Efficacy and safety of traditional Chinese medicine in the treatment of coronary heart disease complicated with anxiety and/or depression after PCI: A systematic review and meta-analysis

Objective: The clinical efficacy and safety of traditional Chinese medicine in the treatment of anxiety and/or depression after PCI for coronary heart disease were systematically evaluated. Methods: The databases of CNKI, Wanfang, VIP, CMB, PubMed, Web of Science, PubMed, Web of Science and Cochrane Library were searched by computer, and the Chinese and English randomized controlled trials(RCTs)of traditional Chinese medicine in the treatment of anxiety and/or depression after PCI of coronary heart disease published from the database to November 2020 were included. The Cochrane bias risk tool and the modified Jadad scale were used to evaluate the quality of the included literature, and the RevMan 5.3 and Stata 16.0 software were used for Meta-analysis. Results: A total of 23 RCTs were included, including 1837 subjects, including 917 cases in the treatment group of traditional Chinese medicine, 920 cases in the control group, the baseline situation between groups was consistent, comparable. Meta-analysis results show that TCM treatment improves the total clinical effective rate[OR=2.34,95％CI(1.61,3.40),P<0.00001],and the efficacy of TCM syndrome[OR=5.19,95％CI(2.74,9.86),P<0.00001],reduce Hamilton anxiety scale HAMA score[SMD=-0.96,95％ CI(-1.78,-0.14),P=0.02],Hamilton Depression Scale HAMD score[SMD=-1.10,95％ CI(-1.79,-0.41),P=0.002],SAS self-rating scale score[SMD=-1.20,95％ CI(-1.75,-0.65),P<0.0001],SDS self-rating scale score[SMD=-1.14,95％ CI(-1.62,-0.65),P<0.00001] and other indicators are better than the control group, and the difference is statistically significant (P<0.05). Conclusion: The combination of traditional Chinese medicine intervention and conventional western medicine treatment after PCI can further improve the clinical efficacy of patients with anxiety and/or depression after PCI of coronary heart disease and has good safety. Due to the general quality of the literature included in this study, the above conclusions need to be further confirmed by high-quality randomized controlled double-blind clinical trials.