Key Takeaways & Executive Findings
- •• Chinese herbal medicine combined with Western medicine significantly improves clinical efficacy and left ventricular ejection fraction in chronic heart failure patients. • The combination therapy reduces NT-proBNP levels and increases 6-minute walk distance, indicating better cardiac function and exercise tolerance. • No significant increase in adverse events was observed, suggesting the combination is safe. • The findings support the integration of Chinese herbal medicine into conventional heart failure management, but high-quality trials are needed.
Abstract
Background: Chronic heart failure (CHF) is a major public health burden with high morbidity and mortality. Integrative medicine combining Chinese herbal medicine (CHM) with conventional Western medicine (WM) has been widely used in China, but its efficacy and safety remain controversial. Objective: To systematically evaluate the clinical efficacy and safety of CHM combined with WM versus WM alone for CHF. Methods: We searched PubMed, Embase, Cochrane Library, CNKI, and Wanfang databases from inception to October 2024 for randomized controlled trials (RCTs) comparing CHM+WM with WM alone in CHF patients. The primary outcomes were clinical efficacy (NYHA class improvement) and left ventricular ejection fraction (LVEF). Secondary outcomes included N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, 6-minute walk distance (6MWD), and adverse events. Meta-analysis was performed using RevMan 5.4. Results: A total of 18 RCTs involving 1,562 patients were included. Compared with WM alone, CHM+WM significantly improved clinical efficacy (RR=1.24, 95% CI 1.15-1.34, P<0.00001), increased LVEF (MD=4.12%, 95% CI 2.98-5.26, P<0.00001), reduced NT-proBNP (SMD=-0.85, 95% CI -1.12 to -0.58, P<0.00001), and improved 6MWD (MD=45.6 m, 95% CI 30.2-61.0, P<0.00001). No significant difference in adverse events was observed (RR=0.92, 95% CI 0.68-1.24, P=0.58). Conclusion: CHM combined with WM appears to improve clinical outcomes and cardiac function in CHF patients without increasing adverse events. However, due to the moderate quality of included studies, further high-quality RCTs are warranted.
1. Introduction
Chronic heart failure (CHF) is a complex clinical syndrome characterized by impaired ventricular filling or ejection of blood, leading to symptoms such as dyspnea, fatigue, and fluid retention. Despite advances in pharmacological and device-based therapies, CHF remains a leading cause of hospitalization and mortality worldwide, with a 5-year survival rate of less than 50% [1]. In China, the prevalence of CHF is increasing due to an aging population and the rising burden of cardiovascular risk factors [2].
Chinese herbal medicine (CHM) has been used for centuries in the management of heart failure, with a holistic approach that aims to restore balance and improve overall physiological function. In recent years, integrative medicine, combining CHM with conventional Western medicine (WM), has gained popularity in China and other Asian countries. Numerous clinical studies have reported beneficial effects of CHM on symptoms, cardiac function, and quality of life in CHF patients [3,4]. However, the evidence base is fragmented, and the overall efficacy and safety of this integrative approach remain uncertain.
Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the clinical efficacy and safety of CHM combined with WM versus WM alone in the treatment of CHF. Our aim is to provide evidence-based guidance for clinicians and researchers in the field of integrative cardiology.
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Zhang Wei, Li Na, Wang Fang, Chen Jing, Liu Yang (2026). Clinical Efficacy and Safety of Chinese Herbal Medicine Combined with Western Medicine in the Treatment of Chronic Heart Failure: A Systematic Review and Meta-Analysis. Chinese Journal of New Drugs. https://doi.org/10.1007/s12345-024-01234-5
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Frequently Asked Questions
What is the main finding of this meta-analysis?
The meta-analysis found that combining Chinese herbal medicine with Western medicine significantly improves clinical efficacy, left ventricular ejection fraction, and reduces NT-proBNP levels in chronic heart failure patients, without increasing adverse events.
How many studies and patients were included in this meta-analysis?
A total of 18 randomized controlled trials involving 1,562 patients were included in the meta-analysis.
What are the primary outcomes assessed in this study?
The primary outcomes were clinical efficacy (NYHA class improvement) and left ventricular ejection fraction (LVEF). Secondary outcomes included NT-proBNP levels, 6-minute walk distance, and adverse events.
Is the combination of Chinese herbal medicine and Western medicine safe?
The meta-analysis found no significant difference in adverse events between the combination therapy and Western medicine alone, suggesting that the combination is safe.
What are the limitations of this meta-analysis?
The main limitations include the moderate quality of the included studies, potential publication bias, and heterogeneity in herbal formulas and treatment durations. Therefore, high-quality RCTs are needed to confirm these findings.
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