma gouteng yin, as an adjunct of blood pressure medicine, needs further study |
Wu 2013 [30] | RCT | 9 (784) | – | Tianma gouteng yin | Conventional medicine | – | Jadad | Tianma gouteng yin can effectively lower the SBP and DBP |
Methodological quality of the included reviews
Included studies | Item 1 | Item 2 | Item 3 | Item 4 | Item 5 | Item 6 | Item 7 | Item 8 | Item 9 | Item 10 | Item 11 | Total score |
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Chen 2014 [11] | N | Y | Y | Y | Y | Y | Y | Y | Y | Y | N | 9 |
Wang 2012 [12] | N | Y | Y | N | Y | Y | Y | Y | Y | Y | N | 8 |
Guo 2013 [13] | N | N | Y | N | Y | N | Y | Y | Y | Y | N | 6 |
Zhou 2012 [22] | N | N | Y | N | Y | N | Y | Y | Y | Y | N | 6 |
Dong 2011 [23] | N | Y | Y | N | Y | N | Y | Y | Y | Y | N | 7 |
Ren 2006 [24] | N | N | N | N | N | N | Y | Y | Y | Y | N | 4 |
Dai 2010 [25] | N | N | Y | Y | Y | Y | Y | Y | Y | N | N | 7 |
Du 2014 [26] | N | Y | N | Y | N | N | Y | Y | Y | Y | N | 6 |
Li 2012 [27] | N | N | N | Y | Y | N | Y | N | Y | Y | N | 5 |
Xiong 2012 [28] | N | Y | Y | Y | Y | Y | Y | Y | Y | N | Y | 9 |
Wang 2013 [29] | N | Y | Y | Y | Y | Y | Y | Y | Y | N | Y | 9 |
Wu 2013 [30] | N | Y | Y | Y | Y | Y | Y | Y | Y | N | Y | 9 |
Effect of interventions
Antihypertensive effect
Decreasing SBP and DBP effect
Traditional Chinese symptom improvement
Adverse events
Summary of other findings
Summary of quality of evidence
Study ID | Outcomes (number of studies) | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Quality of evidence |
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Chen 2014 [11] | Overall antihypertensive effect (12) | Seriousa | No serious | No serious | No serious | Strongly suspectedb | Low |
Traditional Chinese symptom improved (4) | Seriousa | Seriousc | No serious | No serious | Undetected | Low | |
Decrease of C-reactive protein (1) | Seriousa | No serious | No serious | Seriousd | Strongly suspectedb | Very low | |
Decrease of blood lipid (2) | Seriousa | Seriousc | No serious | Seriousd | Undetected | Very low | |
Decrease of serum uric acid homocysteine (2) | Seriousa | No serious | No serious | Seriousd | Strongly suspectede | Very low | |
Adverse events (1) | Seriousa | No serious | No serious | Seriousd | Strongly suspectede | Very low | |
Wang 2012 [12] | Effect of cerebral hemorrhage (6) | Seriousa | No serious | No serious | No serious | Undetected | Moderate |
Nervous function defect of cerebral infarction score (8) | Seriousa | Seriousc | No serious | No serious | Undetected | Low | |
Adverse events (5) | Seriousa | Seriousc | No serious | No serious | Undetected | Low | |
Guo 2013 [13] | Overall antihypertensive effect (9) | Seriousa | No serious | No serious | No serious | Undetected | Moderate |
Zhou 2012 [22] | Overall antihypertensive effect (6) | Seriousa | No serious | No serious | No serious | Undetected | Moderate |
Traditional Chinese symptom improved (4) | Seriousa | Seriousc | No serious | No serious | Undetected | Low | |
safety (5) | Seriousa | Seriousc | No serious | No serious | Undetected | Low | |
Dong 2011 [23] | Overall antihypertensive effect (6) | Seriousa | No serious | No serious | No serious | Strongly suspectedb | Low |
safety (2) | Seriousa | No serious | No serious | Seriousd | Strongly suspectede | Very low | |
Ren 2006 [24] | Overall antihypertensive effect (11) | Seriousa | No serious | No serious | No serious | Strongly suspectedb | Low |
Dai 2010 [25] | Decrease of systolic blood pressure (9) | Seriousa | No serious | No serious | Seriousd | Undetected | Low |
Decrease of diastolic blood pressure (9) | Seriousa | No serious | No serious | Seriousd | Undetected | Low | |
Du 2014 [26] | Relief of hypertensive headache (10) | Seriousa | No serious | No serious | No serious | Strongly suspectedb | Low |
Relief of hypertensive dizziness (5) | Seriousa | No serious | No serious | No serious | Strongly suspectedb | Low | |
Relief of hypertensive insomnia (3) | Seriousa | No serious | No serious | Seriousd | Strongly suspectedb | Very low | |
Li 2012 [27] | Overall antihypertensive effect (17) | Seriousa | No serious | No serious | No serious | Strongly suspectedb | Low |
Traditional Chinese symptom improved (6) | Seriousa | No serious | No serious | No serious | Strongly suspectedb | Low | |
Changes of pulse pressure (4) | Seriousa | Seriousc | No serious | Seriousd | Undetected | Very low | |
Xiong 2012 [28] | Decrease of systolic blood pressure (3) | Seriousa | Seriousc | No serious | Seriousd | Undetected | Very low |
Decrease of diastolic blood pressure (3) | Seriousa | Seriousc | No serious | Seriousd | Undetected | Very low | |
Adverse events (4) | Seriousa | No serious | No serious | Seriousd | Undetected | Low | |
Wang 2013 [29] | Decrease of systolic blood pressure (3) | Seriousa | Seriousc | No serious | No serious | Undetected | Low |
Decrease of diastolic blood pressure (3) | Seriousa | Seriousc | No serious | No serious | Undetected | Low | |
Wu 2013 [30] | Plasma superoxide dismutase increase (3) | Seriousa | No serious | No serious | Seriousd | Undetected | Low |
Overall antihypertensive effect (9) | Seriousa | Seriousc | No serious | No serious | Undetected | Low |