Efficacy and Safety of Shengmai Preparation Combined with Western Medicine for Coronary Heart Disease: A Systematic Review and Meta-Analysis

The efficacy and safety of Shengmai preparation combined with Western medicine (SMP-WM) to treat coronary heart disease (CHD) were reviewed. Twenty-five randomized controlled trials of SMP-WM treatment for CHD were retrieved from seven databases and other trial sources between their inception and April 10, 2021. The risk of bias domains was accessed by Cochrane Collaboration's tool, and the data were statistically analyzed using RevMan 5.3 and Stata 12.0 software. The majority of included studies had a low or unclear risk of overall bias. Total mortality was not reduced (RR = 0.39, 95% CI: 0.13-1.19, p = 0.10), but the cardiovascular events (RR = 0.35, 95% CI: 0.22-0.54, p < 0.01), weekly frequency (SMD = -2.38, 95% CI: -2.89 - -1.88, p < 0.01), and duration (SMD = -3.24, 95% CI: -3.76 - -2.71, p < 0.01) of angina pectoris attacks were significantly decreased by SMP-WM. The SMP-WM combination exerted antiplatelet activity by reducing platelet adhesion (SMD = -0.97, 95% CI: -1.49 - -0.45, p = 0.0003) and the platelet reactivity index (SMD = -1.75, 95% CI: -2.04 - -1.46, p < 0.01). SMP-WM could protect endothelial function by increasing nitric oxide (SMD = 1.28, 95% CI: 0.54-2.02, p < 0.01) and decreasing endothelin (SMD = -1.26, 95% CI: -1.85 - -0.66, p < 0.01). The combination also improved hemorheology by reducing whole blood viscosity (SMD = -1.59, 95% CI: -2.32 - -0.85, p < 0.01), plasma viscosity (SMD = -0.65, 95% CI: -0.86 - -0.45, p < 0.01), and fibrinogen (SMD = -4.21, 95% CI: -4.58 - -3.83, p < 0.01). The SMP-WM combination favorably impacts cardiovascular events, angina symptoms, endothelial function, platelet aggregation, and blood viscosity, with comparable safety to that of routine Western medicine. Further investigation is required to enhance the strength of the evidence.