Background
Methods
Ethics
Search strategy
Inclusion criteria
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The study is a randomized controlled trial (RCT).
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The study includes participants diagnosed with CSX by the criteria listed in ANGINA PECTORIS AND NORMAL CORONARY ARTERIES: CARDIAC SYNDROME X[18].
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The study includes intervention and comparison of any of the following:
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*Routine treatment includes nitrate medications, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers, as recommended in the essay Therapeutic Options for the Management of Patients with Cardiac Syndrome X[19].
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Outcomes to be measured include symptom improvement and electrocardiograph (ECG) changes and/or treadmill test results. Any adverse event defined in “ICH—GCP 1997” [20] should be recorded.
Exclusion criteria
Study selection
Data collection
Statistical analysis
Subgroup analysis, sensitivity, and meta-regression
Results
General characteristics of the included studies
Studies | Case | Age | Gender | Co | F | CP | Outcome | AE | CI | Type of TI | TI |
---|---|---|---|---|---|---|---|---|---|---|---|
Year* | (T/C) | (M/F) | (d) | ||||||||
Sun 2007 [24] | 64(34/30) | 37~62 | T:13/21C:11/19 | 56 | 0 | y | AF,TT | U | RT | Chinese patent drug |
Shenwuguanxinning granules 15 g tid + RT |
Ge 2011 [25] | 39(19/20) | 45~56 | 10/29 | 28 | 0 | y | A,AF,TTET-1 | U | RT | Decoction | Nourishing Qi and Blood Decoction 1 150 mL qd + RT |
Peng 2011 [26] | 46(23/23) | 35~65 | 18/28 | 56 | 0 | y | A,AF,TT | N | RT | Chinese patent drug |
Xinnaotong capsule 0.8 g bid + RT |
Niu 2008 [27] | 50(30/20) | 35~65 | 21/29 | 28 | 0 | y | A,AF,ECG,TT,TCM | N | RT | Chinese patent drug |
Xinxuean granules 15 g tid + RT |
Gao 2005 [28] | 63(33/30) | 45~64 | 0/63 | 28 | 0 | y | A | U | RT | Decoction |
Xiaoyao decoction2 150 mL bid |
Xu 2011 [29] | 30(15/15) | 35~60 | 10/20 | 28 | 0 | y | A,AF,TT | U | RT | Chinese patent drug |
Wenxin granules3 9 g, tid + RT |
Bi 2003 [30] | 60(30/30) | 44~61 | 27/33 | 28 | 6 m | y | A | N | RT | Chinese patent drug |
Tongxinluo 1.52 g, tid |
Wang 2009 [31] | 55(28/27) | 43~65 | T: 5/23 C: 3/24 | 14 | 0 | y | A,ECG,TCM,TTET-1,NOhs-CRP | N | RT | Decoction |
Kuanxionghuoxue decoction4 150 ml bid + RT |
Xu LJ 2002 [32] | 56(36/20) | 31~48 | T:23/13 C:13/7 | 7 | 7d | y | A,ET-1,Holter | U | RT | Chinese patent drug |
Quanshi capsule 1.5 g tid |
Liu 2008 [33] | 58(38/20) | 36~55 | 37/21 | U | 0 | y | A,ECG | U | RT | Chinese patent drug |
Naoxintong tablets, 1.6 g, tid |
Zhang 2002 [34] | 40(20/20) | 30~59 | 18/22 | 15 | 0 | y | A,ECG | U | RT | Decoction |
Taohongsiwu decoction5 150 mL qd |
Lu 2007 [35] | 114(72/72 | 18~60 | 56/88 | 84 | 0 | y | TT,ECG | N | RT | Chinese patent drug |
Tongxinluo capsule 1.52 g tid |
Zhu 2003 [36] | 60(30/30) | 30~59 | 38/22 | 15 | 0 | y | A,ECG | U | RT | Decoction |
Xuefuzhuyu decoction 6150 mL qd |
Liang 2005 [37] | 42(21/21) | 51~60 | 12/30 | 28 | 0 | y | A,AF, TCM,TT hs-CRP | N | RT placebo | Chinese patent drug |
Danshen tablets, three tablets per time, tid + RT |
Yuan 2008 [38] | 40(20/20) | 48~67 | T:9/11 C:13/7 | 28 | 0 | y | AF,TT | U | RT | Injection |
Danhong injection 30 ml + 5% glu or 0.9% NaCI 250 ml, iv, qd |
Wang GF 2008 [39] | 36(18/18) | 33~70 | T:3/15 C:2/16 | 28 | 0 | y | AF,TT,CRP,ET-1,NO | N | RT | Decoction |
Guanmailing decoction7 150 ml bid+ RT |
Zhang SL 2008 [40] | 72(36/36) | 37~62 | T:6/30 C:3/31 | 20 | 0 | y | A | N | R | Chinese patent drug |
Guanmaining
8 10 ml tid + xiaoyao pill, 8 pills, tid+ RT |
Zhang XY 2008 [41] | 68(48/28) | 42~58 | T:11/37 C:6/14 | 21 | 0 | y | A,ECG | U | RT | Decoction | Individualized Chinese formulas against different patterns of syndrome9 150 ML bid+ RT |
Wu 2010 [42] | 50(26/24) | 39~50 | T:10/16 C: 9/15 | 15 | 0 | y | AF,TT, CRP | N | RT | Injection |
Shuxuening injection 20 ml+ 0.9% NaCI 250 ml, iv, qd+ RT |
Li 2009 [43] | 68(36/32) | 49~64 | T:16/20 C:14/18 | 30 | 0 | y | ECG, blood lipid, ET-1,No, | Y | RT | Chinese patent drug |
Tongxinluo capsule, 2.14 g, tid + RT |
Feng 2005 [44] | 32(16/16) | 37~51 | T:7/9 C:8/8 | 28 | 0 | y | AF,TT ET-1 | U | RT | Chinese patent drug |
Tongxinluo capsule, 1.14 g tid+ RT |
Quality assessment of the included studies
Studies year* | Randomization | Allocation concealment | Blinding | Loss to follow-up | ITT analysis |
---|---|---|---|---|---|
Sun 2007 [24] | yes | unclear | unclear | no | unclear |
Ge 2011 [25] | yes | unclear | unclear | no | unclear |
Peng 2011 [26] | yes | unclear | yes | no | unclear |
Niu 2008 [27] | yes | unclear | yes | no | unclear |
Gao 2005 [28] | yes | unclear | unclear | no | unclear |
Xu 2011 [29] | yes | unclear | unclear | no | unclear |
Bi 2003 [30] | yes | unclear | unclear | no | unclear |
Wang 2009 [31] | yes | unclear | unclear | no | unclear |
Xu LJ 2002 [32] | yes | unclear | unclear | no | unclear |
Liu 2008 [33] | yes | unclear | unclear | no | unclear |
Zhang 2002 [34] | yes | unclear | unclear | no | unclear |
Lu 2007 [35] | yes | unclear | unclear | no | unclear |
Zhu 2003 [36] | yes | unclear | unclear | no | unclear |
Liang 2005 [37] | yes | unclear | unclear | no | unclear |
Yuan 2008[38] | yes | unclear | unclear | no | unclear |
Wang GF 2008 [39] | yes | unclear | unclear | no | unclear |
Zhang SL 2008 [40] | yes | unclear | unclear | no | unclear |
Zhang XY 2008 [41] | yes | unclear | unclear | no | unclear |
Wu 2010 [42] | yes | unclear | unclear | no | unclear |
Li 2009 [43] | yes | unclear | unclear | no | unclear |
Feng 2005 [44] | yes | unclear | unclear | no | unclear |
Efficacy and safety analysis
Subgroup analysis
Sensitivity analysis and meta-regression
logRR | Coef. | Std. Err. | t | p | [95% Conf. | Interval] |
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Publication year | −0.0362491 | −0.53 | 0.0690226 | 0.627 | -.2278864 | 0.1553883 |
Sample size | 0.0006184 | 0.09 | 0.0072663 | 0.936 | −0.019556 | 0.0207929 |
Medication course | 0.0027627 | 0.25 | 0.0108927 | 0.812 | −0.0274803 | 0.0330058 |
Type of intervention | 0.12211139 | 0.60 | 0.2020443 | 0.578 | −0.4388511 | 0.683079 |
_cons | 72.78822 | 0.52 | 138.6524 | 0.627 | −312.1727 | 457.7491 |
Mean difference | Coef. | Std.err | T | P | [95% Conf. | Interval] |
---|---|---|---|---|---|---|
Publication year | 8.70691 | 19.39486 | 0.45 | 0.697 | −74.74244 | 92.15626 |
Sample size | .3612435 | 3.40234 | 0.11 | 0.925 | −14.27784 | 15.00033 |
Medication course | .3836948 | 2.185376 | 0.18 | 0.877 | −9.019221 | 9.786611 |
Type of interventions | 67.53072 | 71.69857 | 0.94 | 0.446 | −240.9633 | 376.0248 |
_cons | −17557.2 | 39125.53 | −0.45 | 0.698 | −185900.8 | 150786.4 |
Mean difference | Coef. | t | Std. Err. | P>t | [95% Conf. | Interval] |
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Publication year | 0.1781444 | 0.4136524 | 0.43 | 0.696 | −1.138282 | 1.494571 |
Sample size | 0.0122943 | 0.1209633 | 0.10 | 0.925 | −0.3726648 | 0.3972535 |
Medication course | −0.0931837 | 0.0898212 | −1.04 | 0.376 | −0.3790348 | 0.1926673 |
Type of interventions | −4.132576 | 2.23568 | −1.85 | 0.162 | −11.24751 | 2.982355 |
_cons | −352.001 | 831.7356 | −0.42 | 0.701 | −2998.955 | 2294.953 |