Document Detail

Shengmai (a traditional Chinese herbal medicine) for heart failure.
MedLine Citation:
PMID:  23152229     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This systemic review is an update of a review previously published in 2011. Heart failure is a major public health problem worldwide. Shengmai (a traditional Chinese herbal medicine) has long been used as a complementary treatment for heart failure in China.
OBJECTIVES: To assess the effects (both benefits and harms) of Shengmai for heart failure.
SEARCH METHODS: We searched CENTRAL and DARE on The Cochrane Library (2011, Issue 1), MEDLINE (1948 to March 2011), EMBASE (1980 to March 2011), AMED (1985 to August 2008) (AMED was not searched for the update as it is no longer available to the person conducting the searches), BIOSIS (1969 to March 2011), CBM (1978 to April 2011), VIP (1989 to April 2011) and CNKI (1979 to April 2011). We also handsearched Chinese journals. No language restrictions were applied.
SELECTION CRITERIA: Randomized controlled trials (RCTs) of Shengmai plus usual treatment versus usual treatment alone or Shengmai versus placebo in treating heart failure, irrespective of blinding status, were included. More stringent inclusion criteria were applied in this update and only studies with a clear description of randomization methods and classified as true RCTs were included.
DATA COLLECTION AND ANALYSIS: Two authors independently selected trials, assessed methodological quality and extracted data. Dichotomous and continuous data were calculated as relative risk (RR) and mean difference (MD) or standardized mean difference (SMD), respectively. A random-effects model and fixed-effect model were used to perform meta-analysis with and without heterogeneity, respectively.
MAIN RESULTS: Nine RCTs (600 patients) with seven comparing Shengmai plus usual treatment with usual treatment alone and three comparing Shengmai with placebo (one RCT contained three arms) were included in this updated review. Based upon the seven RCTs (494 patients), improvement of the New York Heart Association (NYHA) functional classification was more common in patients taking Shengmai plus usual treatment than in those receiving usual treatment alone (risk ratio 0.33, 95% confidence interval 0.23 to 0.47). Beneficial effects of Shengmai in treating heart failure were also observed on other outcomes, including an exercise test, ejection fraction, cardiac output, cardiac index and left ventricular end-systolic volume. The three RCTs (106 patients) which compared Shengmai with placebo reported an improvement in NYHA functional classification, ejection fraction, stroke volume, cardiac index and myocardial contractility. Three out of the nine RCTs reported mild adverse effects, and two patients were withdrawn due to the adverse effects. The results of this review should be interpreted with caution. This is due to the studies being of low quality, their small sample size, and the significant heterogeneity for certain outcomes including ejection fraction and cardiac output.
AUTHORS' CONCLUSIONS: Shengmai may be beneficial in treating heart failure, especially in terms of improving the NYHA functional classification with Shengmai plus usual treatment. However, the evidence for its effects on mortality and hospitalisation are not available yet. Therefore more studies, of higher quality and long-term follow-up, are needed to provide more evidence for the future use of Shengmai.
Jie Chen; Yu Yao; Haining Chen; Joey S W Kwong; Jin Chen
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2012-11-14
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  11     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2012  
Date Detail:
Created Date:  2012-11-15     Completed Date:  2013-01-15     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD005052     Citation Subset:  IM    
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MeSH Terms
Cardiotonic Agents / therapeutic use*
Drug Combinations
Drugs, Chinese Herbal / therapeutic use*
Heart Failure / drug therapy*
Phytotherapy / methods*
Randomized Controlled Trials as Topic
Treatment Outcome
Reg. No./Substance:
0/Cardiotonic Agents; 0/Drug Combinations; 0/Drugs, Chinese Herbal; 0/fructus schizandrae, radix ginseng, radix ophiopogonis drug combination
Update In:
Cochrane Database Syst Rev. 2014;4:CD005052   [PMID:  24733159 ]
Update Of:
Cochrane Database Syst Rev. 2011;(2):CD005052   [PMID:  21328272 ]

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