Chinese Herbal Medicine for Aspirin Resistance: A Systematic Review and Meta-Analysis
Identifieur interne : 000239 ( Pmc/Checkpoint ); précédent : 000238; suivant : 000240Chinese Herbal Medicine for Aspirin Resistance: A Systematic Review and Meta-Analysis
Auteurs : Hanyu Chen [République populaire de Chine] ; Zhengjie Shen [République populaire de Chine] ; Jiandong Chen [République populaire de Chine] ; Haowen Zhang [République populaire de Chine] ; Xiaohu Chen [République populaire de Chine]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
To assess the effectiveness and safety of Chinese herbal medicine (CHM) for the treatment of aspirin resistance (AR).
A comprehensive research of seven electronic databases was performed for comparative studies evaluating CHM for AR. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool. Data wasere synthesized by using RevMan 5.3 software. (PROSPERO Registration #CRD42015020182)
18 randomized controlled trials (RCTs) involving 1,460 patients were included. 15 RCTs reported significant difference in the reduction of platelet aggregation rate (PAR) induced by adenosine diphosphate (ADP) (P<0.05), and 11 reported significant effect of CHM plus aspirin to reduce PAR induced by arachidonic acid (AA) (P<0.05) compared with aspirin 100mg/d treatment. The pooling data of 3 RCTs showed the thromboxane B2 (TXB2) in patients with CHM plus aspirin versus aspirin were significantly reduced (Random Effect model (RE), Standard Deviation (SD) = -95.93, 95% Confidential Interval (CI)[-118.25,-73.61], P<0.00001). Subgroup analysis showed that TXB2 (Fixed Effect model (FE), SD = -89.23, 95%CI[-121.96,-56.49], P<0.00001) had significant difference in Tongxinluo capsule plus aspirin versus aspirin. 2 RCTs reported the clinical effective rate, and the meta-analysis result showed a significant difference in intervention and control group (FE, Relative Risk (RR) = 1.67, 95%CI[1.15, 2.42], P = 0.007<0.05). In 4 trials, CHM plus aspirin had better effects of reducing the reoccurrence of cerebral infarction than aspirin (FE, RR = 0.24, 95%CI [0.11, 0.49], P<0.0001). And one trial showed that CHM plus aspirin could decrease the National Institutes of Health Stroke Scale (NHISS) score (P<0.05) and increase the Barthel Index (BI) score (P<0.05). 4 trials stated that there were no adverse effects occurred in intervention group, and analysis showed significant difference of CHM or CHM plus aspirin in reducing the occurrence of adverse events (FE, RR = 0.22, 95%CI[0.13, 0.39], P<0.00001). 5 trials claimed that the CHM monotherapy and CHM adjunctive therapy for AR did not add the risk of bleeding (FE, RR = 0.50, 95%CI[0.20, 1.22], P = 0.13>0.05).
CHM may be effective and safe as an alternative and collaborative therapy for AR. However, the current evidence and potential promising findings should be interpreted with caution due to poor and varying methodological quality of included studies and the heterogeneity of interventions. Thus, further exploration of this strategy with adequately powered RCTs is warranted.
Url:
DOI: 10.1371/journal.pone.0154897
PubMed: 27153119
PubMed Central: 4859478
Affiliations:
Links toward previous steps (curation, corpus...)
Links to Exploration step
PMC:4859478Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Chinese Herbal Medicine for Aspirin Resistance: A Systematic Review and Meta-Analysis</title>
<author><name sortKey="Chen, Hanyu" sort="Chen, Hanyu" uniqKey="Chen H" first="Hanyu" last="Chen">Hanyu Chen</name>
<affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Shen, Zhengjie" sort="Shen, Zhengjie" uniqKey="Shen Z" first="Zhengjie" last="Shen">Zhengjie Shen</name>
<affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Translational Medicine Center of Nanjing University of Chinese Medicine, Key Laboratory of Famous Doctor's Proved Recipe Evaluation and Transformation of State Administration of Traditional Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Translational Medicine Center of Nanjing University of Chinese Medicine, Key Laboratory of Famous Doctor's Proved Recipe Evaluation and Transformation of State Administration of Traditional Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Chen, Jiandong" sort="Chen, Jiandong" uniqKey="Chen J" first="Jiandong" last="Chen">Jiandong Chen</name>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Zhang, Haowen" sort="Zhang, Haowen" uniqKey="Zhang H" first="Haowen" last="Zhang">Haowen Zhang</name>
<affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Chen, Xiaohu" sort="Chen, Xiaohu" uniqKey="Chen X" first="Xiaohu" last="Chen">Xiaohu Chen</name>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">27153119</idno>
<idno type="pmc">4859478</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859478</idno>
<idno type="RBID">PMC:4859478</idno>
<idno type="doi">10.1371/journal.pone.0154897</idno>
<date when="2016">2016</date>
<idno type="wicri:Area/Pmc/Corpus">000391</idno>
<idno type="wicri:Area/Pmc/Curation">000390</idno>
<idno type="wicri:Area/Pmc/Checkpoint">000239</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Chinese Herbal Medicine for Aspirin Resistance: A Systematic Review and Meta-Analysis</title>
<author><name sortKey="Chen, Hanyu" sort="Chen, Hanyu" uniqKey="Chen H" first="Hanyu" last="Chen">Hanyu Chen</name>
<affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Shen, Zhengjie" sort="Shen, Zhengjie" uniqKey="Shen Z" first="Zhengjie" last="Shen">Zhengjie Shen</name>
<affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Translational Medicine Center of Nanjing University of Chinese Medicine, Key Laboratory of Famous Doctor's Proved Recipe Evaluation and Transformation of State Administration of Traditional Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Translational Medicine Center of Nanjing University of Chinese Medicine, Key Laboratory of Famous Doctor's Proved Recipe Evaluation and Transformation of State Administration of Traditional Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Chen, Jiandong" sort="Chen, Jiandong" uniqKey="Chen J" first="Jiandong" last="Chen">Jiandong Chen</name>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Zhang, Haowen" sort="Zhang, Haowen" uniqKey="Zhang H" first="Haowen" last="Zhang">Haowen Zhang</name>
<affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Chen, Xiaohu" sort="Chen, Xiaohu" uniqKey="Chen X" first="Xiaohu" last="Chen">Xiaohu Chen</name>
<affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing</wicri:regionArea>
<wicri:noRegion>Nanjing</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">PLoS ONE</title>
<idno type="eISSN">1932-6203</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Objectives</title>
<p>To assess the effectiveness and safety of Chinese herbal medicine (CHM) for the treatment of aspirin resistance (AR).</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>A comprehensive research of seven electronic databases was performed for comparative studies evaluating CHM for AR. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool. Data wasere synthesized by using RevMan 5.3 software. (PROSPERO Registration #CRD42015020182)</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>18 randomized controlled trials (RCTs) involving 1,460 patients were included. 15 RCTs reported significant difference in the reduction of platelet aggregation rate (PAR) induced by adenosine diphosphate (ADP) (P<0.05), and 11 reported significant effect of CHM plus aspirin to reduce PAR induced by arachidonic acid (AA) (P<0.05) compared with aspirin 100mg/d treatment. The pooling data of 3 RCTs showed the thromboxane B<sub>2</sub>
(TXB<sub>2</sub>
) in patients with CHM plus aspirin versus aspirin were significantly reduced (Random Effect model (RE), Standard Deviation (SD) = -95.93, 95% Confidential Interval (CI)[-118.25,-73.61], P<0.00001). Subgroup analysis showed that TXB<sub>2</sub>
(Fixed Effect model (FE), SD = -89.23, 95%CI[-121.96,-56.49], P<0.00001) had significant difference in Tongxinluo capsule plus aspirin versus aspirin. 2 RCTs reported the clinical effective rate, and the meta-analysis result showed a significant difference in intervention and control group (FE, Relative Risk (RR) = 1.67, 95%CI[1.15, 2.42], P = 0.007<0.05). In 4 trials, CHM plus aspirin had better effects of reducing the reoccurrence of cerebral infarction than aspirin (FE, RR = 0.24, 95%CI [0.11, 0.49], P<0.0001). And one trial showed that CHM plus aspirin could decrease the National Institutes of Health Stroke Scale (NHISS) score (P<0.05) and increase the Barthel Index (BI) score (P<0.05). 4 trials stated that there were no adverse effects occurred in intervention group, and analysis showed significant difference of CHM or CHM plus aspirin in reducing the occurrence of adverse events (FE, RR = 0.22, 95%CI[0.13, 0.39], P<0.00001). 5 trials claimed that the CHM monotherapy and CHM adjunctive therapy for AR did not add the risk of bleeding (FE, RR = 0.50, 95%CI[0.20, 1.22], P = 0.13>0.05).</p>
</sec>
<sec id="sec004"><title>Conclusions</title>
<p>CHM may be effective and safe as an alternative and collaborative therapy for AR. However, the current evidence and potential promising findings should be interpreted with caution due to poor and varying methodological quality of included studies and the heterogeneity of interventions. Thus, further exploration of this strategy with adequately powered RCTs is warranted.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hankey, Gj" uniqKey="Hankey G">GJ Hankey</name>
</author>
<author><name sortKey="Eikelboom, Jw" uniqKey="Eikelboom J">JW Eikelboom</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kuliczkowski, W" uniqKey="Kuliczkowski W">W Kuliczkowski</name>
</author>
<author><name sortKey="Witkowski, A" uniqKey="Witkowski A">A Witkowski</name>
</author>
<author><name sortKey="Polonski, L" uniqKey="Polonski L">L Polonski</name>
</author>
<author><name sortKey="Watala, C" uniqKey="Watala C">C Watala</name>
</author>
<author><name sortKey="Filipiak, K" uniqKey="Filipiak K">K Filipiak</name>
</author>
<author><name sortKey="Budaj, A" uniqKey="Budaj A">A Budaj</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Krasopoulos, G" uniqKey="Krasopoulos G">G Krasopoulos</name>
</author>
<author><name sortKey="Brister, Sj" uniqKey="Brister S">SJ Brister</name>
</author>
<author><name sortKey="Beattie, Ws" uniqKey="Beattie W">WS Beattie</name>
</author>
<author><name sortKey="Buchanan, Mr" uniqKey="Buchanan M">MR Buchanan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Heistein, Lc" uniqKey="Heistein L">LC Heistein</name>
</author>
<author><name sortKey="Scott, Wa" uniqKey="Scott W">WA Scott</name>
</author>
<author><name sortKey="Zellers, Tm" uniqKey="Zellers T">TM Zellers</name>
</author>
<author><name sortKey="Fixler, De" uniqKey="Fixler D">DE Fixler</name>
</author>
<author><name sortKey="Ramaciotti, C" uniqKey="Ramaciotti C">C Ramaciotti</name>
</author>
<author><name sortKey="Journeycake, Jm" uniqKey="Journeycake J">JM Journeycake</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Phankingthongkum, R" uniqKey="Phankingthongkum R">R Phankingthongkum</name>
</author>
<author><name sortKey="Panchavinnin, P" uniqKey="Panchavinnin P">P Panchavinnin</name>
</author>
<author><name sortKey="Chinthammitr, Y" uniqKey="Chinthammitr Y">Y Chinthammitr</name>
</author>
<author><name sortKey="Tresukosol, D" uniqKey="Tresukosol D">D Tresukosol</name>
</author>
<author><name sortKey="Chotinaiwattarakul, C" uniqKey="Chotinaiwattarakul C">C Chotinaiwattarakul</name>
</author>
<author><name sortKey="Tungsubutra, W" uniqKey="Tungsubutra W">W Tungsubutra</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yi, X" uniqKey="Yi X">X Yi</name>
</author>
<author><name sortKey="Zhou, Q" uniqKey="Zhou Q">Q Zhou</name>
</author>
<author><name sortKey="Lin, J" uniqKey="Lin J">J Lin</name>
</author>
<author><name sortKey="Chi, L" uniqKey="Chi L">L Chi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zhang, H" uniqKey="Zhang H">H Zhang</name>
</author>
<author><name sortKey="Chen, X" uniqKey="Chen X">X Chen</name>
</author>
<author><name sortKey="Liu, L" uniqKey="Liu L">L Liu</name>
</author>
<author><name sortKey="Fan, L" uniqKey="Fan L">L Fan</name>
</author>
<author><name sortKey="Cao, J" uniqKey="Cao J">J Cao</name>
</author>
<author><name sortKey="Li, X" uniqKey="Li X">X Li</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sirachainan, N" uniqKey="Sirachainan N">N Sirachainan</name>
</author>
<author><name sortKey="Wijarn, P" uniqKey="Wijarn P">P Wijarn</name>
</author>
<author><name sortKey="Chuansumrit, A" uniqKey="Chuansumrit A">A Chuansumrit</name>
</author>
<author><name sortKey="Kadegasem, P" uniqKey="Kadegasem P">P Kadegasem</name>
</author>
<author><name sortKey="Wongwerawattanakoon, P" uniqKey="Wongwerawattanakoon P">P Wongwerawattanakoon</name>
</author>
<author><name sortKey="Soisamrong, A" uniqKey="Soisamrong A">A Soisamrong</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chadha, Ds" uniqKey="Chadha D">DS Chadha</name>
</author>
<author><name sortKey="Sumana, B" uniqKey="Sumana B">B Sumana</name>
</author>
<author><name sortKey="Karthikeyan, G" uniqKey="Karthikeyan G">G Karthikeyan</name>
</author>
<author><name sortKey="Jayaprasad, V" uniqKey="Jayaprasad V">V Jayaprasad</name>
</author>
<author><name sortKey="Arun, Ss" uniqKey="Arun S">SS Arun</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bishopric, Nh" uniqKey="Bishopric N">NH Bishopric</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Floyd, Cn" uniqKey="Floyd C">CN Floyd</name>
</author>
<author><name sortKey="Ferro, A" uniqKey="Ferro A">A Ferro</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Patrono, C" uniqKey="Patrono C">C Patrono</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Harrison, P" uniqKey="Harrison P">P Harrison</name>
</author>
<author><name sortKey="Frelinger, Ar" uniqKey="Frelinger A">AR Frelinger</name>
</author>
<author><name sortKey="Furman, Mi" uniqKey="Furman M">MI Furman</name>
</author>
<author><name sortKey="Michelson, Ad" uniqKey="Michelson A">AD Michelson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liu, L" uniqKey="Liu L">L Liu</name>
</author>
<author><name sortKey="Li, J" uniqKey="Li J">J Li</name>
</author>
<author><name sortKey="Zhang, Y" uniqKey="Zhang Y">Y Zhang</name>
</author>
<author><name sortKey="Zhang, S" uniqKey="Zhang S">S Zhang</name>
</author>
<author><name sortKey="Ye, J" uniqKey="Ye J">J Ye</name>
</author>
<author><name sortKey="Wen, Z" uniqKey="Wen Z">Z Wen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Maione, F" uniqKey="Maione F">F Maione</name>
</author>
<author><name sortKey="Cantone, V" uniqKey="Cantone V">V Cantone</name>
</author>
<author><name sortKey="Chini, Mg" uniqKey="Chini M">MG Chini</name>
</author>
<author><name sortKey="De Feo, V" uniqKey="De Feo V">V De Feo</name>
</author>
<author><name sortKey="Mascolo, N" uniqKey="Mascolo N">N Mascolo</name>
</author>
<author><name sortKey="Bifulco, G" uniqKey="Bifulco G">G Bifulco</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lee, Jj" uniqKey="Lee J">JJ Lee</name>
</author>
<author><name sortKey="Kim, T" uniqKey="Kim T">T Kim</name>
</author>
<author><name sortKey="Cho, Wk" uniqKey="Cho W">WK Cho</name>
</author>
<author><name sortKey="Ma, Jy" uniqKey="Ma J">JY Ma</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wen, D" uniqKey="Wen D">D Wen</name>
</author>
<author><name sortKey="He, W" uniqKey="He W">W He</name>
</author>
<author><name sortKey="Wang, H" uniqKey="Wang H">H Wang</name>
</author>
<author><name sortKey="Chen, T" uniqKey="Chen T">T Chen</name>
</author>
<author><name sortKey="Wang, H" uniqKey="Wang H">H Wang</name>
</author>
<author><name sortKey="Wu, H" uniqKey="Wu H">H Wu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Huang, Lf" uniqKey="Huang L">LF Huang</name>
</author>
<author><name sortKey="Shi, Hl" uniqKey="Shi H">HL Shi</name>
</author>
<author><name sortKey="Gao, B" uniqKey="Gao B">B Gao</name>
</author>
<author><name sortKey="Wu, H" uniqKey="Wu H">H Wu</name>
</author>
<author><name sortKey="Yang, L" uniqKey="Yang L">L Yang</name>
</author>
<author><name sortKey="Wu, Xj" uniqKey="Wu X">XJ Wu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liu, Aj" uniqKey="Liu A">AJ Liu</name>
</author>
<author><name sortKey="Li, Hq" uniqKey="Li H">HQ Li</name>
</author>
<author><name sortKey="Li, Jh" uniqKey="Li J">JH Li</name>
</author>
<author><name sortKey="Wang, Yy" uniqKey="Wang Y">YY Wang</name>
</author>
<author><name sortKey="Chen, D" uniqKey="Chen D">D Chen</name>
</author>
<author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Song, Sj" uniqKey="Song S">SJ Song</name>
</author>
<author><name sortKey="Zhao, Xz" uniqKey="Zhao X">XZ Zhao</name>
</author>
<author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name>
</author>
<author><name sortKey="Zhou, Xd" uniqKey="Zhou X">XD Zhou</name>
</author>
<author><name sortKey="Xu, Jp" uniqKey="Xu J">JP Xu</name>
</author>
<author><name sortKey="Sun, Xj" uniqKey="Sun X">XJ Sun</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chai, Zq" uniqKey="Chai Z">ZQ Chai</name>
</author>
<author><name sortKey="Wei, L" uniqKey="Wei L">L Wei</name>
</author>
<author><name sortKey="Ding, Y" uniqKey="Ding Y">Y Ding</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liu, Hq" uniqKey="Liu H">HQ Liu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yin, Ch" uniqKey="Yin C">CH Yin</name>
</author>
<author><name sortKey="Bi, Dp" uniqKey="Bi D">DP BI</name>
</author>
<author><name sortKey="Du, M" uniqKey="Du M">M Du</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zhang, Jl" uniqKey="Zhang J">JL Zhang</name>
</author>
<author><name sortKey="Fu, Hj" uniqKey="Fu H">HJ Fu</name>
</author>
<author><name sortKey="Zhao, Lb" uniqKey="Zhao L">LB Zhao</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liu Q, K" uniqKey="Liu Q K">K Liu Q</name>
</author>
<author><name sortKey="Wang, Z" uniqKey="Wang Z">Z Wang</name>
</author>
<author><name sortKey="Xie, J" uniqKey="Xie J">J Xie</name>
</author>
<author><name sortKey="Liu, M" uniqKey="Liu M">M Liu</name>
</author>
<author><name sortKey="Zou, Wh" uniqKey="Zou W">WH Zou</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wang, J" uniqKey="Wang J">J Wang</name>
</author>
<author><name sortKey="Yang, Jj" uniqKey="Yang J">JJ Yang</name>
</author>
<author><name sortKey="Tian, F" uniqKey="Tian F">F Tian</name>
</author>
<author><name sortKey="Dong, J" uniqKey="Dong J">J Dong</name>
</author>
<author><name sortKey="Zhou, Y" uniqKey="Zhou Y">Y Zhou</name>
</author>
<author><name sortKey="Yang, Xb" uniqKey="Yang X">XB Yang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Su, Wj" uniqKey="Su W">WJ Su</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wu, Th" uniqKey="Wu T">TH Wu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ma, Xj" uniqKey="Ma X">XJ Ma</name>
</author>
<author><name sortKey="Gu, N F" uniqKey="Gu N">N.F Gu</name>
</author>
<author><name sortKey="Xiao, Ch" uniqKey="Xiao C">CH Xiao</name>
</author>
<author><name sortKey="Liu, Cj" uniqKey="Liu C">CJ Liu</name>
</author>
<author><name sortKey="Yin, Xy" uniqKey="Yin X">XY Yin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Guo, H Y" uniqKey="Guo H">H Y Guo</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liu Y, J" uniqKey="Liu Y J">J Liu Y</name>
</author>
<author><name sortKey="Zhang, K" uniqKey="Zhang K">K Zhang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cheng, G" uniqKey="Cheng G">G Cheng</name>
</author>
<author><name sortKey="Min, Nb" uniqKey="Min N">NB Min</name>
</author>
<author><name sortKey="Lv, Xl" uniqKey="Lv X">XL Lv</name>
</author>
<author><name sortKey="Han, Xy" uniqKey="Han X">XY Han</name>
</author>
<author><name sortKey="Shou, Xl" uniqKey="Shou X">XL Shou</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zhang, X" uniqKey="Zhang X">X Zhang</name>
</author>
<author><name sortKey="Wu, Cf" uniqKey="Wu C">CF Wu</name>
</author>
<author><name sortKey="Lu, Gp" uniqKey="Lu G">GP Lu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zhang, L" uniqKey="Zhang L">L Zhang</name>
</author>
<author><name sortKey="Liu, T" uniqKey="Liu T">T Liu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tu, X P" uniqKey="Tu X">X P Tu</name>
</author>
<author><name sortKey="Zheng, Cl" uniqKey="Zheng C">CL Zheng</name>
</author>
<author><name sortKey="Xu, Xr" uniqKey="Xu X">XR Xu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Huang, Hm" uniqKey="Huang H">HM Huang</name>
</author>
<author><name sortKey="Ding, Yb" uniqKey="Ding Y">YB Ding</name>
</author>
<author><name sortKey="Deng, Wh" uniqKey="Deng W">WH Deng</name>
</author>
<author><name sortKey="Pan, Xp" uniqKey="Pan X">XP Pan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liu, Df" uniqKey="Liu D">DF Liu</name>
</author>
<author><name sortKey="Li, Jy" uniqKey="Li J">JY Li</name>
</author>
<author><name sortKey="Tian, Qy" uniqKey="Tian Q">QY Tian</name>
</author>
<author><name sortKey="Xu, Q" uniqKey="Xu Q">Q Xu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Eikelboom, Jw" uniqKey="Eikelboom J">JW Eikelboom</name>
</author>
<author><name sortKey="Hirsh, J" uniqKey="Hirsh J">J Hirsh</name>
</author>
<author><name sortKey="Weitz, Ji" uniqKey="Weitz J">JI Weitz</name>
</author>
<author><name sortKey="Johnston, M" uniqKey="Johnston M">M Johnston</name>
</author>
<author><name sortKey="Yi, Q" uniqKey="Yi Q">Q Yi</name>
</author>
<author><name sortKey="Yusuf, S" uniqKey="Yusuf S">S Yusuf</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Larsen, Sb" uniqKey="Larsen S">SB Larsen</name>
</author>
<author><name sortKey="Grove, El" uniqKey="Grove E">EL Grove</name>
</author>
<author><name sortKey="Kristensen, Sd" uniqKey="Kristensen S">SD Kristensen</name>
</author>
<author><name sortKey="Hvas, Am" uniqKey="Hvas A">AM Hvas</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hurlen, M" uniqKey="Hurlen M">M Hurlen</name>
</author>
<author><name sortKey="Seljeflot, I" uniqKey="Seljeflot I">I Seljeflot</name>
</author>
<author><name sortKey="Arnesen, H" uniqKey="Arnesen H">H Arnesen</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27153119</article-id>
<article-id pub-id-type="pmc">4859478</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0154897</article-id>
<article-id pub-id-type="publisher-id">PONE-D-15-37404</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject>
<subj-group><subject>Mathematical and Statistical Techniques</subject>
<subj-group><subject>Statistical Methods</subject>
<subj-group><subject>Meta-Analysis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Physical Sciences</subject>
<subj-group><subject>Mathematics</subject>
<subj-group><subject>Statistics (Mathematics)</subject>
<subj-group><subject>Statistical Methods</subject>
<subj-group><subject>Meta-Analysis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Anatomy</subject>
<subj-group><subject>Body Fluids</subject>
<subj-group><subject>Blood</subject>
<subj-group><subject>Platelets</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Anatomy</subject>
<subj-group><subject>Body Fluids</subject>
<subj-group><subject>Blood</subject>
<subj-group><subject>Platelets</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Physiology</subject>
<subj-group><subject>Body Fluids</subject>
<subj-group><subject>Blood</subject>
<subj-group><subject>Platelets</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Physiology</subject>
<subj-group><subject>Body Fluids</subject>
<subj-group><subject>Blood</subject>
<subj-group><subject>Platelets</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Hematology</subject>
<subj-group><subject>Blood</subject>
<subj-group><subject>Platelets</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Cell Biology</subject>
<subj-group><subject>Cellular Types</subject>
<subj-group><subject>Animal Cells</subject>
<subj-group><subject>Blood Cells</subject>
<subj-group><subject>Platelets</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Diagnostic Medicine</subject>
<subj-group><subject>Signs and Symptoms</subject>
<subj-group><subject>Infarction</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Pathology and Laboratory Medicine</subject>
<subj-group><subject>Signs and Symptoms</subject>
<subj-group><subject>Infarction</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject>
<subj-group><subject>Research Assessment</subject>
<subj-group><subject>Systematic Reviews</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Hematology</subject>
<subj-group><subject>Blood Coagulation</subject>
<subj-group><subject>Platelet Aggregation</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Pharmaceutics</subject>
<subj-group><subject>Drug Therapy</subject>
<subj-group><subject>Antiplatelet Therapy</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject>
<subj-group><subject>Research Design</subject>
<subj-group><subject>Clinical Research Design</subject>
<subj-group><subject>Adverse Events</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject>
<subj-group><subject>Database and Informatics Methods</subject>
<subj-group><subject>Database Searching</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Chinese Herbal Medicine for Aspirin Resistance: A Systematic Review and Meta-Analysis</article-title>
<alt-title alt-title-type="running-head">Chinese Herbal Medicine for Aspirin Resistance</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Chen</surname>
<given-names>Hanyu</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Shen</surname>
<given-names>Zhengjie</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chen</surname>
<given-names>Jiandong</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zhang</surname>
<given-names>Haowen</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chen</surname>
<given-names>Xiaohu</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>Department of Cardiology, Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>Translational Medicine Center of Nanjing University of Chinese Medicine, Key Laboratory of Famous Doctor's Proved Recipe Evaluation and Transformation of State Administration of Traditional Chinese Medicine, Nanjing, China</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Gao</surname>
<given-names>Jian-Xin</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>Shanghai Jiao Tong University School of Medicine, CHINA</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: HYC ZJS XHC. Performed the experiments: HYC ZJS JDC HWZ. Analyzed the data: ZJS HYC. Contributed reagents/materials/analysis tools: HYC ZJS. Wrote the paper: HYC ZJS XHC.</p>
</fn>
<corresp id="cor001">* E-mail: <email>chenxhdoctor@126.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>6</day>
<month>5</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<volume>11</volume>
<issue>5</issue>
<elocation-id>e0154897</elocation-id>
<history><date date-type="received"><day>25</day>
<month>8</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>20</day>
<month>4</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© 2016 Chen et al</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>Chen et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pone.0154897.pdf"></self-uri>
<abstract><sec id="sec001"><title>Objectives</title>
<p>To assess the effectiveness and safety of Chinese herbal medicine (CHM) for the treatment of aspirin resistance (AR).</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>A comprehensive research of seven electronic databases was performed for comparative studies evaluating CHM for AR. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool. Data wasere synthesized by using RevMan 5.3 software. (PROSPERO Registration #CRD42015020182)</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>18 randomized controlled trials (RCTs) involving 1,460 patients were included. 15 RCTs reported significant difference in the reduction of platelet aggregation rate (PAR) induced by adenosine diphosphate (ADP) (P<0.05), and 11 reported significant effect of CHM plus aspirin to reduce PAR induced by arachidonic acid (AA) (P<0.05) compared with aspirin 100mg/d treatment. The pooling data of 3 RCTs showed the thromboxane B<sub>2</sub>
(TXB<sub>2</sub>
) in patients with CHM plus aspirin versus aspirin were significantly reduced (Random Effect model (RE), Standard Deviation (SD) = -95.93, 95% Confidential Interval (CI)[-118.25,-73.61], P<0.00001). Subgroup analysis showed that TXB<sub>2</sub>
(Fixed Effect model (FE), SD = -89.23, 95%CI[-121.96,-56.49], P<0.00001) had significant difference in Tongxinluo capsule plus aspirin versus aspirin. 2 RCTs reported the clinical effective rate, and the meta-analysis result showed a significant difference in intervention and control group (FE, Relative Risk (RR) = 1.67, 95%CI[1.15, 2.42], P = 0.007<0.05). In 4 trials, CHM plus aspirin had better effects of reducing the reoccurrence of cerebral infarction than aspirin (FE, RR = 0.24, 95%CI [0.11, 0.49], P<0.0001). And one trial showed that CHM plus aspirin could decrease the National Institutes of Health Stroke Scale (NHISS) score (P<0.05) and increase the Barthel Index (BI) score (P<0.05). 4 trials stated that there were no adverse effects occurred in intervention group, and analysis showed significant difference of CHM or CHM plus aspirin in reducing the occurrence of adverse events (FE, RR = 0.22, 95%CI[0.13, 0.39], P<0.00001). 5 trials claimed that the CHM monotherapy and CHM adjunctive therapy for AR did not add the risk of bleeding (FE, RR = 0.50, 95%CI[0.20, 1.22], P = 0.13>0.05).</p>
</sec>
<sec id="sec004"><title>Conclusions</title>
<p>CHM may be effective and safe as an alternative and collaborative therapy for AR. However, the current evidence and potential promising findings should be interpreted with caution due to poor and varying methodological quality of included studies and the heterogeneity of interventions. Thus, further exploration of this strategy with adequately powered RCTs is warranted.</p>
</sec>
</abstract>
<funding-group><award-group id="award001"><funding-source><institution>the National Natural Science Foundation Project of China</institution>
</funding-source>
<award-id>81273943</award-id>
<principal-award-recipient><name><surname>Chen</surname>
<given-names>Xiaohu</given-names>
</name>
</principal-award-recipient>
</award-group>
<funding-statement>CXH received the funding from the National Natural Science Foundation of China (NO.81273943), available from <ext-link ext-link-type="uri" xlink:href="http://isisn.nsfc.gov.cn/egrantindex/funcindex/prjsearch-list">http://isisn.nsfc.gov.cn/egrantindex/funcindex/prjsearch-list</ext-link>
.</funding-statement>
</funding-group>
<counts><fig-count count="14"></fig-count>
<table-count count="2"></table-count>
<page-count count="24"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>All relevant data are within the paper and its Supporting Information files.</p>
</notes>
</front>
</pmc>
<affiliations><list><country><li>République populaire de Chine</li>
</country>
</list>
<tree><country name="République populaire de Chine"><noRegion><name sortKey="Chen, Hanyu" sort="Chen, Hanyu" uniqKey="Chen H" first="Hanyu" last="Chen">Hanyu Chen</name>
</noRegion>
<name sortKey="Chen, Hanyu" sort="Chen, Hanyu" uniqKey="Chen H" first="Hanyu" last="Chen">Hanyu Chen</name>
<name sortKey="Chen, Jiandong" sort="Chen, Jiandong" uniqKey="Chen J" first="Jiandong" last="Chen">Jiandong Chen</name>
<name sortKey="Chen, Xiaohu" sort="Chen, Xiaohu" uniqKey="Chen X" first="Xiaohu" last="Chen">Xiaohu Chen</name>
<name sortKey="Shen, Zhengjie" sort="Shen, Zhengjie" uniqKey="Shen Z" first="Zhengjie" last="Shen">Zhengjie Shen</name>
<name sortKey="Shen, Zhengjie" sort="Shen, Zhengjie" uniqKey="Shen Z" first="Zhengjie" last="Shen">Zhengjie Shen</name>
<name sortKey="Zhang, Haowen" sort="Zhang, Haowen" uniqKey="Zhang H" first="Haowen" last="Zhang">Haowen Zhang</name>
<name sortKey="Zhang, Haowen" sort="Zhang, Haowen" uniqKey="Zhang H" first="Haowen" last="Zhang">Haowen Zhang</name>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Bois/explor/OrangerV1/Data/Pmc/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000239 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd -nk 000239 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Bois |area= OrangerV1 |flux= Pmc |étape= Checkpoint |type= RBID |clé= PMC:4859478 |texte= Chinese Herbal Medicine for Aspirin Resistance: A Systematic Review and Meta-Analysis }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/RBID.i -Sk "pubmed:27153119" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd \ | NlmPubMed2Wicri -a OrangerV1
![]() | This area was generated with Dilib version V0.6.25. | ![]() |