Shengmai (a traditional Chinese herbal medicine) for heart failure.
BACKGROUND
Heart failure is a major public health problem world-wide. Shengmai (a traditional Chinese herbal medicine) has long been used as a complementary treatment for heart failure in China.


OBJECTIVE
To determine the effect (both benefits and harms) of shengmai plus usual treatment versus usual treatment alone for heart failure.


METHODS
We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (Issue 2, 2005), MEDLINE (1966 to May 2005), EMBASE (1984 to March 2004), AMED (1985 to July 2005), Chinese BioMedical Literature Database(1978 to April 2004), DARE (Issue 2, 2005) and BIOSIS (1997 to 2004). Seventeen Chinese journals were also handsearched.


METHODS
Trials of shengmai plus usual treatment versus usual treatment alone for heart failure were included. Randomized or quasi-randomized controlled trials, regardless of whether they were blinded, were included.


METHODS
Two reviewers selected trials, assessed methodological quality and extracted data independently. Dichotomous and continuous data were calculated as relative risk (RR), and weighted mean differences (WMD), respectively. No heterogeneity was detected between included trials. A fixed-effect model was used to perform meta-analysis.


RESULTS
Nineteen trials were included studies. Methodological quality of the included studies was low. Compared to usual treatment alone, shengmai plus usual treatment showed significant improvement in New York Heart Association classification of clinical status (RR 0.32; 95% CI 0.25 to 0.40), mortality (RR 0.25; 95% CI 0.07 to 0.86), and tumour necrosis factor-alpha (WMD -0.52; 95% CI -0.99 to -0.05). Improvements were also seen in hemodynanic tests (one trial, 100 participants). No adverse affects were reported in any of the included trials.


CONCLUSIONS
It is possible that shengmai plus usual treatment may be beneficial compared to usual treatment alone for heart failure. However the evidence is weak because of the poor quality of the included trials. Long-term and high quality studies are needed to provide clear evidence for the future use of shengmai.
Chen
J
J
Huaxi Hospital, Sichuan University, Clinical Epidemiology and Evidence-Based Medicine, Guo Xue Xiang 37#, Chengdu, Sichuan, China, 610041. chenjin888@sohu.com
Wu
G
G
Li
S
S
Yu
T
T
Xie
Y
Y
Zhou
L
L
Wang
L
L
D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008517:Phytotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; C009252:fructus schizandrae, radix ginseng, radix ophiopogonis drug combination