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Danshen (Chinese medicinal herb) preparations for acute myocardial infarction

  1. Taixiang Wu1,*,
  2. Juan Ni2,
  3. Jiafu Wei2

Editorial Group: Cochrane Heart Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 13 FEB 2008

DOI: 10.1002/14651858.CD004465.pub2

Database Title

Additional Information

How to Cite

Wu T, Ni J, Wei J. Danshen (Chinese medicinal herb) preparations for acute myocardial infarction. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD004465. DOI: 10.1002/14651858.CD004465.pub2.

Author Information

  1. 1

    West China Hospital, Sichuan University, Chinese Cochrane Centre, Chinese EBM Centre, Chengdu, Sichuan, China

  2. 2

    West China Hospital of Sichuan University, Clinical Epidemiology, Chengdu, Sichuan, China

*Taixiang Wu, Chinese Cochrane Centre, Chinese EBM Centre, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, 610041, China. txwutx@hotmail.com. txwutx@public.cd.sc.cn.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Acute myocardial infarction (AMI) is the most important cause of morbidity from ischaemic heart disease, and is among the leading causes of death in the western world. Danshen, a Chinese herbal medicine, is widely used in China for treatment of several diseases, including AMI.

Objectives

To assess the effects (both benefits and harms) of danshen preparations for AMI.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (issue 4, 2006), MEDLINE (1966-2006), EMBASE (1980-2006), and the Chinese Biomedical Database (CBM) (1982-2006). We also handsearched 75 Chinese medical journals.

Selection criteria

Randomised controlled trials (RCTs) lasting at least 7 days were sought. Since it seemed evident that few RCTs were available, we also considered other controlled studies.

Data collection and analysis

Eligibility and trial quality were assessed by three reviewers.

Main results

Six studies comprised of 2368 participants were included. Only one trial was judged to be a genuine RCT and showed no statistically significant difference in reduction of total mortality (Peto OR 0.55, 95% CI 0.23 to 1.32), but a quasi-RCT reported a reduced total mortality (Peto OR 0.42, 95% CI 0.23 to 0.77). Pooling these trials yielded an approximate halving of mortality in those patients treated with danshen preparations plus usual care compared with usual care alone (Peto OR 0.46, 95% CI 0.28 to 0.75).

Authors' conclusions

The evidence to support use of danshen preparations is too weak to make any judgement about its effects. Evidence from RCTs is insufficient and of low quality. The safety of danshen preparations is unproven, although some adverse events have been reported. More evidence from high quality trials is needed to support the clinical use of danshen preparations.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Danshen (Chinese medicinal herb) preparations for acute myocardial infarction

Danshen - a Chinese herbal treatment - is widely used in China in addition to usual western forms of therapy in the treatment of acute myocardial infarction (AMI). However there is no strong evidence to support its use, and few rigorous studies have been conducted. Well designed and conducted randomised controlled trials are needed to provide adequate evidence of its role in the treatment of AMI.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

丹參(中藥草藥)配方在急性心肌梗塞的使用

急性心肌梗塞(AMI)是缺血性心臟病中最重要的罹病率,而且在西方世界仍是主要的死亡原因.丹參,一種中藥藥材,被廣泛的用在治療各種疾患,包括急性心肌梗塞.

目標

評估丹參對於急性心肌梗塞的利弊.

搜尋策略

我們搜尋了考科藍資料庫中的對照試驗(2006年第4期), Medline(1966年∼2006年), EMBASE(1980年∼2006年),和中國生藥資料庫(1982年∼2006年).我們同時也手動尋找了75種中國醫學期刊.

選擇標準

我們尋找為期最少七天的隨機對照試驗.因為這樣只有少數的隨機對照試驗符合資格.所以我們也考慮納用其他的對照試驗.

資料收集與分析

三個評論者來評估試驗的資格和品質.

主要結論

六個試驗,共2368個參與者被納入.只有一個試驗被評為名副其實的隨機對照試驗,該試驗顯示對於死亡率沒有艇計學上的差異(Peto OR 0.55,95%信賴區間 0.23∼1.32).但是另一個隨機對照試驗中顯示出總死亡率的減少(Peto OR 0.55, 95% CI 0.23 to 1.32),這些試驗的綜合起來發現,除了平常的照護外,另外加上丹參,比起只用平常的照護(usual care)的病人,死亡率大概減半(Peto OR 0.46,95% 信賴區間 0.28∼0.75)

作者結論

支持使用丹參的證據因為過於單薄,而不能評定他的效果.隨機對照測試的證據是不夠而且品質不佳的.雖然一些副作用有被報導過,但丹參的安全性始終未被證實,仍需要更多高品質的試驗證實丹參的臨床用途

翻譯人

本摘要由臺北榮民總醫院高建華翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

在中國針對急性心肌梗塞, 丹參, 一種中藥療法, 廣泛地加入西式的療法之中.然而證據不足以支持此一療法,而且嚴謹的試驗太少,我們需要設計良好和嚴謹執行的隨機臨床試驗,來提供足夠的證據.

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