A systematic review and meta-analysis of the efficacy of addition and reduction of Shixiao powder in the treatment of coronary heart disease

Objective To evaluate the effectiveness and safety of combining Shixiao Powder with Western medicine for treating coronary heart disease-induced angina. Methods The databases CNKI, VIP, Wanfang, SinoMed, PubMed, Embase, Web of Science, and Cochrane were searched until March 19th, 2024 for randomized controlled studies on the treatment of angina pectoris in coronary heart disease using Shixiao Powder combined with Western medicine. Quality assessment was conducted using the Cochrane Collaboration's tool. Heterogeneity was tested using the Chi-squared-based Q statistic test and I2 statistic. Results The study included a total of 15 articles, with 1204 patients in the cohort, divided into 625 cases in the observation group and 579 cases in the control group. Compared to Western medicine alone, the combination of Shixiao powder and Western medicine significantly improved the effective rate in treating angina pectoris of coronary heart disease [RR = 1.25, 95%Cl (1.18–1.32), P < 0.00001]. The improvement in ECG ST segment was superior [RR = 1.32, 95%Cl (1.21–1.43), P < 0.00001]. Additionally, there was a decrease in serum CRP level [WMD=−0.8, 95%Cl (-1.43–0.18), Z = 2.52, P = 0.012 < 0.05]. The assessment of publication bias concluded that there was no publication bias, suggesting that the conclusions of this study are accurate and reliable. Conclusion The current evidence supports that combining Shixiao Powder with Western medicine effectively and safely treats angina pectoris associated with coronary heart disease. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/recorddashboard , PROSPERO CRD42024537794.