Meta-Analysis of the Effect of Traditional Chinese Medicine Compounds Combined with Standard Western Medicine for the Treatment of Diabetes Mellitus Complicated by Coronary Heart Disease

Abstract

This study aimed to systematically evaluate the clinical efficacy and safety of traditional Chinese medicine (TCM) compounds combined with standard treatments for diabetes mellitus (DM) complicated by coronary heart disease (CHD). We performed a systematic and comprehensive search of the China Knowledge Network, WanFang, WeiPu, PubMed, and Web of Science, including Chinese and English articles, for randomized controlled trials (RCTs) assessing the use of Chinese herbal compounds for the treatment of DM complicated by CHD published before June 1, 2020. The literature was screened according to standard criteria. Risk assessment, based on the Jadad scale, was performed using the Review Manager5.3 software for meta-analysis. In total, 23 articles were selected, including 2405 cases. The meta-analysis showed that the combination of standard treatments with TCM compounds significantly improved the overall treatment efficacy for DM complicated by CHD (OR(odds ratio) = 4.39; 95% confidence interval (95% CI), 3.30–5.84; $P<0.0001$ ), fasting blood glucose level (mean difference (MD) = −1.04; 95% CI, −1.96 to −0.13; $P=0.03$ ), total cholesterol level (MD = −1.16; 95% CI, −1.48 to −0.83; $P<0.0001$ ), triglyceride (MD = −0.46; 95% CI, −0.62 to −0.29; $P<0.0001$ ), low-density lipoprotein level (MD = −0.57; 95% CI, −0.87 to −0.27; $P=0.0002$ ), high-density lipoprotein level (MD = 0.19; 95% CI, 0.12 to 0.26; $P=0.02$ ), and electrocardiogram (OR = 4.20; 95% CI, 3.15 to 8.18; $P<0.0001$ ). In contrast, there was no improvement of 2-hour postprandial glucose level (MD = −1.03; 95% CI, −2.14 to 0.08; $P=0.07$ ), or adverse reactions (OR = 0.53; 95% CI, 0.19 to 5.50; $P=0.21$ ). We concluded that the combined therapy has some benefits in treating DM complicated by CHD. However, these results should be confirmed by further referenced evidence, high risk assessment, and lower publication bias.