Published online Feb 6, 2024. doi: 10.12998/wjcc.v12.i4.766
Peer-review started: November 30, 2023
First decision: December 18, 2023
Revised: December 25, 2023
Accepted: January 15, 2024
Article in press: January 15, 2024
Published online: February 6, 2024
Heart failure (HF) is a cardiovascular condition with significant morbidity and mortality. While traditional Chinese medicine (TCM) is often used as a complementary approach for HF management, there is a lack of systematic evaluations on its impact. This study aims to fill this gap by analyzing randomized controlled trials (RCTs) focusing on TCM for HF treatment. The study assesses methodological quality, performs a meta-analysis, and evaluates evidence quality based on established standards. The results provide valuable insights into the potential advantages and limitations of TCM in managing HF. However, caution is advised due to the low and medium quality of the included RCTs, necessitating further high-quality research for confirming effectiveness.
The main motivation behind this research is the need for systematic evaluations of the impact of TCM on HF management. Despite its common use as a complementary approach, there is a lack of comprehensive studies analyzing the effects of TCM on clinical outcomes, TCM syndrome scores, and B-type natriuretic peptide (BNP) levels in HF patients. By conducting a meta-analysis of RCTs, this study aims to bridge this gap and provide valuable insights into the potential advantages and limitations of TCM in HF management. The findings will guide future research and contribute to the understanding of TCM's role in HF treatment.
The main objectives of this study were to systematically analyze the effects of TCM on clinical comprehensive outcomes, TCM syndrome scores, and BNP levels in HF patients. The study aimed to evaluate the quality of evidence for these trials by conducting a meta-analysis of RCTs. The objectives were realized through the retrieval and inclusion of relevant RCTs, assessment of methodological quality, meta-analysis using appropriate software, and rating of evidence quality based on established criteria. Realizing these objectives provided valuable insights into the effectiveness of TCM as a complementary therapy for HF and highlighted the need for further high-quality research in this field.
This study utilized a systematic search across Chinese and English databases to identify relevant RCTs on TCM for heart failure treatment. Methodological quality assessment employed the Cochrane risk-of-bias tool, while meta-analysis and publication bias evaluation were conducted using RevMan 5.3 software. The quality of evidence was appraised using GRADE criteria. A total of 16 RCTs involving 1660 HF patients were included, with a comprehensive analysis of clinical outcomes, TCM syndrome scores, and BNP levels. Novelty lies in the comprehensive nature of the analysis, providing crucial insights into the potential benefits and limitations of TCM in managing HF.
The meta-analysis of 16 RCTs revealed that the combination of TCM with conventional Western medicine (CWM) effectively improved comprehensive clinical outcomes, decreased TCM syndrome scores, and reduced BNP levels in patients with HF. The differences between the TCM and CWM groups were statistically significant for all three outcome measures. However, the overall quality of evidence was rated as low to medium due to the limitations of the included RCTs. These findings contribute valuable insights into the potential benefits of TCM in HF management, highlighting the need for further high-quality research in this field.
This study concludes that the combination of TCM with CWM treatment effectively improves comprehensive clinical outcomes, reduces TCM syndrome scores, and decreases BNP levels in HF patients. However, it is important to exercise caution when applying these results due to the low and medium quality of the included RCTs. This study fills the gap in systematic evaluations of TCM's impact on HF management by providing crucial insights into the potential advantages and constraints of TCM. Further research utilizing high-quality RCTs is needed to validate these findings.
Future research should focus on conducting high-quality RCTs with larger sample sizes and longer follow-up periods to establish the efficacy and safety of TCM in HF management. Additionally, investigations into the mechanisms underlying TCM's effects on comprehensive clinical outcomes, TCM syndrome scores, and BNP levels are crucial. It is essential to explore TCM's potential role as a standalone or complementary therapy and to address the limitations identified in this study to provide more robust evidence for TCM's application in HF treatment.