title: Systematic review on randomized controlled trials of coronary heart disease complicated with depression treated with Chinese herbal medicines.
abstract: OBJECTIVE
  This systemic review evaluated the efficacy and safety of Chinese herbal medicines (CHMs) in patients with coronary heart disease (CHD) complicated with depression.
  
  
  METHODS
  All databases were retrieved till September 30, 2014. Randomized controlled trials (RCTs) comparing CHMs with placebo or conventional Western medicine were retrieved. Data extraction, analyses and quality assessment were performed according to the Cochrane standards. RevMan 5.3 was used to synthesize the results.
  
  
  RESULTS
  Thirteen RCTs enrolling 1,095 patients were included. Subgroup analysis was used to assess data. In reducing the degree of depression, CHMs showed no statistic difference in the 4th week [mean difference (MD)=-1.06; 95% confidence interval (CI)-2.38 to 0.26; n=501; I(2)=73%], but it was associated with a statistically significant difference in the 8th week (MD=-1.00; 95% CI-1.64 to-0.36; n=436; I(2)=48%). Meanwhile, the combination therapy (CHMs together with antidepressants) showed significant statistic differences both in the 4th week (MD=-1.99; 95% CI-3.80 to-0.18; n=90) and in the 8th week (MD=-5.61; 95% CI-6.26 to-4.97; n=242; I(2)=87%). In CHD-related clinical evaluation, 3 trials reported the intervention group was superior to the control group. Four trials showed adverse events in the intervention group was less than that in the control group.
  
  
  CONCLUSIONS
  CHMs showed potentially benefits on patients with CHD complicated with depression. Moreover, the effect of CHMs may be similar to or better than antidepressant in certain fields but with less side effects. However, because of small sample size and potential bias of most trials, this result should be interpreted with caution. More rigorous trials with larger sample size and higher quality are warranted to give high quality of evidence to support the use of CHMs for CHD complicated with depression.
authors.affiliation: Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.
authors.forename: An-Lu
authors.initials: AL
authors.lastname: Wang
authors.affiliation: Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Luo
authors.affiliation: Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Shang
authors.affiliation: Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China. xuhaotcm@hotmail.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003327:Coronary Disease / Q000150:complications* / Q000188:drug therapy*; D003863:Depression / Q000150:complications* / Q000188:drug therapy*; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D000928:Antidepressive Agents; D004365:Drugs, Chinese Herbal
keywords: Chinese herbal medicine; coronary heart disease; depression; systematic review