Efficacy and safety of Shen Gui capsules for chronic heart failure: a systematic review and meta-analysis

Jiaqi Yan; Chaorong Zhang; Yuanping Wang; Xia Yan; Lili Jin

doi:10.3389/fphar.2024.1347828

Efficacy and safety of Shen Gui capsules for chronic heart failure: a systematic review and meta-analysis

Front Pharmacol. 2024 Apr 10:15:1347828. doi: 10.3389/fphar.2024.1347828. eCollection 2024.

Authors

Jiaqi Yan¹, Chaorong Zhang¹, Yuanping Wang², Xia Yan³, Lili Jin²

Affiliations

¹ Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
² Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine, Cardiovascular Department, The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ Medical Examination Center, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.

Abstract

Background: Although Shen Gui capsules (SGCP) are widely used as an adjuvant treatment for chronic heart failure (CHF), their clinical efficacy and safety remain controversial.

Purpose: To assess the efficacy and safety of SGCP in the treatment of CHF through a systematic review and meta-analysis, to provide high-quality evidence for evidence-based medicine.

Methods: Seven databases were searched for randomized controlled trials (RCTs) assessing SGCP for CHF, from inception to 9 January 2023. RCT quality of evidence was evaluated using the Cochrane Handbook for the Evaluation of Intervention Systems to assess risk of bias and Grading of Recommendations Assessment, Development, and Evaluation. A meta-analysis with subgroup and sensitivity analyses was performed using Review Manager 5.4 and Stata 12.

Results: Nine RCTs representing 888 patients with CHF were included in the review. Meta-analysis revealed that SGCP combined with conventional heart failure therapy is more advantageous for improving left ventricular ejection fraction [LVEF; mean difference (MD) = 5.26, 95% confidence interval (CI) (3.78, 6.74), p < 0.0000] and increasing effective rate [relative risk (RR) = 1.21, 95%CI (1.14, 1.29), p < 0.001] compared with conventional therapy alone. The experimental treatment also reduced brain natriuretic peptide [MD = -100.15, 95%CI (-157.83, -42.47), p = 0.0007], left ventricular end-diastolic diameter [MD = -1.93, 95%CI (-3.22, -0.64), p = 0.003], and hypersensitive C-reactive protein [MD = -2.70, 95%CI (-3.12,-2.28), p < 0.001] compared with the control group. However, there was not a statistically significant difference in tumor necrosis factor-α [MD = -14.16, 95%CI (-34.04, 5.73), p = 0.16] or left ventricular end-systolic diameter [MD = -1.56, 95%CI (-3.13, 0.01), p = 0.05]. Nor was there a statistically significant between-groups difference in incidence of adverse events (p > 0.05).

Conclusion: SGCP combined with conventional heart failure therapy can improve LVEF and increase the effective rate to safely treat patients with CHF. However, further high-quality studies are needed to confirm these findings, due to the overall low quality of evidence in this literature.

Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/logout.php, PROSPERO [CRD42023390409].

Keywords: Shen Gui capsule; chronic heart failure; efficacy; meta-analysis; safety.

Publication types

Systematic Review

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China (grant number 82174156), the Key-Area Research and Development Program of Guangdong Province (grant number 2020B1111100004), Medical Scientific Research Foundation of Guangdong Province of China (A202404) and the Guangdong Provincial Department of Finance “Construction Project of Key Hospitals with Traditional Chinese Medicine Characteristics” (2023, No. 139).