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Potential effectiveness of traditional Chinese medicine for cardiac syndrome X (CSX): a systematic review and meta-analysis

Jia-ying Wang1, Lu Xiao1, Jing Chen2, Jing-bo Zhai2, Wei Mu1, Jing-yuan Mao3 and Hongcai Shang12*

Author Affiliations

1 The Center of Evidence Based Medicine, Tianjin University of Traditional Chinese Medicine, Anshan West Road, Tianjin 300193, China

2 Tianjin Institution of Clinical Evaluation, Tianjin University of Traditional Chinese Medicine, Yuquan Road, Tianjin 300193, China

3 Cardiovascular Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Anshan West Road, Tianjin 300193, China

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BMC Complementary and Alternative Medicine 2013, 13:62  doi:10.1186/1472-6882-13-62

Published: 17 March 2013



Treatment of cardiac syndrome X with unknown pathological mechanism remains a big challenge for clinicians. Complementary and alternative medicine may bring a new choice for its management. The aim of this study is to evaluate the clinical effects of traditional Chinese medicine on cardiac syndrome X patients.


We systematically searched databases such as Cochrane CENTRAL, PubMed, EMBASE, CBM, Chinese National Knowledge Infrastructure (CNKI), WanFang and VIP, and handsearched relevant journals to identify randomized controlled trials. Following the steps of systematic review recommended by the Cochrane group, we assessed the quality of included studies, extracted valid data and undertook meta-analysis.


Twenty one moderate-to low-quality randomized controlled trials involving 1143 patients were included. The results showed that traditional Chinese medicine could improve angina [OR=1.34, 95% CI: 1.2 to 1.50], electrocardiogram (ECG), endothelin-1 (ET-1) levels, prolong exercise duration in treadmill tests, and reduce angina frequency per week compared with routine treatment. No other side effect was reported except two cases of stomach pain.


Compared with conventional treatment, traditional Chinese medicine shows the potential of optimizing symptomatic outcomes and improving ECG and exercise duration. The efficacy of TCM may find explanation in its pharmacological activity of adjusting the endothelial function. TCM, as a kind of alternative and complementary medicine, may provide another choice for CSX patients.