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Transplant International : Official... Nov 2021In donation after circulatory death (DCD), (thoraco)abdominal regional perfusion (RP) restores circulation to a region of the body following death declaration. We... (Meta-Analysis)
Meta-Analysis
In donation after circulatory death (DCD), (thoraco)abdominal regional perfusion (RP) restores circulation to a region of the body following death declaration. We systematically reviewed outcomes of solid organ transplantation after RP by searching PubMed, Embase, and Cochrane libraries. Eighty-eight articles reporting on outcomes of liver, kidney, pancreas, heart, and lung transplants or donor/organ utilization were identified. Meta-analyses were conducted when possible. Methodological quality was assessed using National Institutes of Health (NIH)-scoring tools. Case reports (13/88), case series (44/88), retrospective cohort studies (35/88), retrospective matched cohort studies (5/88), and case-control studies (2/88) were identified, with overall fair quality. As blood viscosity and rheology change below 20 °C, studies were grouped as hypothermic (HRP, ≤20 °C) or normothermic (NRP, >20 °C) regional perfusion. Data demonstrate that RP is a safe alternative to in situ cold preservation (ISP) in uncontrolled and controlled DCDs. The scarce HRP data are from before 2005. NRP appears to reduce post-transplant complications, especially biliary complications in controlled DCD livers, compared with ISP. Comparisons for kidney and pancreas with ISP are needed but there is no evidence that NRP is detrimental. Additional data on NRP in thoracic organs are needed. Whether RP increases donor or organ utilization needs further research.
Topics: Death; Graft Survival; Humans; Organ Preservation; Organ Transplantation; Perfusion; Retrospective Studies; Tissue Donors; Tissue and Organ Procurement
PubMed: 34570380
DOI: 10.1111/tri.14121 -
Electronic Physician Mar 2018Increased whole blood viscosity is associated with increased risk of morbidity and mortality of several life-threatening diseases, including cardiovascular and... (Review)
Review
BACKGROUND
Increased whole blood viscosity is associated with increased risk of morbidity and mortality of several life-threatening diseases, including cardiovascular and cerebrovascular disease. The effect of diet on human health has been indicated in many studies, and a health dietary pattern can reduce the incidence of several chronic diseases.
OBJECTIVE
The aim of this systematic review was to assess the effect of diet on blood viscosity and related parameters such as haematocrit (HCT).
METHODS
This systematic review was carried out in 2017. MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception to 2 May 2017. We selected and included randomized clinical trials (RCTs) in the study. The inclusion criteria were articles that describe the effect of any types of local and traditional diet on blood viscosity in apparently healthy individuals.
RESULTS
Three randomized controlled trials were included in this systematic review. Different diets were used in the included trials. In one study, ingested dried-bonito broth (DBB) for four weeks, significantly reduced the blood passage time in the intervention group from 55.4±3.4 to 47.6±2.0 sec (mean ± SEM, p<0.05) compared with no significant change in the placebo group. Another study has shown significantly increased blood fluidity score in a vegetarian group in contrast to the control group after six weeks. In the last study, plasma viscosity was significantly decreased in a group which used onion-olive-oil capsules compared to the placebo group, with a highly significant difference between the two groups (p=0.0015).
CONCLUSIONS
Our components of food diets may decrease blood viscosity in health status. Better and expanded methodology may improve our results.
PubMed: 29765583
DOI: 10.19082/6563 -
Medicina (Kaunas, Lithuania) Sep 2023: Diabetes can cause various vascular complications. The Compounded Danshen-Dripping-Pill (CDDP) is widely used in China. This study aimed to analyze the effectiveness... (Meta-Analysis)
Meta-Analysis Review
Effectiveness and Safety of Fufang Danshen Dripping Pill (Cardiotonic Pill) on Blood Viscosity and Hemorheological Factors for Cardiovascular Event Prevention in Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis.
: Diabetes can cause various vascular complications. The Compounded Danshen-Dripping-Pill (CDDP) is widely used in China. This study aimed to analyze the effectiveness and safety of CDDP in the blood viscosity (BV) with type 2 diabetes mellitus (T2DM). : We conducted a systematic search of seven databases from their inception to July 2022 for randomized controlled trials that used CDDP to treat T2DM. To evaluate BV, we measured low shear rate (LSR), high shear rate (HSR), and plasma viscosity (PV). Homocysteine and adiponectin levels were also assessed as factors that could affect BV. : We included 18 studies and 1532 patients with T2DM. Meta-analysis revealed that CDDP significantly reduced LSR (mean difference [MD] -2.74, 95% confidence interval [CI] -3.77 to -1.72), HSR (MD -0.86, 95% CI -1.08 to -0.63), and PV (MD -0.37, 95% CI -0.54 to -0.19) compared to controls. CDDP also reduced homocysteine (MD -8.32, 95% CI -9.05 to -7.58), and increased plasma adiponectin (MD 2.72, 95% CI 2.13 to 3.32). Adverse events were reported less frequently in the treatment groups than in controls. : CDDP is effective in reducing BV on T2DM. However, due to the poor design and quality of the included studies, high-quality, well-designed studies are required in the future.
Topics: Humans; Diabetes Mellitus, Type 2; Cardiotonic Agents; Blood Viscosity; Adiponectin; Drugs, Chinese Herbal; Cardiovascular Diseases; Homocysteine
PubMed: 37893448
DOI: 10.3390/medicina59101730 -
The Cochrane Database of Systematic... Sep 2015Intermittent claudication (IC) is a symptom of peripheral arterial disease (PAD) and is associated with high morbidity and mortality. Pentoxifylline, one of many drugs... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Intermittent claudication (IC) is a symptom of peripheral arterial disease (PAD) and is associated with high morbidity and mortality. Pentoxifylline, one of many drugs used to treat IC, acts by decreasing blood viscosity, improving erythrocyte flexibility and promoting microcirculatory flow and tissue oxygen concentration. Many studies have evaluated the efficacy of pentoxifylline in treating individuals with PAD, but results of these studies are variable. This is an update of a review first published in 2012.
OBJECTIVES
To determine the efficacy of pentoxifylline in improving the walking capacity (i.e. pain-free walking distance and total (absolute, maximum) walking distance) of individuals with stable intermittent claudication, Fontaine stage II.
SEARCH METHODS
For this update, the Cochrane Vascular Group Trials Search Co-ordinator searched the Specialised Register (last searched April 2015) and the Cochrane Register of Studies (2015, Issue 3).
SELECTION CRITERIA
All double-blind, randomised controlled trials (RCTs) comparing pentoxifylline versus placebo or any other pharmacological intervention in patients with IC Fontaine stage II.
DATA COLLECTION AND ANALYSIS
Two review authors separately assessed included studies,. matched data and resolved disagreements by discussion. Review authors assessed the methodological quality of studies by using the Cochrane 'Risk of bias' tool and collected results related to pain-free walking distance (PFWD) and total walking distance (TWD). Comparison of studies was based on duration and dose of pentoxifylline.
MAIN RESULTS
We included in this review 24 studies with 3377 participants. Seventeen studies compared pentoxifylline versus placebo. In the seven remaining studies, pentoxifylline was compared with flunarizine (one study), aspirin (one study), Gingko biloba extract (one study), nylidrin hydrochloride (one study), prostaglandin E1 (two studies) and buflomedil and nifedipine (one study). The quality of the evidence was generally low, with large variability in reported findings.. Most included studies did not report on random sequence generation and allocation concealment, did not provide adequate information to allow selective reporting to be judged and did not report blinding of assessors. Heterogeneity between included studies was considerable with regards to multiple variables, including duration of treatment, dose of pentoxifylline, baseline walking distance and participant characteristics; therefore, pooled analysis was not possible.Of 17 studies comparing pentoxifylline with placebo, 14 reported TWD and 11 reported PFWD; the difference in percentage improvement in TWD for pentoxifylline over placebo ranged from 1.2% to 155.9%, and in PFWD from -33.8% to 73.9%. Testing the statistical significance of these results generally was not possible because data were insufficient. Most included studies suggested improvement in PFWD and TWD for pentoxifylline over placebo and other treatments, but the statistical and clinical significance of findings from individual trials is unclear. Pentoxifylline generally was well tolerated; the most commonly reported side effects consisted of gastrointestinal symptoms such as nausea.
AUTHORS' CONCLUSIONS
Given the generally poor quality of published studies and the large degree of heterogeneity evident in interventions and in results, the overall benefit of pentoxifylline for patients with Fontaine class II intermittent claudication remains uncertain. Pentoxifylline was shown to be generally well tolerated.Based on total available evidence, high-quality data are currently insufficient to reveal the benefits of pentoxifylline for intermittent claudication.
Topics: Ankle Brachial Index; Humans; Intermittent Claudication; Pentoxifylline; Platelet Aggregation Inhibitors; Quality of Life; Randomized Controlled Trials as Topic; Vasodilator Agents; Walking
PubMed: 26417854
DOI: 10.1002/14651858.CD005262.pub3 -
The Cochrane Database of Systematic... Oct 2020Intermittent claudication (IC) is a symptom of peripheral arterial disease (PAD) and is associated with high morbidity and mortality. Pentoxifylline, one of many drugs... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intermittent claudication (IC) is a symptom of peripheral arterial disease (PAD) and is associated with high morbidity and mortality. Pentoxifylline, one of many drugs used to treat IC, acts by decreasing blood viscosity, improving erythrocyte flexibility, and promoting microcirculatory flow and tissue oxygen concentration. Many studies have evaluated the efficacy of pentoxifylline in treating people with PAD, but results of these studies are variable. This is the second update of a review first published in 2012.
OBJECTIVES
To determine the efficacy of pentoxifylline in improving the walking capacity (i.e. pain-free walking distance and total (absolute, maximum) walking distance) of people with stable intermittent claudication, Fontaine stage II.
SEARCH METHODS
For this update, the Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase and CINAHL databases, and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 28 January 2020. There were no language restrictions.
SELECTION CRITERIA
We included all double-blind, randomised controlled trials (RCTs) comparing pentoxifylline versus placebo or any other pharmacological intervention in people with IC Fontaine stage II.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected studies for inclusion, assessed the included studies, matched data and resolved disagreements by discussion. Review authors assessed the methodological quality of studies using the Cochrane 'Risk of bias' tool and collected results related to the outcomes of interest, pain-free walking distance (PFWD), total walking distance (TWD), ankle-brachial pressure index (ABI), quality of life (QoL) and side effects. Comparison of studies was based on duration and dose of pentoxifylline. We used GRADE criteria to assess the certainty of the evidence.
MAIN RESULTS
We identified no new eligible studies for this update. This review includes 24 studies with 3377 participants. Seventeen studies compared pentoxifylline versus placebo. The seven remaining studies compared pentoxifylline with flunarizine (one study), aspirin (one study), Gingko biloba extract (one study), nylidrin hydrochloride (one study), prostaglandin E1 (two studies), and buflomedil and nifedipine (one study). Risk of bias for the individual studies was generally unclear because there was a lack of methodological reporting for many of the included studies, especially regarding randomisation and allocation methods. Most included studies did not provide adequate information to allow selective reporting to be judged and did not report blinding of assessors. Heterogeneity between included studies was considerable with regards to multiple variables, including duration of treatment, dose of pentoxifylline, baseline walking distance and participant characteristics; therefore, pooled analysis for comparisons which included more than one study, was not possible. Pentoxifylline compared to placebo Of 17 studies comparing pentoxifylline with placebo, 11 reported PFWD and 14 reported TWD; the difference in percentage improvement in PFWD for pentoxifylline over placebo ranged from -33.8% to 73.9% and in TWD ranged from 1.2% to 155.9%. It was not possible to pool the data of the studies because data were insufficient and findings from individual trials were unclear. Most included studies suggested a possible improvement in PFWD and TWD for pentoxifylline over placebo (both low-certainty evidence). The five studies which evaluated pre-exercise ABI comparing pentoxifylline and placebo found no evidence of a difference (moderate-certainty evidence). Two of the three studies that evaluated QoL between people who received pentoxifylline and placebo were larger studies that used validated QoL tools and generally found no evidence of a difference between groups. One small, short-term study, which did not specify which QoL tool was used, reported improved QoL in the pentoxifylline group (moderate-certainty evidence). Pentoxifylline generally was well tolerated; the most commonly reported side effects consisted of gastrointestinal symptoms such as nausea (low-certainty evidence). Certainty of the evidence from this review was low or moderate, with downgrading due to risk of bias concerns, inconsistencies between studies and the inability to evaluate imprecision because meta-analysis could not be undertaken. The seven remaining studies compared pentoxifylline with either flunarizine, aspirin, Gingko biloba extract, nylidrin hydrochloride, prostaglandin E1, or buflomedil and nifedipine; data were too limited to allow any meaningful conclusions to be made.
AUTHORS' CONCLUSIONS
There is a lack of high-certainty evidence for the effects of pentoxifylline compared to placebo, or other treatments, for IC. There is low-certainty evidence that pentoxifylline may improve PFWD and TWD compared to placebo, but no evidence of a benefit to ABI or QoL (moderate-certainty evidence). Pentoxifylline was reported to be generally well tolerated (low-certainty evidence). Given the large degree of heterogeneity between the studies, the role of pentoxifylline for people with IC Fontaine class II remains uncertain.
Topics: Ankle Brachial Index; Humans; Intermittent Claudication; Pentoxifylline; Platelet Aggregation Inhibitors; Quality of Life; Randomized Controlled Trials as Topic; Vasodilator Agents; Walking
PubMed: 33063850
DOI: 10.1002/14651858.CD005262.pub4 -
HEMORHEOLOGY INDEX CHANGES IN A RAT ACUTE BLOOD STASIS MODEL: A SYSTEMATIC REVIEW AND META-ANALYSIS.African Journal of Traditional,... 2017Blood stasis has received increasing attention in research related to traditional Chinese medicine (TCM) and integrative Chinese and Western medicine. More than 90% of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Blood stasis has received increasing attention in research related to traditional Chinese medicine (TCM) and integrative Chinese and Western medicine. More than 90% of research studies use hemorheology indexes to evaluate the establishment of animal blood stasis models rather than pathological methods, as hemorheology index evaluations of blood stasis were short of the consolidated standard. The aim of this study was to evaluate the accuracy of hemorheology indexes in rat models of acute blood stasis (ABS) based on studies in which the ABS model had been confirmed by pathological methods.
MATERIALS AND METHODS
We searched the Chinese National Knowledge Infrastructure database (CNKI), Chinese Medical Journal Database (CMJD), Chinese Biology Medicine disc (CBM), Wanfang database, and PubMed for studies of rat blood stasis models; the search identified 18 studies of rat ABS models induced by subcutaneous injection of epinephrine combined with an ice bath. Each included study received a modified Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) score list and methodological quality assessment, then data related to whole blood viscosity, plasma viscosity, platelet aggregation rate, erythrocyte aggregation index, and fibrinogen concentration were extracted. Extracted data were analyzed using Revman 5.3; heterogeneity was tested using Egger's test.
RESULTS
A total of 343 studies of rat blood stasis were reviewed. Eighteen studies were included in this meta-analysis; the mean CAMARADES score was 3.5. The rat ABS model revealed a significant increase in whole blood viscosity (medium shear rate), whole blood viscosity (high shear rate), plasma viscosity, platelet aggregation rate, erythrocyte aggregation index, and fibrinogen concentration compared to controls, with weighted mean differences (WMD) of 2.42 mPa/s (95% confidence interval (CI) = 1.73 - 3.10); 1.76 mPa/s (95% CI = 1.28 - 2.24); 0.39 mPa/s (95% CI = 0.24 - 0.55); 13.66% (95% CI = 9.78 - 17.55); 0.84 (95% CI = 0.53 - 1.16); and 1.22 g/L (95% CI = 0.76 - 1.67), respectively. Subgroup analysis showed that whole blood viscosity, plasma viscosity, and the platelet aggregation rate test methods were more sensitive when measured at 0-24 h than at 24-72 h after induction of blood stasis.
CONCLUSIONS
Rat blood stasis studies have incomplete experimental design and quality controls, and thus need an integrated improvement. Meta-analysis of included studies indicated that the unified hemorheology index of whole blood viscosity (medium and high shear rate), platelet aggregation rate, erythrocyte aggregation rate, and fibrinogen concentration might be used for assessment of rat ABS models independent of pathology methods.
Topics: Acute Disease; Animals; Disease Models, Animal; Hematologic Diseases; Hemorheology; Humans; Medicine, Chinese Traditional; Rats
PubMed: 28638872
DOI: 10.21010/ajtcam.v14i4.12 -
Antioxidants (Basel, Switzerland) Feb 2021Seminal fluid viscosity is a key parameter to achieve fertilization. Viscosity is more frequently increased in patients with infertility. However, the mechanism by which... (Review)
Review
INTRODUCTION
Seminal fluid viscosity is a key parameter to achieve fertilization. Viscosity is more frequently increased in patients with infertility. However, the mechanism by which hyperviscosity causes infertility is still poorly understood. As an increased blood viscosity is associated with diseases caused by oxidative stress, it can be supposed that there is a relationship between seminal fluid viscosity and oxidative stress in male infertility. Therefore, this systematic review aims to investigate the relationship between hyperviscous seminal fluid and oxidative stress.
MATERIALS AND METHODS
We performed a systematic search on the following databases Pubmed, MEDLINE, Cochrane, and Scopus from the earliest available date to 10 January 2021, using Medical Subjects Headings (MeSH) indexes and keywords searches. The study included all the articles that evaluated the relationship between increased seminal fluid viscosity and oxidative stress. Article reviews even though dealing with seminal fluid hyperviscosity were excluded.
RESULTS
5 articles were included in this systematic review. The results demonstrated an important impairment of antioxidant systems and increased oxidative stress in patients with high seminal fluid viscosity.
CONCLUSIONS
These findings suggest that a careful assessment of oxidative stress in patients with hyperviscosity may be very useful in clinical practice. Infertile patients with seminal fluid hyperviscosity could benefit from the treatment with antioxidants to protect sperm cells from oxidative damage and to improve their functional properties.
PubMed: 33673452
DOI: 10.3390/antiox10030356 -
Evidence-based Complementary and... 2019A systematic review of randomized trials was performed to assess the effect of Ginkgo Biloba Dropping Pills (GBDP) on clinical hemorheology and blood lipid indicators. (Review)
Review
OBJECTIVE
A systematic review of randomized trials was performed to assess the effect of Ginkgo Biloba Dropping Pills (GBDP) on clinical hemorheology and blood lipid indicators.
METHODS
The data of the Embase, Cochrane Library, PubMed, Clinical Trials, China National Knowledge Infrastructure, the Wanfang database, the VIP database, and the Sinomed were retrieved by computers from the establishment of the database to March 27, 2018, and screened and extracted by two researchers according to inclusion and exclusion criteria. Cochrane 5.0 recommended bias risk assessment tool was used to evaluate the methodological quality of the included literature, and Revman 5.3 software were used for meta-analysis.
RESULTS
10 literatures were finally selected in accordance with the standard. There were a total of 1201 cases, 608 cases in ginkgo biloba dropping pill group and 593 in routine treatment group. Compared with control group, GBDP significantly improved plasma viscosity [N=383, RR= - 0.45, 95%CI=(-0.86,-0.04), P=0.03], whole blood high shear [N=232, RR= - 0.92,95%CI=(-1.69, -0.16), P =0.02], whole blood low shear [N = 232, RR = - 2.22, 95% CI = (- 3.74, -0.7), P = 0.004], red blood cell specific volume [N =132, RR = - 4.55, 95% CI = (- 6.36, 2.73), P < 0.000 01], fibrinogen [N=243, RR=-0.60,95%CI=(-0.82,-0.39), P<0.00001], triglyceride [N=912, RR=-0.60,95%CI=(-1.12, -0.07), P =0.03], cholesterol [N=912, RR=-0.97,95%CI=(-1.41, -0.52), P <0.0001], low-density cholesterol [N=1100, RR=-0.72,95%CI=(-1.19, -0.25), P =0.003], and sensitivity analysis before and after of high-density cholesterol [N=1020, RR=0.08,95%CI=(-0.17,0.34), P =0.52] and [N=683, RR=0.27,95%CI=(0.13,0.42), P =0.0003]. And seven adverse reactions were reported.
CONCLUSION
GBDP can improve hemorheology indexes, which is to reduce the blood viscosity, to improve blood lipid status, and to prevent and treat cardiocerebral and renal vascular diseases to a certain extent, with slight clinical adverse reactions. But our results were based on small amount of clinical studies with poor quality and insufficient evidence, which may lead to low credibility of conclusions. Therefore, more large-sample, multiple-center, randomized controlled clinical trials and related mechanisms researches are needed to obtain better clinical trial evidence in order to verify the further effectiveness and safety of GBDP on hemorheology.
PubMed: 31379955
DOI: 10.1155/2019/2609625 -
Frontiers in Pharmacology 2023Xueshuantong (lyophilized) for injection (XST) is an effective botanical drug for treating unstable angina pectoris (UAP). However, a meta-analysis of XST combined with...
Xueshuantong (lyophilized) for injection (XST) is an effective botanical drug for treating unstable angina pectoris (UAP). However, a meta-analysis of XST combined with conventional treatment (CT) against UAP has not been conducted. Therefore, this study aimed to investigate the effectiveness and safety of XST combined with CT for UAP patients compared to CT alone. Randomized controlled trials (RCT) of XST in UAP patients were retrieved from the Cochrane Library, PubMed, Web of Science, EMBASE, CNKI, VIP, Wanfang, and Chinese Biological Medicine Database databases. A meta-analysis was performed using Revman 5.4 and Stata 16.0, and the quality of the included literature was evaluated based on the Cochrane risk-of-bias 2.0 (RoB2.0) tool. The aggregate 95% confidence intervals (CIs), mean difference (MD), and relative risk (RR) estimates were calculated. A GRADE assessment was performed using GRADEprofiler 3.6, and trial sequent analysis was performed using TSA 0.9. Thirty-four studies involving 3,518 patients were included in the analysis. The combination of CT with XST improved the comprehensive clinical efficacy (RR = 1.22, 95% CI: 1.18-1.26, < 0.00001) and ECG improvement (RR = 1.24, 95% CI: 1.18-1.31, < 0.00001). The frequency of angina attacks was lower (MD = -0.73, 95% CI: -0.92 to -0.55, < 0.00001), and the duration was shorter (MD = -1.08, 95% CI: -1.44 to -0.72, < 0.00001) in the group that received CT combined with XST compared to the one without XST. Total cholesterol levels (MD = -1.30, 95% CI: -1.83 to -0.78, < 0.00001) and triglyceride levels (MD = -0.76, 95% CI: -0.93 to -0.59, < 0.00001) were lower in patients who received CT in combination with XST than those who received CT alone. CT combined with XST reduced whole blood viscosity (MD = -0.72, 95% CI = -0.99 to -0.44, < 0.00001) and plasma viscosity (MD = -0.24, 95% CI: -0.46 to -0.03, = 0.03). There was no statistically significant difference in the incidence of cardiovascular events or adverse events among patients treated with the combination of XST and CT compared to CT alone. The GRADE assessment indicated that the composite quality of the evidence was low. The trial sequent analysis showed an adequate sample size and stable findings for the clinical efficacy of CT combined with XST for unstable angina. The present systematic review and meta-analysis conditionally indicate that XST combined with CT improved the clinical outcomes of patients with unstable angina more than CT alone with a better safety profile. However, the results need further validation due to limitations in the quality of the included studies. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022357395.
PubMed: 37089918
DOI: 10.3389/fphar.2023.1074400 -
Frontiers in Public Health 2021Coronary heart disease (CHD) is one of the most common diseases in clinical cardiovascular practice, mainly afflicting the middle-aged and elderly. It will greatly... (Meta-Analysis)
Meta-Analysis
The Effects of Aspirin With Combined Compound Danshen Dropping Pills on Hemorheology and Blood Lipids in Middle-Aged and Elderly Patients With CHD: A Systematic Review and Meta-Analysis.
Coronary heart disease (CHD) is one of the most common diseases in clinical cardiovascular practice, mainly afflicting the middle-aged and elderly. It will greatly affect elderly quality of life, and even affect their psychological and physical health. At present, CHD is treated with western drugs alone, but this can produce drug dependency. In recent years, Traditional Chinese Medicine (TCM) combine western drugs has been used as a complementary and alternative therapy, and its effectiveness and safety have been proven, attracting the attention of numerous researchers. Our study aimed to compare the efficacy of Aspirin with Combined Compound Danshen Dropping Pills had a superior effect on the treatment of Hemorheology and Blood Lipids in Middle-aged and Elderly Patients with CHD. Determine the effectiveness and safety of Aspirin with Combined Compound Danshen Dropping Pills in the treatment of CHD, and obtain high quality clinical evidence. Based on the PRISMA Statement, inclusion and exclusion criteria were formulated. Randomized controlled trials (RCTs) on the Effects of Aspirin with Combined Compound Danshen Dropping Pills on Hemorheology and Blood Lipids in Middle-aged and Elderly Patients with CHD were found following a search of 4 mainstream medical databases. RCTs found to meet the study's requirement were included; data information was then extracted, and the quality assessed using the Cochrane bias risk assessment tool. Through RevMan software, Meta analysis was carried out for overall TC, TG, HDL-C, LDL-C hematocrit, high shear viscosity, low shear viscosity, plasma viscosity, PAGM, and TXB effective rate. The relative risk (RR) and 95% confidence interval (95% ) were calculated; heterogeneity was tested and its source found; publication bias was assessed through the Egger and Begg tests, and by means of funnel plots. 22 RCTs were found, involving 1,987 cases. The results of the Meta analysis showed that, compared to drug therapy alone, Aspirin with Combined Compound Danshen Dropping Pills had a superior effect on the treatment of Hemorheology and Blood Lipids in Middle-aged and Elderly Patients with CHD. The meta analysis results show the effects on TC [MD = -0.91, 95% CI (-1.09, -0.73)], on TG [MD = -0.94, 95% CI (-1.22, -0.66)], on HDL-C [MD = 0.40, 95% CI (0.27, 0.53)], on LDL-C [MD = -0.99, 95% CI (-1.24, -0.74)], on hematocrit [MD = -2.69, 95% CI (-3.73, -1.65)], on high shear blood viscosity [MD = -1.11, 95% CI (-2.18, -0.05)], on low shear viscosity [MD = -0.79, 95% CI (-0.89, -0.68)], on plasma viscosity [MD = -0.26, 95% CI (-0.52, 0.01)], on PAMG [MD = -10.75, 95% CI (-16.84, -4.67)], and on TXB [MD = -11.84, 95% CI (-14.75, -8.92)]. The source of heterogeneity might be related to the state of patient, efficacy of drugs in the control group and difference in judgment criteria for efficacy. The Egger test and Begg test showed that publication bias did not occur in our study. The combination of compound dropping pill DSP with aspirin has some therapeutic effect on blood lipids and hemorheology in patients with CHD, ince some of the RCTs featured a very small sample size, the reliability and validity of our study's conclusion may have been affected as well; therefore, the explanation should be treated with some caution. In the future, a large number of higher-quality RCTs are still needed to confirm the results of our study.
Topics: Aged; Aspirin; Coronary Disease; Hemorheology; Humans; Lipids; Middle Aged; Salvia miltiorrhiza
PubMed: 34222174
DOI: 10.3389/fpubh.2021.664841