A systematic review and meta-analysis of a Chinese herbal remedy, Qili Qiangxin, as an adjuvant therapy to patients with heart failure

摘要

Methods: We searched six electronic databases until June2014 for randomized controlled trials (RCTs) of Qili Qiangxinfor patients with heart failure. After independent identificationof included trials and data extraction, we performed dataanalysis and quality assessment of the included trials usingReview Manager 5.2 and GRADEpro software. We conductedthe review based on our registered protocol [PROSPERO registration:CRD42013006106].Results: A total of 121 RCTs (123 publications) publishedbetween 2005 and 2014 were included, involving 10,731 heartfailure patients aged from 18 to 98 years old. The methodologicalquality of majority of included trials was poor.Meta-analysis showed no significant difference between QiliQiangxin plus conventional treatment and conventional treatmentalone for mortality (RR 0.48, 95%CI 0.20 to 1.14; n=483patients). However, Qili Qiangxin plus conventional treatmentreduced the major cardiovascular events (RR 0.47, 95%CI 0.31to 0.70; n=168 patients) and re-hospitalization due to heartfailure (RR 0.51, 95%CI 0.37 to 0.70; n=465 patients) comparedwith conventional treatment alone. Qili Qiangxin improvedNYHA levels (RR 1.40, 95%CI 1.30 to 1.50; n=4147 patients) andquality of life (MD -8.48 scores, 95% CI -9.56 to -7.39; n=792patients) measured by Minnesota Living with Heart FailureQuestionnaire (lower scores better). There were no seriousadverse events reported to Qili Qiangxin.Conclusion: Qili Qiangxin appears to be beneficial in reducingcardiovascular events, re-hospitalization and quality oflife in patients with heart failure. It appears to be safe. Thisfinding was based on low quality of clinical trials and mustbe interpreted with caution. Further large, rigorous trials arewarranted to confirm the benefit.