title: Shenmai injection as an adjuvant treatment for chronic cor pulmonale heart failure: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Shenmai injection (SM), as a traditional Chinese medicine injection, is widely used for chronic cor pulmonale heart failure in mainland China. It is essential to systematically assess the efficacy and safety of SM as an adjuvant treatment for chronic cor pulmonale heart failure.
  
  
  METHODS
  Eight English and Chinese electronic databases were searched, from inception to December 2014, to identify randomized controlled trials (RCTs) of SM for chronic cor pulmonale heart failure. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of eligible studies. Meta-analysis was performed by Review Manager 5.2.
  
  
  RESULTS
  Twenty-seven RCTs with 2045 participants were identified. The methodological quality of the included studies was generally low. Only one trial reported data on death. None of the included trials reported quality of life. The meta-analysis indicated that compared to conventional treatment, the combination of SM and conventional treatment was more effective in terms of the New York Heart Association classification (RR, 1.26; 95% CI, 1.20-1.32; P < 0.00001), Left Ventricular Ejection Fraction (MD, 11.33; 95% CI, 8.59-14.07; p < 0.00001), partial pressure of oxygen (MD, 1.00; 95% CI, 0.64-1.36; P < 0.00001) and partial pressure of carbon dioxide (MD, 0.83; 95 % CI, 0.58-1.08; p < 0.00001). In addition, two trials reported that SM plus conventional treatment was superior to the conventional treatment alone to reduce B-type natriuretic peptide. No serious adverse drug events or reactions were reported.
  
  
  CONCLUSIONS
  SM plus conventional treatment appeared to be effective and relatively safe for chronic cor pulmonale heart failure. However, due to the generally low methodological quality and small sample size, this review didn't find evidence to support routine use of SM as an adjuvant treatment for chronic cor pulmonale heart failure.
authors.affiliation: Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China. 504176620@qq.com.|Guang'an men Hospital, China Academy of Chinese Medical Sciences, Beijing, China. 504176620@qq.com.
authors.forename: Liwei
authors.initials: L
authors.lastname: Shi
authors.affiliation: Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China. ktzu2014@163.com.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China. okfrom2008@hotmail.com.
authors.forename: Xing
authors.initials: X
authors.lastname: Liao
authors.affiliation: Department of Epidemiology, University of California-Los Angeles, Los Angeles, CA, USA. chaiyanhi@hotmail.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chai
authors.affiliation: Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China. 1140714457@qq.com.|Guang'an men Hospital, China Academy of Chinese Medical Sciences, Beijing, China. 1140714457@qq.com.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Luo
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D006801:Humans; D011660:Pulmonary Heart Disease / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000277:Adjuvants, Pharmaceutic; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; C009252:fructus schizandrae, radix ginseng, radix ophiopogonis drug combination