Danshen (Chinese medicinal herb) preparations for acute myocardial infarction
- PMID: 18425903
- PMCID: PMC8406986
- DOI: 10.1002/14651858.CD004465.pub2
Danshen (Chinese medicinal herb) preparations for acute myocardial infarction
Abstract
Background: Acute myocardial infarction (AMI) is the most important cause of morbidity from ischaemic heart disease, and is among the leading causes of death in the western world. Danshen, a Chinese herbal medicine, is widely used in China for treatment of several diseases, including AMI.
Objectives: To assess the effects (both benefits and harms) of danshen preparations for AMI.
Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (issue 4, 2006), MEDLINE (1966-2006), EMBASE (1980-2006), and the Chinese Biomedical Database (CBM) (1982-2006). We also handsearched 75 Chinese medical journals.
Selection criteria: Randomised controlled trials (RCTs) lasting at least 7 days were sought. Since it seemed evident that few RCTs were available, we also considered other controlled studies.
Data collection and analysis: Eligibility and trial quality were assessed by three reviewers.
Main results: Six studies comprised of 2368 participants were included. Only one trial was judged to be a genuine RCT and showed no statistically significant difference in reduction of total mortality (Peto OR 0.55, 95% CI 0.23 to 1.32), but a quasi-RCT reported a reduced total mortality (Peto OR 0.42, 95% CI 0.23 to 0.77). Pooling these trials yielded an approximate halving of mortality in those patients treated with danshen preparations plus usual care compared with usual care alone (Peto OR 0.46, 95% CI 0.28 to 0.75).
Authors' conclusions: The evidence to support use of danshen preparations is too weak to make any judgement about its effects. Evidence from RCTs is insufficient and of low quality. The safety of danshen preparations is unproven, although some adverse events have been reported. More evidence from high quality trials is needed to support the clinical use of danshen preparations.
Conflict of interest statement
None known.
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References
References to studies included in this review
Chen 1984a {published data only}
-
- Chen DQ, Wong XZ, Zhao LY, Li MQ. Yiqi Huoxue mixture with Western medicine compared to Western medicine alone in the treatment of 430 patients with AMI and an animal research. Journal of Medical Research 1984, (9):20‐1.
Chen 1984b {published data only}
-
- Chen KJ, Qian ZH, Dong QZ, Tu XH, Tao SY, Tao SQ. A randomised controlled trial of Yiqi Huoxue Zhusheyie injection in the treatment of 224 patients with AMI. Chinese Journal of Integrated Traditional Chinese and Western Medicine 1984;4(7):416.
Chen 2001 {published data only}
-
- Chen KY, Wu DL, Chen XL, Wang XF, Shi DZ. A clinical observation for the effect of "Quyu Huatan Xiezhuo" formulation in the treatment of patients with AMI. China Journal of Traditional Chinese Medicine 2001;16(5):34‐6.
Li 2004 {published data only}
-
- Li Y, Chen LX, Liu QQ. Huangqi, Shenmai injection combined with Fufang danshen injection in the treatment of 99 patients with AMI. Journal of Traditional Chinese Medicine 2004;45(1):45.
Wang 1994 {published data only}
-
- Wang SY, Dai RH, Fan WF. The effect of "Dan Shen" injection for acute myocardial infection. Journal of Traditional Chinese Medicine 1994;35(1):29‐30.
Zhang 1996 {published data only}
-
- Zhang Y, Zhang KL. Influence of isosorbide dinitrate for heart function of AMI patients. Qingdao Medical Journal 1996;28(1):12‐4.
References to studies excluded from this review
Cha 1998 {published data only}
-
- Cha YX. Observation for the effect of Bothropsatrox antithrombusase in the treatment of acute myocardial infarction. Jiaotong Medicine 1998;12(1):30.
Chen 1987 {published data only}
-
- Chen DQ, Weng XZ, Zhao LY. Integrated TCM and Western medicine compared to Western medicine alone in the treatment of 233 patients with AMI complicated with arrhythmia. Shanxi TCM 1987;3(2):19‐21.
Chen 1988 {published data only}
-
- Chen DQ. Comparing TCM with Western medicine in the treatment of 181 patients with AMI complicated with heart failure. Journal of Practical Internal TCM 1988;2(1):17‐8.
Chen 1996 {published data only}
-
- Chen HT. Observation for effects of middle and low does urokinase in the treatment of 43 senior patients with AMI. Chinese Journal of Clinical Pharmacology and Therapeutic 1996;1(1):41‐3.
Chen 2004 {published data only}
-
- Chen SQ, Jiang H. Bothropsatrox antithrombusase in the treatment of patients with AMI. Journal of Microcycology 2004;14(3):87 and 90.
Cui 1983 {published and unpublished data}
-
- Cui ZC, Li QL, Yao JN, Wang M, Gu FS, Su CL, et al. The effect of blood serum enzyme, platelet congregate activity and blood rheology in "Kangxingeng Heji" for acute myocardial infarction. Integrate Chinese Traditional and Western Medicine Journal 1983;3(5):268‐9. - PubMed
Cui 2004 {published data only}
-
- Cui CX, Wei XL. Obervation for the effects of integrated traditional Chinese and western medicine in the treatment of patients with AMI. Liaoning Journal of TCM 2004;31(10):868‐9.
CYG 1981 {published data only}
-
- Beijing Chao‐yang Hospital and TCM Institute Guang‐an Men Hospital coronary heart disease group. The primary observation for comparing of integrated Chinese traditional medicine and Western medicine to western medicine along in the treatment of 276 patients with acute myocardial infection. Chinese Journal of Integrated Traditonal Chinese and Western Medicine 1981;1(1):10‐1.
Deng 1998 {published data only}
-
- Deng XM, Tang AH. Observation for the effect of integrated traditional Chinese and western medicine in the treatment of 36 patients with AMI. Jounal of Guangxi College of TCM 1998;15(2):29‐30.
Dong 2002 {published and unpublished data}
-
- Dong SP, Shen J. The efficacy of "Huangqi", "Dan Shen" injection for acute myocardial infarction. Taishan Waisheng 2002;26(3):36.
GAM 1984 {published data only}
-
- Guang Anmen hospital, Chao Yang hospital, Beijing Red Cross Hospital heart group. "Yiqi Huoxue Heji" for acute myocardial infarction. Journal of Traditional Chinese Medicine 1984, (12):22‐3.
Han 1992 {published data only}
-
- Han GZ. Integrated traditional Chinese medicine with Western medicine in the treatment of 88 patients with acute myocardial infarction. Shanxi TCM 1992;13(4):152‐3.
He 2000 {published data only}
-
- He WG, Fang D, Li YJ, Liang FQ. Observation on the effect of defirase for acute myocardial infarction. Journal of Youjiang Medical College for Nationalities 2000;22(5):715‐6.
Li 1995 {published data only}
-
- Li ZS. Bothropsatrox antithrombusase in the treatment of patients with AMI. Shandon Medicine 1995;35(9):18.
Li 2003 {published and unpublished data}
-
- Li J, Jiang T. The effect of compound Danshen pill in the treatment of patients with acute myocardial infarction left ventrical reconstruction. Tian Jin Pharmacy 2003;15(1):36‐8.
Liang 1999 {published and unpublished data}
-
- Liang TJ, Gao SZ, Wang AW. The effect of blood serum muscle‐calcium protein in "Dan Shen" compound pill for acute myocardial infarction patients. Li Shizhen Medicine and Materia Medica Research 1999;10(2):90.
Liang 2000 {published data only}
-
- Liang J, Li QR, Wang LM. Comparing the effect of thrombolytic combined with TCM in the treatment of 32 patients with AMI. Anthology of Medicine 2000;19(6):868‐9.
Liang 2001 {published data only}
-
- Liang JL, Sun ZX, Qu F. A clinical observation on integrated traditional Chinese and western medicine in the treatment of patients with AMI. Journal of Tianjin College of Traditional Chinese Medicine 2001;20(3):24‐5.
Liu 1998 {published data only}
-
- Liu LS, Wang W, Fang WQ, Pan XW, Huang P, Ma FZ, et al. Effects of captopril combined with other medicines on clinical cardiovascular events among 14962 patients with acute myocardial infarction ‐ Chinese Cardiac Study (CCS‐1) subgroup report. Chinese Journal of Hypertension 1998;6(2):157‐60.
Liu 2006b {published data only}
-
- Liu DF, Liu L. Xiaogentang decoction with western medicine in the treatment of 30 patients with AMI. Shanxi TCM 2006;27(7):786‐7.
Luo 2001 {published data only}
-
- Luo B. Integrate traditional Chinese and western medicine for acute myocardial infarction complicated with heart failure. Hubei Journal of TCM 2001;23(4):13.
Qian 1996 {published data only}
-
- Qian KY, Tian ZZ. Integrated TCM and western medicine in the treatment of 50 patients with AMI. Chinese Journal of Integrated Traditional Chinese and Western Medicine 1996;16(5):308‐9.
Shi 2000 {published and unpublished data}
-
- Shi XY, Xia ZY, Fang JG, Gu JZ, Wu LW, Yu JP. Effects of salvia miltiorrhiza compound injection on serum endothelin, prostaglandin I2/thromboxane A2 atio alteration following myocardial ischemia‐reperfusion in patients undergoing intracardiac surgery. Chinese Journal of Integrate Chinese Traditional and Western Medicine 2000;20(12):896‐8. - PubMed
Sun 1992 {published data only}
-
- Sun JQ, Wang SK, Cheng JL, Wu ST, Wang XJ, Huang JH. Observation for effect of integrated traditional Chinese medicine with western medicine in the treatment of 37 patients with acute myocardial infection. Acta Chinese Medicine and Pharmacology 1992, (1):34‐5.
Sun 1997 {published data only}
-
- Sun WF, Wang LL, Wang XM, Wang GL, Yin ZY. Integrated traditional Chinese and western medicine for acute myocardial infarction complicated with heart failure. Acta Chinese Medicine and Pharmacology 1997, (2):10.
Tang 1999 {published data only}
-
- Tang CS. Clinical observation on the effect of Shanmai injection in the treatment of 60 patients with AMI. Hainan Medicine 1999;10(6):54‐5.
Wang 1995 {published data only}
-
- Wang JK. Observation for the clinical effect of Danshen compound in the treatment of 51 patients with acute myocardial infarction in an hour. Ge Jiu Science and Technology 1995, (1):18‐21.
Wang 1999 {published data only}
-
- Wang ZF, Shu HQ, Wang LN. Bothropsatrox antithrombusase in the treatment of 80 patients with AMI. Journal of Snake 1999;11(4):63‐4.
Wang 2000 {published data only}
-
- Wang Q, Yin XZ, Zhao RJ, Chang YP, Jiang ZP. Observation for the effects of Shanmai injection combined with Danshen powder injection in the treatment of patients with AMI with conduction block. Chinese Journal of TCM Emergency 2000;9(6):261.
Wang 2003 {published and unpublished data}
-
- Wang YS, Zhang S, Zhang D, Liu ZM. Protective effects of Shenmai and salvia Miltiorrhiza injection on ischemia and reperfusion myocardium in acute myocardial infarction patients. Chin J Crit Care Med 2003;23(12):834‐5.
Wu 2005 {published data only}
-
- Wu ZD, Guo XQ. Point injecting by Danshan injection for the hiccup after AMI. Guangdo Medicine 2005;26(3):407‐8.
Xie 2001 {published data only}
-
- Xie J, Li SQ, Zhao L. A clinical study of Dan Ao in the treatment of patients with AMI. Clinical Medicine 2001;21(10):50‐1.
Xu 2001 {published data only}
-
- Xu GH, Zhang XS, Huang ZX, Liu M. Observation for the effect of "Wutou Cishitang" decoction with "Dan Shen" injection in the treatment of acute myocardial infarction. New Chinese Medicine 2001;33(9):30‐1.
Xu 2003 {published and unpublished data}
-
- Xu XL, Wang BW. The effect of re‐open rate with integrated Chinese traditional and western medicine for acute myocardial infarction. Chinese Journal of Practical Medicine 2003;3(9):831‐2.
Yang 1997 {published data only}
-
- Yang YS, Zhang H, Zhang RJ, Wu XX. Observation for effect of integrated traditional Chinese medicine in the treatment of patients with acute myocardial infection. Tianjin Journal of TCM 1997;14(3):105‐6.
Ye 2006 {published data only}
-
- Ye ZB. Bothropsatrox antithrombusase in the treatment of AMI. Chinese Medical Journal of Metallurgical Industry 2006;23(2):162‐3.
Yuan 2003 {published and unpublished data}
-
- Yuan ZM, Di RA, Zhao WY. "Dan Shen" injection with vienal dissolve embolism therapy for 46 patients with acute myocardial infection. Shanxi TCM 2003;24(2):107‐8.
Zhang 1999 {published data only}
-
- Zhang DJ, Tang BX, Xu NT, Yang RP, Chang BX, Yan JL. Comparing integrated Chinese traditonal medicine to western medicine in 52 patients with acute myocardial infarction. Clinical Report 1999, (5):16‐7.
Zhang 2001 {published and unpublished data}
-
- Zhang YH. The effect of "Dan Shen" compound pill for the QT period disperse degree of acute myocardial infarction. Chinese Journal of Cardiovasc Rehabil Medicine 201;10(4):371‐2.
Zhong 2000 {published and unpublished data}
-
- Zhong JB, Zhang JC, Miao Y, Tu XH, Qian HY, Xu MY. Observation on the therapeutic effect of " Phlegm‐Stasis Eliminating Formula" in the treatment of acute myocardial infarction in early stage. Shanghai Journal of Traditional Chinese Medicine 2000;34(4):26‐7. [ISSN:1007‐1334]
Zhou 1996 {published data only}
-
- Zhou YH. Observation for the effect of polarization fluid combined with Mg, low‐melocule dextran and "Dan Shen" compound injection for acute myocardial infarction. Journal of Emergency in Traditional Chinese and Westen Medicine 1996;3(9):397‐8.
Zhou 1998 {published data only}
-
- Zhou Y, You WQ, Xiou H. Danshen and Huangqi injection in the treatment of 50 patients with AMI complicated with heart function deficiency. Information on Traditional Chinese Medicine 1998, (2):24‐5.
Zhu 2000 {published data only}
-
- Zhu MJ, Shi XQ, Fan HL. Clinical observation for integrated traditional Chinese medicine and Western medicine in the treatment of 58 patients with AMI. Journal of Shanxi TCM 2000;16(4):30‐1.
Additional references
Bensky 1987
-
- Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. Seattle: Eastland Press, 1987:384.
BHMA 1983
-
- British Herbal Medicine Association. British Herbal Pharmacopoeia. Bournemouth: BHMA, 1983.
Brooks 2001
-
- Brooks N. Guideline for the management of patients with acute coronary syndromes without persistent ECG ST segment elevation. British Cardiac Society guidelines and Medical Practice Committee and Royal College of Physicians Clinical Effectiveness and Evaluation Unit. Heart 2001;85(2):133‐42. - PMC - PubMed
Burton 1996
-
- Burton E.Sobel. Acute myocardial infarction. In: Bennet C J, Plum F editor(s). Cecil's Textbook of Medicine. 20th Edition. Philadelphia: WB Saunders, 1996. [o‐7216‐3561‐x]
Chan 2001
-
- Chan TY. Interaction between warfarin and danshen (Salvia miltiorrhiza). Annals of Pharmacotherapy 2001;35(4):501‐4. - PubMed
Garjani 2000
-
- Garjani A, Nazemiyeh H, Maleki N, Valizadeh H. Effects of extracts from flowering tops of Crataegus meyeri A. Pojark. on ischaemic arrhythmias in anaesthetized rats. Phytotherapy Research 2000;14(6):428‐31. - PubMed
He 2006
-
- He Q. Analysis for 25 patients with side effect caused by Fufang Danshen injection. Clinical Medicine 2006;26(12):91.
Herlitz 1989
-
- Herlitz J, Blohm M, Hartford M, Hjalmarsson A, Holmberg S, Karlson BW. Delay time in suspected acute myocardial infarction and the importance of its modification. Clinical Cardiology 1989;12(7):370‐4. - PubMed
Higgins 2006
-
- Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6 [updated September 2006]. www.cochrane.org/resources/handbook/hbook.htm.
ICSI 2005
-
- Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of chest pain and acute coronary syndrome (ACS). http://www.guideline.gov/summary/summary.aspx?doc_id=8362&nbr=4683 [accessed 15 Jan 2006].
Liu 2006a
-
- Liu Y, Song Y, Li M. Danshen's pharmaceutic function and its clinical use. Chinese Journal of Misdiagnosis 2006;6(24):4732‐3.
Lu 2006
-
- Lu JJ, Chen YH. Two cases of anaphylaxic shock caused by Fufang Danshen injection intravenous drip. Clinical Misdiagnosis & Mistherapy 2006;19(7):90.
McCann 2001
-
- MacIntyre K, Stewart S, Capewell S, Chalmers JW, Pell JP, Boyd J, et al. A population‐based study of 201,114 men and women following a first acute myocardial infarction. Journal of the American College of Cardiology 2001;38(3):729‐35. - PubMed
Moher 2001
-
- Moher D, Schulz KF, Altman D. The CONSORT Statement: Revised Recommendations for Improving the Quality of Reports of Parallel‐Group Randomized Trials. Journal of the American Medical Association 2001;285(15):1987‐91. - PubMed
MVS 2002
-
- MVS. MVS Pathophysiology: Myocardial Infarction. http://sprojects.mmip.mcgill.ca/mvs/PATHOS/MI.HTM#anchor175396 2002.
Negard 1996
-
- Nagai M, Noguchi M, Iizuka T, Otani K, Kamata K. Vasodilator effects of des(alpha‐carboxy‐3,4‐ dihydroxyphenethyl)lithospermic acid (8‐epiblechnic acid), a derivative of lithospermic acids in salviae miltiorrhizae radix. Biological and Pharmaceutical Bulletin 1996;19:228‐32. - PubMed
NHLBI 1992
-
- National Heart Lung and Blood Institute. Morbidity and Mortality: Chartbook on Cardiovascular, Lung, and Blood Diseases. Bethesda, Md, US: NHLBI, May 1992.
Sang 1979
-
- Sang GW. The investigation of pharmacological effect of Dan Shen and Dan Shen compound. ZheJiang medicine 1979;1(1):25‐9.
Wang 1996
-
- Wang X, Pang J, Shan C, Yang S, Zheng Y. Effect of danshen injection on pulmonary thromboembolism and platelet free radical levels in mice. Zhongguo Zhong Yao Za Zhi 1996;21:558‐60. - PubMed
WHO 1979
-
- World Health Organization. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation 1979;59(3):607‐9. - PubMed
Wu 1998
-
- Wu YJ, Hong CY, Lin SJ, Wu P, Shiao MS. Increase of vitamin E content in LDL and reduction of atherosclerosis in cholesterol‐fed rabbits by a water‐soluble antioxidant‐rich fraction of Salvia miltiorrhiza. Arteriosclerosis, Thrombosis & Vascular Biology 1998;18(3):481‐6. - PubMed
Wu 2007
-
- Wu TX, Li YP, Bian ZX, Li TQ, Li J, Dagenais S, et al. Consolidated Standards for Reporting Trials of Traditional Chinese Medicine (CONSORT for TCM). Journal of Evidence‐Based Medicine 2007;7(8):601‐5.
Xu 2006
-
- Xu MG, Luo YH. Analysis for side effects of 98 patients treated by Fufang Danshen injection. Journal of Hubei Institute for Nationalities. Medical Edition 2006;23(3):1.
Zhen 1997
-
- Zhen HZ, Dong ZH, She J. Danshen. Modern Study of Traditional Chinese Medicine. Vol. 2, Beijing: Xue Yuan Publish House, 1997:1093‐1193.
Zhou 1991
-
- W Zhou. Protective effect of Dan Shen on myocardial ischemia and reperfusion: An isolated rat heart study. American Journal of Chinese Medicine 1990;18:19‐21. - PubMed
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