Effectiveness and Safety of Integrated Rehabilitation Exercises of Traditional Chinese and Western Medicine for Coronary Heart Disease after Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis
YU Rui, WANG Jianru, WEI Jingjing, et al. Effectiveness and Safety of Integrated Rehabilitation Exercises of Traditional Chinese and Western Medicine for Coronary Heart Disease after Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis[J]. Journal of Traditional Chinese Medicine2021, 62(7): 591-598.
YU Rui, WANG Jianru, WEI Jingjing, et al. Effectiveness and Safety of Integrated Rehabilitation Exercises of Traditional Chinese and Western Medicine for Coronary Heart Disease after Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis[J]. Journal of Traditional Chinese Medicine2021, 62(7): 591-598.DOI: 10.13288/j.11-2166/r.2021.07.009.
Objective To evaluate the effectiveness and safety of integrated rehabilitation exercises of traditional Chinese and Western medicine(IRE) in the treatment of coronary heart disease(CHD) after percutaneous coronary intervention(PCI)
and to provide evidence for its clinical application. Methods Databases including CNKI
Wanfang
VIP
Sinomed
MEDLINE
Cochrane Library
and Embase were searched from their inception dates to April 30 th
2020. Randomized controlled trials(RCTs) comparing IRE plus conventional treatment versus conventional treatment alone following PCI in treatment of CHD were included. Conventional treatments were standardized drugs and health education
while IRE included aerobic exercise
impedance training
Taiji
Baduanjin
and others. The interventions lasted at least three months. The outcomes were incidence of major adverse cardiovascular events(MACE)
left ventricular ejection fraction(LVEF) value
6-minute walking distance(6 MWD)
peak oxygen uptake(peak VO2)
anaerobic threshold(AT)
and metabolic equivalent(MET). The Cochrane bias of risk tool was used to evaluate the methodological quality of the included studies. RevMan 5.3 software was used to perform Meta-analyses. Results Twenty-two RCTs involving 2085 patients were included. The overall methodological quality of the included studies was moderate. Results from meta-analyses showed that compared to control group
the IRE group significantly reduced the incidence of MACE in CHD patients after PCI(OR=0.36
95%CI 0.24 to 10.52
P<0.01)
increased LVEF value(MD=18.74
95%CI 14.33 to 23.14
P<0.01)
increased 6 MWD(MD=18.74
95%CI 14.33 to 23.14
P<0.01)
improved peak VO2(MD=2.33
95%CI 1.85 to 2.82
P<0.01) and AT(MD=2.17
95%CI 1.59 to 2.75
P<0.01)
and increased MET(MD=0.95
95%CI 0.63 to 1.28
P<0.01). Only two trials reported safety outcomes. Conclusion IRE following PCI has effects in decreasing incidence of MACE
improving cardiopulmonary function
and increasing exercise endurance in patients with CHD
and there are no serious adverse events; however
highly qualified RCTs are still needed for further verification.