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Network meta-analysis of oral Chinese patent medicines for coronary heart disease with diabetesNew Chinese medicines help heart patients with diabetes control blood sugar and pain better

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Key Takeaway
Consider specific Chinese patent medicines for targeted biomarker improvement in CHD with diabetes.

This systematic review and network meta-analysis assessed the efficacy of various oral Chinese patent medicines combined with conventional Western therapy in patients with coronary heart disease complicated by diabetes mellitus. The analysis included data from 7,988 patients. The review compared these interventions against conventional Western therapy alone to determine relative efficacy across multiple secondary outcomes.

Shexiang Baoxin Pills combined with conventional Western medicine exhibited optimal efficacy for reducing triglycerides, improving high-density lipoprotein cholesterol, decreasing left ventricular end-systolic diameter, reducing angina pectoris frequency and duration, and lowering inflammatory markers including interleukin-6, tumor necrosis factor-alpha, high-sensitivity C-reactive protein, endothelin-1, fibrinogen, and malondialdehyde. Tongxinluo Capsules combined with conventional Western medicine achieved the best outcomes for clinical efficacy, reducing 2-hour postprandial blood glucose, improving left ventricular end-diastolic diameter, and increasing nitric oxide levels.

Yindan Xinnaotong Soft Capsules combined with conventional Western medicine showed the most prominent effects on increasing left ventricular ejection fraction, reducing whole blood high-shear and low-shear viscosity, and improving superoxide dismutase levels. Jinlida Granules combined with conventional Western medicine yielded the best results for reducing fasting blood glucose, low-density lipoprotein cholesterol, and total cholesterol. Guanxinning Tablets combined with conventional Western medicine demonstrated optimal efficacy for reducing glycated hemoglobin. Liuwei Dihuang Pills combined with conventional Western medicine achieved optimal efficacy for reducing the incidence of major adverse cardiovascular events. Yangxinshi Tablets combined with conventional Western medicine exhibited the most significant decrease in N-terminal pro-B-type natriuretic peptide. Danzhi Jiangtang Capsules combined with conventional Western medicine achieved the best outcomes for reducing total cholesterol.

The primary outcome was not reported in this analysis. The authors synthesized findings based on specific secondary outcomes such as glycemic control, lipid profiles, cardiac function, angina-related measures, inflammatory markers, endothelial function, hemorheological parameters, and major adverse cardiovascular events. Adverse reactions were listed as a secondary outcome category but specific rates were not detailed in the provided data. The practice relevance is restrained due to the heterogeneity of the Chinese patent medicines and the lack of reported primary outcomes or specific adverse event frequencies.

Imagine waking up with chest pain that feels like heavy weight on your chest. This is angina, a warning sign from a heart under stress. Now imagine having diabetes too. This combination makes the heart disease much harder to treat.

Doctors have struggled for years to find the perfect mix of medicines for these patients. Standard treatments often lower blood sugar but do not always stop the chest pain or protect the heart muscle well enough.

But here is the twist. A massive new study looks at a different kind of medicine. These are oral Chinese patent medicines. They have been used for centuries in traditional healing. Now science is finally measuring how they work alongside modern Western drugs.

The research team looked at how these medicines change the body. Think of your blood vessels like a busy highway. Diabetes and heart disease cause traffic jams. These medicines act like a switch that clears the jam. They help blood flow smoothly again.

Another way to think about it is a lock and key. Your body has specific receptors that control inflammation and blood sugar. Some of these medicines fit the lock perfectly to turn down the fire of inflammation. This stops the damage to the heart walls.

The study team searched many databases for trials. They found 71 different studies. Together, these studies included nearly 8,000 patients. The researchers used advanced math to compare many different medicines at once. This is called a network meta-analysis.

They tested many things. They looked at blood sugar levels. They checked cholesterol numbers. They measured how well the heart pumps blood. They also tracked how often patients felt chest pain.

One medicine stood out for heart pain. Shexiang Baoxin Pills helped lower triglycerides and improved heart muscle size. Another medicine, Tongxinluo Capsules, was best for lowering blood sugar after meals.

Different pills worked for different problems. Some lowered cholesterol better than others. Some reduced the stickiness of the blood. This stickiness can cause clots that lead to heart attacks.

This does not mean these treatments are available in every pharmacy yet.

The study results are promising but not perfect. The researchers had to be careful. The studies they looked at had different methods. Some were small. Some were done in only one hospital. This makes it hard to be 100% sure about the results.

Experts say we need bigger studies. We need trials with thousands of patients in many countries. Only then can we be sure these medicines work for everyone.

For now, patients should talk to their doctor. Do not stop taking your current medicines without advice. These Chinese medicines might be an option to discuss. They could fit into your current treatment plan.

The road ahead is clear. More research is needed. Scientists want to confirm these findings with larger groups of people. They also want to check for any side effects over a long time.

Until then, the message is hopeful. There are new tools to help heart patients with diabetes. These tools offer hope for better control of blood sugar and less pain. The goal is a healthier heart for everyone.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
BackgroundCoronary heart disease (CHD) frequently coexists with diabetes mellitus (DM), resulting in a complex metabolic–vascular disorder with poor cardiovascular prognosis. Oral Chinese patent medicines (OCPMs) are widely used as adjunctive therapies in China. However, their comparative efficacy and safety remain unclear.MethodsWe systematically searched Chinese and international databases for randomized controlled trials (RCTs) evaluating OCPMs combined with conventional Western therapy in patients with CHD complicated by DM. We conducted a network meta-analysis using R and Stata software. The evaluated outcomes included glycemic control, lipid profiles, cardiac function, angina-related measures, inflammatory markers, endothelial function, hemorheological parameters, major adverse cardiovascular events (MACEs), and adverse reactions. We assessed treatment rankings using the surface under the cumulative ranking curve.ResultsA total of 71 RCT articles were included, with a total sample size of 7,988 patients, involving 14 types of OCPMs. The NMA revealed the following results: Shexiang Baoxin Pills combined with conventional Western medicine exhibited optimal efficacy in reducing triglycerides (TG), improving high-density lipoprotein cholesterol (HDL-C) and left ventricular end-systolic diameter (LVESD), decreasing the weekly frequency and duration of angina pectoris episodes, and lowering levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), endothelin-1 (ET-1), and fibrinogen (FIB). Tongxinluo Capsules combined with conventional Western medicine achieved the best outcomes in clinical efficacy, reducing 2-h postprandial blood glucose (2 h PBG), improving left ventricular end-diastolic diameter (LVEDD), increasing nitric oxide (NO), and improving malondialdehyde (MDA). Yindan Xinnaotong Soft Capsules combined with conventional Western medicine showed the most prominent effects in enhancing left ventricular ejection fraction (LVEF), reducing whole blood high-shear viscosity and low-shear viscosity, and improving superoxide dismutase (SOD). Guanxinning Tablets combined with conventional Western medicine demonstrated optimal efficacy in lowering glycated hemoglobin (HbA1c). Jinlida Granules combined with conventional Western medicine yielded the best results in reducing fasting blood glucose (FBG) and low-density lipoprotein cholesterol (LDL-C). Liuwei Dihuang Pills combined with conventional Western medicine achieved optimal efficacy in reducing the incidence of MACE. Yangxinshi Tablets combined with conventional Western medicine exhibited the most significant decrease in N-terminal pro-B-type natriuretic peptide (NT-proBNP). Finally, Danzhi Jiangtang Capsules combined with conventional Western medicine achieved the best outcomes in reducing total cholesterol (TC).ConclusionsOCPMs combined with conventional therapy provide multidimensional benefits for patients with CHD complicated by diabetes. However, the findings should be interpreted with caution due to heterogeneity and variable study quality, highlighting the need for high-quality, large-scale, multicenter RCTs to confirm these results.Systematic Review RegistrationPROSPERO CRD42024626573.
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