A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris

BACKGROUND: A growing number of studies suggest that Gualou Xiebai Banxia (GLXBBX) decoction, a well-known Chinese herbal formula, has beneficial effects on eliminating angina pectoris symptoms and improving condition of stable angina pectoris (SAP) patients. However, whether this treatment is effective and safe for SAP or not, evidence supporting the effectiveness and safety of this treatment is still incomplete. Besides, there is lack of systematic review to assess the detailed situation (including risk of bias and methodology) of current related clinical studies. This study aimed to evaluate the effectiveness and safety of GLXBBX in treating SAP. METHODS: The major databases (MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP) Database, Chinese Biomedical Database (CBM), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Database) were searched from inception to March 2019. Randomized controlled trials (RCTs) of GLXBBX alone or combined with conventional drugs against conventional drugs for SAP were identified. Two assessors reviewed each trial independently. The methodological quality of the eligible studies was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias. Both the data extraction and the literature quality screening evaluation were conducted independently by 2 researchers. RESULT: Totally 17 clinical RCTs were included in this study, involving 1676 patients. Due to the high probability of bias of the included studies, it was inappropriate to undertake a meta-analysis. Thus, we only conducted a systematic review and mainly discussed the methodology and limitation of the included studies. CONCLUSION: Although the current evidence prompted that GLXBBX might benefit SAP patients in improvement of angina pectoris, ECG, and blood lipid on a certain extent, this systematic review revealed no definite conclusion about the application of GLXBBX for SAP due to the poor methodological quality, high risk of bias, and inadequate reporting on clinical data. More rigorous, multicenter, sufficient-sample, and double-blind randomized clinical trials are warranted.