{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:47:07Z","timestamp":1762508827751,"version":"3.41.2"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Coronary slow flow (CSF) is a common cardiovascular phenomenon with no effective treatment in conventional Western medicine (CWM). Shexiang Baoxin Pill (SXBXP) is a widely used Chinese medicine for cardiovascular disease in China, and clinical studies have shown that it has good efficacy for CSF.<\/jats:p><jats:p><jats:bold>Objective:<\/jats:bold> To systematically evaluate the efficacy and safety of SXBXP for CSF.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Seven databases were searched to identify related randomized controlled trials (RCTs). The Meta-analysis, trial sequential analysis (TSA), and Grades of Recommendation, Assessment, Development and Evaluation (GRADE) were performed using Stata 14.1, TSA 0.9.5.10 Beta and GRADE profiler 3.2.2 software respectively.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of 10 RCTs were included. Meta-analysis showed that compared with CWM treatment alone, SXBXP combined with CWM further improved the angina pectoris efficacy [RR = 1.37, 95% CI (1.23, 1.52), <jats:italic>p<\/jats:italic> &amp;lt; 0.000 01] and nitric oxide (NO) level [WMD = 11.32, 95% CI (0.04, 22.59), <jats:italic>p<\/jats:italic> = 0.049], decreased the mean corrected TIMI frame count (CTFC) [WMD = \u22124.23, 95% CI (\u22125.51, \u22122.95), <jats:italic>p<\/jats:italic> &amp;lt; 0.000 01], CTFC of the left anterior descending artery (LAD) [WMD = \u22126.36, 95% CI (\u221212.07, \u22120.65), <jats:italic>p<\/jats:italic> = 0.029], left circumflex artery (LCX) [WMD = -5.73, 95% CI (\u22128.79, \u22122.67), <jats:italic>p<\/jats:italic> &amp;lt; 0.000 01], and right coronary artery (RCA) [WMD = \u22126.72, 95% CI (\u221210.60, \u22122.84), <jats:italic>p<\/jats:italic> = 0.001], decreased the positive rate of treadmill exercise test [RR = 0.45, 95% CI (0.25, 0.83), <jats:italic>p<\/jats:italic> = 0.010], endothelin-1 (ET-1) level [WMD = -11.03, 95% CI (\u221213.92, \u22128.14), <jats:italic>p<\/jats:italic> &amp;lt; 0.000 01], high-sensitivity C-reactive protein (hs-CRP) [WMD = \u22121.95, 95% CI (\u22122.57, \u22121.34), <jats:italic>p<\/jats:italic> &amp;lt; 0.000 01], and adverse reactions [RR = 0.20, 95% CI (0.05, 0.85), <jats:italic>p<\/jats:italic> = 0.030]. The GRADE evidence quality rating presented with moderate, low or very low quality of evidence. TSA further affirmed the clinical efficacy.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Although some results suggest that there may be a positive effect of SXBXP for CSF, the quality of the primary study including the reporting is too poor and therefore, no benefits could be demonstrated. More high-quality studies are still needed to further confirm the efficacy and safety.<\/jats:p><jats:p><jats:bold>Systematic review registration:<\/jats:bold><jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>, identifier (CRD42022329469).<\/jats:p>","DOI":"10.3389\/fphar.2022.955146","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T07:11:49Z","timestamp":1661152309000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Meta-analysis and trial sequential analysis of shexiang baoxin pill for coronary slow flow"],"prefix":"10.3389","volume":"13","author":[{"given":"Hongxin","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingyuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingjun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1177\/0003319707304943","article-title":"Increased high sensitive CRP level and its significance in pathogenesis of slow coronary flow","volume":"58","author":"Barutcu","year":"2007","journal-title":"Angiology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1001\/jama.2013.879","article-title":"Reporting of patient-reported outcomes in randomized trials: The CONSORT PRO extension","volume":"309","author":"Calvert","year":"2013","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1007\/s00508-014-0559-8","article-title":"The association of serum albumin with coronary slow flow","volume":"126","author":"Cetin","year":"2014","journal-title":"Wien. 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