title: Puerarin injection for unstable angina pectoris.
abstract: BACKGROUND
  Puerarin is extracted from the Chinese herb puerariae lobata. Many users of Chinese herbal medicine believe that puerarin has positive effects in the treatment of coronary heart disease (CHD). In recent years puerarin injection has been widely used to treat CHD and angina pectoris.
  
  
  OBJECTIVE
  To assess the benefits and harms of puerarin injection for unstable angina.
  
  
  METHODS
  The following electronic databases were searched: The Cochrane Controlled Trials Register on The Cochrane Library (Issue 3, 2004), MEDLINE (1995 to 2004), EMBASE (1995 to 2004), CBM (1995 to 2004), Chinese Cochrane Centre Controlled Trials Register (to 2004), Current Controlled Trials (www.controlled-trials.com) and The National Research Register. We also hand searched 60 Chinese traditional medicine journals.
  
  
  METHODS
  Randomised controlled trials undertaken on adults with unstable angina evaluating the following types of interventions: Puerarin injection compared to western drugs or placebo, or puerarin injection used with western drugs compared to western drugs alone.
  
  
  METHODS
  Data were extracted and analysed independently by two reviewers. Differences in data extraction and analysis were resolved by consensus, referring back to the original article. Study authors were contacted for additional information. Adverse effects information was collected from the trials.
  
  
  RESULTS
  20 trials involving 1240 people were included. All trials identified were classified as having a high risk of bias because of poor reported methodology. The duration of treatment was 7-20 days and no information supplied suggested longer follow-ups were conducted for any trials. This limited the observation to participants who were not undertaking normal activities of daily living. The primary outcome (death) was not report in any trial. For all the secondary outcome measures, frequency of acute angina attacks, improvements in ECG, doses and incidence of nitroglycerine needed and levels of plasma endothelin, there was no evidence that puerarin had better or worse effects to other conventional treatments. There was strong evidence to suggest that puerarin injection plus western drugs was a better treatment option than western drugs alone.
  
  
  CONCLUSIONS
  Puerarin injection may be effective in unstable angina when used in addition to conventional treatments. However, these finding should be interpreted with care because of the very low methodological quality of studies and potential publication bias. In the light of the findings, a more rigorously designed, randomised double-blind placebo-controlled trial is needed.
authors.forename: Q
authors.initials: Q
authors.lastname: Wang
authors.forename: T
authors.initials: T
authors.lastname: Wu
authors.forename: X
authors.initials: X
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Ni
authors.forename: X
authors.initials: X
authors.lastname: Duan
authors.forename: J
authors.initials: J
authors.lastname: Zheng
authors.forename: J
authors.initials: J
authors.lastname: Qiao
authors.forename: L
authors.initials: L
authors.lastname: Zhou
authors.forename: J
authors.initials: J
authors.lastname: Wei
mesh_terms: D000328:Adult; D000789:Angina, Unstable / Q000188:drug therapy*; D006801:Humans; D007529:Isoflavones / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D007529:Isoflavones; D014665:Vasodilator Agents; C033607:puerarin