Skip to main content
NCBI home page
Medicine logoLink to Medicine
. 2022 Dec 9;101(49):e32133. doi: 10.1097/MD.0000000000032133

The effect of Taohong Siwu decoction combined with antihypertensive medicine in the treatment of hypertension: Meta-analysis

Peng-Cheng Xie a, Qiu-Er Liang a, Wan-Qing Tu a, Ting Xie a, Lai Kwan Lam a,*, Li-Guo Chen a,*
PMCID: PMC9750686  PMID: 36626486

Background:

Taohong Siwu Decoction (THSWD) is a classic prescription of traditional Chinese medicine. Recent research has shown that the practical components of THSWD have specific curative effects on various cardiovascular diseases, including hypertension, suggesting THSWD could effectively lower blood pressure (BP) with fewer side effects. However, little information is available regarding the effectiveness of THSWD combined with antihypertensive medicine on hypertension.

Objective:

This meta-analysis aimed to study the efficacy and safety of THSWD in treating hypertension.

Methods:

According to the search strategy, 8 databases were searched, including China Knowledge Network (CNKI), Wanfang Database, VIP Database, Pubmed, China Biomedical Literature Database (CBM), web of science, EMBASE and Cochrane Library, for the randomized controlled trial of THSWD on hypertension. 9 RCTs were included and 827 patients were involved. This meta-analysis used RevMan 5.4 to evaluate the articles.

Results:

This review included 9 RCTs. All studies were THSWD with the antihypertensive drug compared with single antihypertensive western medicine. The total effective rate of THSWD combined with corresponding western medicine was significantly improved (Relative risk = 1.26; 95% CI: 1.16–1.37, P < .00001), which could effectively reduce the systolic BP (MD = −15.28 mm Hg; 95% CI: −20.17 to −10.40, P < .00001=, diastolic BP (MD = −9.70 mm Hg; 95% CI: −12.66 to −6.73, P < .00001), Triglycerides (MD = −1.48, 95%CI: −2.09 to −0.87, P < .00001), total cholesterol (MD = −1.43, 95% CI: −1.63 to −1.24, P < .00001) and low density lipoprotein cholesterol (MD = −0.93, 95% CI: −1.07 to −0.80, P < .00001). Compared with the single routine western medicine group, THSWD combined with the corresponding western medicine increased serum high-density lipoprotein (MD = 0.41, 95% CI: 0.35 to 0.46, P < .00001).

Conclusion:

THSWD combined with antihypertensive drugs in treating hypertension was curative in lowering BP, improving blood lipid levels and reducing the incidence of adverse reactions compared to antihypertensive medications treatment. However, more high-quality studies are needed due to the biased results and the small number of studies for further verification of the effectiveness of THSWD, and providing a new treatment for clinical reference.

Keywords: antihypertensive drugs; efficacy, hypertension; meta analysis; systematic review; Taohong Siwu decoction

1. Introduction

Hypertension is 1 of the chronic cardiovascular and cerebrovascular diseases with high mortality and morbidity.[1] Since the fast growth of aging population in China, the proportion of elderly hypertensive patients is gradually increasing. According to the Guidelines for the Management of Senile Hypertension in China 2019, the prevalence rate of hypertension in elderly over 80 years old is almost 90%.[2] The common antihypertensive drugs are calcium channel blocker, angiotensin receptor antagonist and angiotensin converting enzyme inhibitor, which have side effects such as cough, sore throat, abdominal pain, vomiting and dizziness.[3] Therefore, Chinese medicine becomes more popular in the treatment of hypertension and is known for its positive effect and fewer side effects.

Traditional Chinese medicine (TCM) comprehensively treats hypertension and the multiple organ lesion caused by hypertension.[4] Taohong Siwu Decoction (THSWD) is frequently used for blood stasis syndrome in TCM. AS a classic prescription of Traditional Chinese Medicine, it was first seen in the medical books named The Golden Mirror of Medicine. It is mainly used to treat various blood stasis syndromes. There are 6 herbs in THSWD, including peach kernel, safflower, angelica, prepared rhizome of rehmannia, Ligusticum wallichii and white peony root. THSWD can promote blood circulation and remove blood stasis. In TCM theory, peach kernel and safflower are monarch drugs in this prescription and play the dominant role, and ligusticum wallichii has the effect of promoting blood circulation as well. Rehmannia glutinosa, paeonia lactiflora and angelica sinensis can nourish blood. Hypertension with blood stasis syndrome is 1 of the common clinical types of hypertension in China.[4] Modern research have proved that THSWD can improve endothelial cell injury,[5–7] and ameliorate aortic endothelial diastolic function by improving serum nitric oxide, Endothelin-1 and other related factors, so as to play a essential role in reducing blood pressure (BP).[8] The results of network pharmacological analysis showed that anti-cardiovascular compounds, such as kaempferol, quercetin and luteolin, were contained in THSWD which can regulate hypertension-related genes ADRB2 and CALM1, through different pathways like cAMP and Ras pathway to treat hypertension.[9] Moreover, clinical studies demonstrated that THSWD has a prominent clinical antihypertensive effect.[10–12]The clinical symptoms of blood stasis syndrome, such as headache, vertigo, dark tongue with petechiae and pulse astringency, are in line with the indications of THSWD.

This study aimed to assess the efficacy and safety of THSWD combined with western medicine on hypertension in order to enhance the reliability of the THSWD clinical studies and provide reference for clinical application.

2. Methods

2.1. Search strategy

A comprehensive literature search was performed in China Knowledge Network (CNKI), Wanfang Database, VIP Database, Pubmed, China Biomedical Literature Database (CBM), web of science, EMBASE and Cochrane Library. ([BP, High] OR [hypertension] OR [High BP]) AND ([tao hong si wu] OR [THSWD] OR [tao hong si wu decoction]) were listed and used as search terms to search Chinese and English articles from the date of inception to March 1, 2022.

2.2. Inclusion and exclusion criteria

In this study, the inclusion criteria were as follows:

  1. Patients were diagnosed with hypertension according to the relevant criteria of hypertension diagnosis in the Guide.

  2. TCM syndrome type of patients was blood stasis type. According to the diagnostic criteria of blood stasis syndrome drawn up by the Professional Committee of Promoting Blood Circulation and Removing Blood Stasis of Chinese Society of Integrated Traditional Chinese and Western Medicine and related studies, the main symptoms of hypertension blood stasis syndrome include headache, numbness and pain of neck and limbs, mania, dark tongue with ecchymosis, distension of sublingual collaterals and astringent pulse.

  3. THSWD combined with conventional antihypertensive western medicine was the intervention in the experimental groups. Patients could be treated with different doses of THSWD according to the condition.

  4. The study was designed as a randomized controlled clinical study and original study only.

  5. Articles were written in English or Chinese.

The exclusion criteria were as follows:

  1. Patients who were having other non-cardiovascular complications or were taking other hebal medicine.

  2. Acupuncture, massage, cupping and other therapies were included in treatments.

  3. Animal experiments or surgical treatments.

  4. Repeated or retrieved literature.

2.3. Data extraction

Two investigators collected the data independently. The extracted information included as follow: first author, year of publication, number of patients, study design, dosage of medication, duration of therapy, outcomes, and quality assessment of each study.

2.4. Quality evaluation

The quality assessment was independently conducted by 2 examiners. Disagreements were resolved by discussion. The risk bias assessment tool provided by Cochrane Handbook was used to evaluates the methodological quality of literature, including the generation of random sequence, distribution concealment, blind method, incomplete outcome data, selective report and other bias.

2.5. Evaluation of outcome

The primary endpoints were BP included systolic blood pressure (SBP) and diastolic blood pressure (DBP), and total effective rate. The secondary endpoints were triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and adverse reactions. Clinical symptoms which indicated as” recovery,” “improvement” and “marked effect” were all included in the effective range. Also, the diastolic BP decreased less than 10 mm Hg but reached the normal range, or the diastolic BP decreased by 10 to 19 mm Hg were known as effective. In addition, adverse events were selected for safety evaluation.

2.6. Statistical analysis

RevMan5.4 recommended by Cochrane handbook was used for this meta-analysis. The relative risk (RR) was used for statistics, and the confidence interval was 95%. I2 statistics and Q test served to test heterogeneity. If significant heterogeneity (I2 > 50% or P < .05) is observed, the random effect model is used for statistical analysis. If the study is homogeneous (I2 < 50% or P > .05), the fixed effect model is used. Funnel chart was used to evaluate publication bias. This review was conducted following PRISMA guidelines.

All analyses were based on previous published studies, thus no ethical approval and patient consent are required

3. Results

3.1. Basic characteristics of included data

A total of 166 studies were retrieved after a primary search in 8 electronic databases, and 93 duplicate studies were excluded. After reading the title and abstract, 58 articles were excluded because the participants in studies had other non-cardiovascular complications or were taking other herbal medicines at the same time. In addition, animal experiments and the articles that using surgical treatments were excluded. Then, 15 studies were evaluated, and 3 were excluded because they were duplicate publications. 3 studies were excluded because patients were not grouped randomly. Finally, 9 studies were included,[13–21] involving 827 hypertensive patients, as shown in Figure 1.

Figure 1.

Figure 1.

Open in a new tab

Flow diagram of study selection and identification. Blood pressure; Total effective rate; Triglyceride; Total cholesterol; Low-density Lipoprotein cholesterol; High-density Lipoprotein cholesterol; and Adverse events.

3.2. Study characteristics

The characteristics of each study were summarized in Table 1. The sample size ranged from 45 to 150. Patients’ average ages range from 54.89 to 72.03 years old and the average durations vary from 5.48 to 15.25 years. Western medicine include Amlodipine, Amlodipine besylate, Nifedipine and Valsartan. The components of THSWD-based formula in each study were depicted in Table 2. Treatment durations ranged from 3 to 4 weeks.

Table 1.

Basic characteristics of the included trials.

Study Sample Size (C/E) Gender (Male/Female) Average Age Average Duration of Disease Grouping Method Intervention Measures Treatment Duration Outcome Measures
C E C E C E C E
Wang 2020 43/43 23/20 25/18 61.01 ± 1.17 60.19 ± 1.26 7.74 ± 1.49 yrs 7.65 + 1.41 yrs TRN Amlodipine (2.5 mg, qd) TSD (600 mL/d) + C 21 d ①③④⑤⑥
Li 2020 40/40 29/11 30/10 55.65 ± 10.21 54.89 ± 10.16 5.48 ± 1.85 yrs 6.05 ± 1.65 yrs OMR Amlodipine (10 mg, qd) Modified TSD (1 dose/d) + C 1 mo ①③④
Zhong 2015 23/22 9/14 11/11 65.1 - OMR ABT (2.5 mg, qd) TSD + C 21 d ①②
Lou 2018 30/30 17/13 18/12 68.23 ± 1.13 68.24 ± 1.14 15.24 ± 1.26 yrs 15.25 ± 1.23 yrs OMR ABT (5 mg, qd) Modified TSD (1 dose/d) + C 4 wks ①②
Fei 2019 75/75 45/30 46/29 71.67 ± 6.14 71.26 ± 6.26 8.63 ± 3.14 yrs 8.56 ± 3.26 yrs TRN ABT (2.5 mg, qd) Modified TSD (1 dose/d) + C 21 d ②
Liao 2019 30/30 14/16 16/14 60.2 ± 1.8 61.3 ± 1.0 7.6 ± 1.7 yrs 7.7 ± 0.6 yrs OMR Nifedipine (20 mg, qd) TSD (300 mL/d) + Amlodipine (5 mg, qd) 4 wks ①③④⑤⑥
Zhong 2020 29/29 15/14 13/16 71.93 ± 3.88 72.03 ± 3.90 9.01 ± 1.01 mo 8.98 ± 0.98 mo TRN ABT (5 mg, qd) Modified TSD (300 mL/d) + C 30 d ①②⑦
Jin 2021 44/44 27/17 25/19 67.45 ± 2.16 67.48 ± 2.19 9.13 ± 1.45 yrs 9.16 ± 1.47 yrs TRN ABT (2.5 mg, qd) TSD (1 dose/d) + C 21 d ①⑦
Song 2014 55/55 32/23 36/19 58.5 ± 8.0 58.8 ± 8.2 – OMR Valsartan (80 mg, qd) Modified TSD (400 mL/d) + C 4 wks ②
Open in a new tab

ABT = Amlodipine besylate tablets, C = control group, E = experimental group, N = no, OMR = only mention random, TER = total effective rate, TRN = table of random number, TSD = Taohong Siwu Decoction, Y = yes.

① BP; ② Total effective rate; ③ TG; ④ TC; ⑤ LDL-C; ⑥ HDL-C; ⑦ Adverse events.

Table 2.

Components of CHM used in the included trials.

References Prescription Medicinal herbs
Jin 2021[20] THSWD Angelica sinensis 15 g, Radix Rehmanniae Preparata 15 g, Rhizoma Ligustici Chuanxiong 8 g, Radix Paeoniae Alba 10 g, Semen Persicae 9 g and Carthami Flos 6 g
Song 2014[16] Modified THSWD Angelica sinensis 25 g, Radix Paeoniae Alba 20 g, Atractylodes macrocephala 20 g, Rhizoma Ligustici Chuanxiong 20 g, Carthami Flos 15 g, Semen Persicae 15 g, Radix Rehmanniae Preparata 15 g, Radix Codonopsis 10 g, Rhizoma Cyperi 10 g and Radix Glycyrrhizae 8 g
Zhong 2015[13] THSWD Angelica sinensis 15 g, Radix Paeoniae Rubra 10 g, Rhizoma Ligustici Chuanxiong 8 g, Carthami Flos 6 g, Semen Persicae 9 g and Radix Rehmanniae Preparata 15 g.
Lou 2018[17] Modified THSWD Angelica sinensis 20 g, Radix Paeoniae Alba 20 g, Atractylodes macrocephala 20 g, Rhizoma Ligustici Chuanxiong 20 g, Carthami Flos 15 g, Semen Persicae 15 g, Radix Rehmanniae Preparata 15 g, Radix Codonopsis 10 g, Rhizoma Cyperi 10 g, Glycyrrhrizae Radix 8 g
Fei 2019[21] Modified THSWD Angelica sinensis 20 g, Radix Paeoniae Alba 20 g, Atractylodes macrocephala 20 g, Rhizoma Ligustici Chuanxiong 20 g, Carthami Flos 15 g, Semen Persicae 15 g, Radix Rehmanniae Preparata 15 g, Radix Codonopsis 10 g, Rhizoma Cyperi 10 g, Glycyrrhrizae Radix 8 g
Liao 2019[18] THSWD Angelica sinensis 15 g, Radix Paeoniae Rubra 15 g, Rhizoma Ligustici Chuanxiong 15 g, Carthami Flos 15 g, Semen Persicae 15 g and Radix Rehmanniae Preparata 15 g.
Li 2020[19] Modified THSWD Angelica sinensis 25 g, Radix Paeoniae Alba 15 g, Atractylodes macrocephala 20 g, Rhizoma Ligustici Chuanxiong 15 g, Carthami Flos 15 g, Almond 15 g, Radix Rehmanniae Preparata 15 g, Radix Codonopsis 10 g, Rhizoma Cyperi 10 g, Glycyrrhrizae Radix 8 g, and appropriate amount of liquor
Wang 2020[15] THSWD Angelica sinensis 15 g, Radix Paeoniae Rubra 10 g, Rhizoma Ligustici Chuanxiong 8 g, Carthami Flos 6 g, Semen Persicae 9 g and Radix Rehmanniae Preparata 15 g.
Zhong 2020[14] Modified THSWD Licorice 8 g, Rhizoma Cyperi 10 g, Radix Codonopsis each 10 g, Radix Rehmanniae Preparata 15 g, Semen Persicae 15 g, Carthami Flos 15 g, Rhizoma Ligustici Chuanxiong 20 g, Atractylodes macrocephala 20 g, Radix Paeoniae Alba 20 g, Radix Angelicae Sinensis 20 g
Open in a new tab

CHM = Chinese Herbal medicine, THSWD = Taohong Siwu decoction.

Total effective rate were reported in 5 studies.[13,14,16,17,21] BP outcomes were reported in 9 studies, with continuous BP in 7 trials[13–15,17–20] and categorical BP in 2 trials.[16,21] Serum lipid levels were reported in 3 trials.[15,18,19] Adverse events were reported in 2 trials.[14,20]

4. Results

4.1. Primary endpoint

4.1.1. Methodologic quality.

4 trials used the table of random number for random grouping.[14,15,20,21] The other 5 trials mentioned randomization in the text without detailed information.[13,16–19] Details regarding concealment of allocation and blinding of patient, investigator and assessor were unclear in all studies. All trials reported that all the enrolled subjects had completed the trials. Both selective reporting and other potential threat to validity are in low risk of bias in the original trials. Additionally, no study reported the methods of follow-up (Fig. 2).

Figure 2.

Figure 2.

Open in a new tab

Methodologic quality of the included trials based on the Cochrane handbook.

4.1.2. BP.

BP was reported in 7 trials.[13–15,17–20] There were 238 patients in THSWD groups and 239 patients in antihypertensive drugs groups. Both SBP and DBP were with significant heterogeneity (SBP: chi-square = 42.37, P < .00001, I2 = 86%; DBP: chi-square = 40.13, P < .00001, I2 = 85%) and random-effects model was applied. Subgroup analysis was made according to age which was 1 of the important factors of hypertension and the heterogeneity decreased significantly. The results of these 7 trials showed a significant effect of THSWD combined with antihypertensive drugs on SBP (MD = −15.28 mm Hg; 95% CI: −20.17 to −10.40, P < .00001) and DBP (MD = −9.70 mm Hg; 95% CI: −12.66 to −6.73, P < .00001) compared with antihypertensive drugs (Fig. 3A and B). In the other 2 trials,[16,21] the data was analyzed using a fixed-effects model (chi-square = 1.00, P = .32, I2 = 0). A significant decrease on BP was identified in favor of THSWD therapy compared with the antihypertensive drugs (RR = 1.23; 95% CI: 1.11 to 1.36,P < .0001) (Fig. 3C).

Figure 3.

Figure 3.

Open in a new tab

Forest plots of the comparison of THSWD versus antihypertensive drugs for the outcome of BP. A, SBP; B, DBP; C, categorical BP. BP = blood pressure, DBP = diastolic blood pressure, SBP = systolic blood pressure.

4.1.3. Total effective rate.

5 studies assessed the total effective rate of THSWD with antihypertensive drugs on both BP and the symptoms.[13,14,16,17,21] There were 211 patients in the THSWD groups and 212 patients in the antihypertensive drugs groups. A fixed-effects model was applied based on the test of heterogeneity (chi-square = 2.60, P = .63, I2 = 0%). THSWD therapy compared with antihypertensive drugs was more efficient in treating hypertension (RR = 1.26; 95% CI: 1.16–1.37, P < .00001) (Fig. 4).

Figure 4.

Figure 4.

Open in a new tab

Forest plot of the comparison of THSWD versus THSWD combined with antihypertensive drugs for the outcome of symptoms.

4.2. Secondary endpoint

4.2.1. TG, TC.

3 studies reported TG and TC.[15,18,19] There were 113 patients in experiment groups and control groups, respectively. The random effect model was selected for TG data according to the heterogeneity test results (chi-square = 86.73, P < .00001, I2 = 98%) (Fig. 5A). We didn’t perform subgroup analysis because there were too few documents. Considering the heterogeneity test results of TC data (chi-square = 1.07, P = .58, I2 = 0%), the fixed-effects model was selected. It showed that THSWD with antihypertensive medicine could effectively reduce TG (MD = −1.48, 95% CI: −2.09 to −0.87, P < .00001) and TC (MD = −1.43, 95% CI: −1.63 to −1.24, P < .00001) (Fig. 5A and B).

Figure 5.

Figure 5.

Open in a new tab

Forest plot of the comparison of THSWD versus antihypertensive drugs for the outcome of TG and TC. A, TG; B, TC. TG = triglyceride; TC = total cholesterol.

4.2.2. HDL-C, LDL-C.

2 studies reported HDL-C and LDL-C.[15,18] There were 73 patients in THSWD groups and antihypertensive drugs groups, respectively. Based on the heterogeneity test of HDL data (chi-square = 1.29, P = .26, I2 = 23%), we used random effect model. According to the heterogeneity test results of LDL-C (LDL-C: chi-square = 0.32, P = .85, I2 = 0), the fixed effect model was applied. Compared with antihypertensive drugs, THSWD combined with antihypertensive drugs could effectively increase HDL-C (MD = 0.41, 95% CI: 0.35 to 0.46, P < .00001) and decrease LDL-C (MD = −0.93, 95% CI: −1.07 to −0.80, P < .00001) (Fig. 6A and B).

Figure 6.

Figure 6.

Open in a new tab

Forest plot of the comparison of THSWD versus antihypertensive drugs for the outcome of HDL-C and LDL-C. A, HDL-C; B, LDL-C. HDL-C = high-density lipoprotein cholesterol, LDL-C = low-density lipoprotein cholesterol.

4.2..3. Adverse events.

Two trials (2/9, 22.2%)[14,20] reported adverse events. The fix effect model was used to analyze the data considering the heterogeneity test results (chi-square = 1.01, P = .32, I2 = 1%). There were 10 adverse events in 73 patients in the control group, while only 2 patients in the experimental group, which could be considered that the incidence of adverse events in the experimental groups was fewer than that in the control group (OR = 0.17, 95% CI: 0.04 to 0.81, P = .03) (Fig. 7).

Figure 7.

Figure 7.

Open in a new tab

Forest plot of the incidence of adverse events.

5. Discussion

5.1. Findings of this study

The main goal of hypertension management is lowering BP, which is a vital strategy to decrease the morbidity and mortality of cardiovascular diseases (CVD) and other diseases.[22] Chinese herbal medicine (CHM) is widely used in China as a pharmacological intervention, and many studies have been conducted on CHM for hypertension. An evidence map review in 2020 showed that CHM was chiefly used in the treatment of elderly hypertension and as a prevention of its complications; it also reported the benefits of CHM in lowering BP, increasing total effective rate and reducing adverse events.[23] Also, Blood stasis is 1 of the main syndrome elements of hypertension.[24] THSWD is a classic Chinese medicine decoction for blood stasis syndromes such as pains in the body, and dark purple lips, THSWD commonly uses in the treatment of hypertension. This meta-analysis reveals the overall efficacy of THSWD as the treatment for hypertension.

Our results suggested that THSWD with antihypertensive drugs markedly improved the BP, TC, TG, LDL-C and HDL-C, and showed a increase in total effective rate and a decrease in adverse events compared to the control groups. The pooled analysis presented in Figure 3 suggested that THSWD with antihypertensive drugs is likely more effective in patients aged 60 to 65 years old. The control groups in the studies were using THSWD with amlodipine,[13–15,17,19–21] nifedipine,[18] valsartan[16] respectively. THSWD can decrease the whole blood viscosity, plasm viscosity[25,26] and hemoglobin[27] of the blood stasis model. It can also reduce BP, improve endothelium-dependent relaxation and the level of nitric oxide, Endothelin-1, endothelial cell protein C receptor, vonwillebrand factor, showing the protection to vascular endothelial cells.[8]The study conducted by Qi Wu et al[28] demonstrated that THSWD relaxes blood vessels through an endothelium-dependent way. Amlodipine and nifedipine are dihydropyridine calcium channel blockers, amlodipine acts on the vascular smooth muscle to reduce BP and decrease peripheral resistance[29]; nfedipine acts on small and large arteries to increase arterial compliance for reducing BP.[30] Valsartan is an angiotensin receptor blockers, it blocks the action of angiotensin II to relax the blood vessels.[31]These 3 drugs are commonly used for hypertension.[32] The promoting blood circulation function of THSWD can remove blood stasis and act on vascular endothelial cells for relaxation, it may cause THSWD combined with different antihypertensive drugs showing more prominent in our study.

The increase in blood lipid levels leads to a decrease in vascular compliance in elderly, causing an increased risk of mortality for hypertensive patients.[33] The results showed a significant decrease in TC, TG and LDL-C compared with the control group, THSWD combined with anti-hypertensive drugs could more effectively improve combined with different antihypertensive drugs. It is noticed that the average decrease is 1.48 mmol/L in TG and 1.43 mmol/L in TC. The heterogeneity of TG was high (I2 = 98%). After deepening the analysis, the reason of the great heterogeneity may be related to age. Some studies have shown the cholesterol clearance rate of the elderly over 60 years old is lower than that of the young.[34,35] Moreover, there was a statistically significant difference between the experiment group and the control group in the incidence of adverse events (Fig. 7). It suggested that THSWD with anti-hypertensive drugs is safer than using anti-hypertensive drugs alone. We also observed a significant increase in HDL-C which were still in the normal range.

5.2. Limitations of this study

There are several limitations in this study. Firstly, only 9 RCTs studies were analyzed even with a comprehensive literature review. Secondly, the frequency of treatment, length of the duration, time interval, and efficacy standard were all different in studies. Thirdly, no follow-up was performed in all studies. Besides, the random allocation method and blinding were not completely described in some studies. Only 3 studies reported the diagnostic criteria of TCM syndrome. All limitations above could have affected the results but the conclusion is still reliable.

6. Conclusion

THSWD combined with conventional therapy demonstrated the efficacy in the treatment of hypertension in improving the BP, TC, TG, LDL-C and HDL-C. It is probably safer than using antihypertensive drugs alone. The effects of THSWD should be considered in the treatment for further verification and a long-term study should be conducted.

Author contributions

The authors would like to thank all members in this study. PCX conducted the conception and design of the study, analysis and interpretation of data, writing of the article and final approval of the version to be published. LKL and WQT collected and analyzed the data. QEL and TX contributed to the writing of the manuscript. LGC and LKL revised the manuscript. All authors reviewed and agreed the final manuscript.

Abbreviations:

BP =
blood pressure
CHM =
Chinese herbal medicine
DBP =
diastolic blood pressure
HDL-C =
high density lipoprotein cholesterol
LDL-C =
low density lipoprotein cholesterol
RR =
relative risk
SBP =
systolic blood pressure
TC =
total cholesterol
TCM =
traditional Chinese medicine
TG =
triglycerides
THSWD =
Taohong Siwu Decoction
vWF =
VonWillebrand factor

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

This work was supported by the National Natural Sciences Foundation of China, Li-Guo Chen, No. 8217140814, 01/01/2022.

The authors have no conflicts of interest to disclose.

How to cite this article: Xie P-C, Liang Q-E, Tu W-Q, Xie T, Lam LK, Chen L-G. The effect of Taohong Siwu decoction combined with antihypertensive medicine in the treatment of hypertension: Meta-analysis. Medicine 2022;101:49(e32133).

Contributor Information

Peng-Cheng Xie, Email: wzfs2017@126.com.

Qiu-Er Liang, Email: 767489777@qq.com.

Wan-Qing Tu, Email: tuwanqing@126.com.

Ting Xie, Email: wzfs2017@126.com.

References

  • [1].Wang Z, Chen Z, Zhang L, et al. Status of hypertension in China: results from the China hypertension survey, 2012-2015. Circulation. 2018;137:2344–56. [DOI] [PubMed] [Google Scholar]
  • [2].Li J, Fan L, Hua Q, et al. 2019 Chinese guidelines for the management of hypertension in the elderly. Chin J Geriatr Res. 2019;6:1–27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [3].Chen ZW. Analysis of common adverse drug reactions in hypertension. China Pract Med. 2021;16:162–3. [Google Scholar]
  • [4].Meng X, Xiong XJ. Interpretation of expert consensus on diagnosis and treatment of hypertension with traditional Chinese medicine. Chin J Exp Tradit Med Formulae. 2022;28:192–205. [Google Scholar]
  • [5].Wang X, Jiang H, Changhong Q, et al. Time-dose effects of Taohong Siwu decoction on number and funcitional activity of peripheral blood endothelial progenitor cells. Chin J Tissue Eng Res. 2019;23:1354–8. [Google Scholar]
  • [6].Mao HM, Liu XH, Shi DZ. Reasearch progress on the mechanism of Taohong Siwu decoction in the treatment of coronary atherosclerotic heart disease. Glob Tradit Chin Med. 2016;9:1145–8. [Google Scholar]
  • [7].Li RS, Li DY, Chen WN, et al. Taohong Siwu decoction regulated functions of endothelial cells and treated arteriosclerosis obliterans: an experimental study. Chin J Integr Tradit West Med. 2014;34:191–6. [PubMed] [Google Scholar]
  • [8].Chen XD, Chen WH, Liu TH, et al. The effect of Taohongsiwu decoction on aortic diastolic function and the protective effect of endothelial cells in hypertensive rats. Lishizhen Med Mater Med Res. 2021;32:785–9. [Google Scholar]
  • [9].Liu TH, Chen WH, Chen XD, et al. Network pharmacology identifies the mechanisms of action of Taohongsiwu decoction against essential hypertension. Med Sci Monit. 2020;26:e920682. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [10].Wang M. Study on the ultrasonic characteristics of Taohong Siwu decoction add and subtract in the treatment of hypertensive heart disease. J Sichuan Tradit Chin Med. 2015;33:48–9. [Google Scholar]
  • [11].Wang F, Wang P, Liu MY, et al. Observation on the therapeutic effect of modified Taohong Siwu Decoction on eldly type 2 diabetes mellitus complicated with hypertension in community. Beijing J Tradit Chin Med. 2021;40:536–8. [Google Scholar]
  • [12].Fan MM, Wang YP. Clinical observation on treating 62 cases of senile hypertension with the Banxia Baizhu Tianma decoction plus the Taohong Siwu decoction. Clin J Chin Med. 2015;7:115–6. [Google Scholar]
  • [13].Zhong XY. Synergy treatment of Tao-Hong-Si-Wu-Tang and amlodipine besylate on senile hypertension of blood-stagnated. Guangming J Chin Med. 2015;30:1326–8. [Google Scholar]
  • [14].Zhong EY. Clinical effect of Taohong Siwu decoction combined with amlodipine besylate tablets in treating senile hypertension and blood stasis syndrome. Chin J Clin Ration Drug Use. 2020;13:41–2. [Google Scholar]
  • [15].Wang XY, Zhai ZP. Therapeutic effect of Taosiwu decoction combined with amlodipine on hypertension complicated with coronary heart disease. China Health Care. 2020;38:12–3. [Google Scholar]
  • [16].Song LY. Clinical observation of modified Taohong Siwu decoction in treating early renal damage of hypertension. Guiding J Tradit Chin Med Pharm. 2014;20:126–7. [Google Scholar]
  • [17].Lou YL, Li AJ. Clinical observation on treatment of senile hypertension and blood stasis syndrome with Taohong Siwu decoction combined with western medicine. Guangming J Chin Med. 2018;33:3218–20. [Google Scholar]
  • [18].Liao RP. Clinical observation of Taohong Siwu decoction combined with amlodipine in treating hypertension complicated with coronary heart disease. Electron J Clin Med Lit. 2019;6:166. [Google Scholar]
  • [19].Li P. Clinical effect of Taohong Siwu decoction combined with amlodipine in treating hypertension complicated with coronary heart disease. Health Horizon. 2020;11:120. [Google Scholar]
  • [20].Jin L. Clinical effect of Taohong Siwu decoction combined with amlodipine in treating hypertension complicated with coronary heart disease. Inn Mongolia J Tradit Chin Med. 2021;40:66–7. [Google Scholar]
  • [21].Fei CX. Evaluation of clinical effect of Taohong Siwu decoction combined with amlodipine besylate tablets in treating senile hypertension with blood stasis syndrome. Clin J Chin Med. 2019;11:52–3. [Google Scholar]
  • [22].Ferdinand KC, Nasser SA. Management of essential hypertension. Cardiol Clin. 2017;35:231–46. [DOI] [PubMed] [Google Scholar]
  • [23].Zhang Y, Wang B, Ju C, et al. Traditional Chinese medicine for essential hypertension: a clinical evidence map. Evid Based Complement Alternat Med. 2020;2020:5471931. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [24].Wang J, Xiong X, Liu W. Traditional chinese medicine syndromes for essential hypertension: a literature analysis of 13,272 patients. Evid Based Complement Alternat Med. 2014;2014:418206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [25].Jiang HJ. Study on the Optimization of the Preparation Process of the Classical Prescription Taohong Siwu Decoction and Its Pharmacodynamics in Treating Blood Deficiency and Blood Stasis: Chengdu University of Traditional Chinese Medicine; 2021. Available from: https://kns.cnki.net/KCMS/detail/detail.aspx?dbname=CMFD202201&filename=1022471838.nh.
  • [26].Zhang X, Li P, Hua Y, et al. Urinary metabolomics study the mechanism of Taohong Siwu decoction intervention in acute blood stasis model rats based on liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2018;1074–1075:51–60. [DOI] [PubMed] [Google Scholar]
  • [27].Lai LN, Li JX, Zheng CX, et al. Effects of five recipes for promoting blood circulation on blood routine, erythrocyte sedimentation rate and organ coefficients of heart and liver in New Zealand rabbits with blood stasis syndrome[J/OL]. J Liaoning Univ Tradit Chin Med. 2022;009:024. [Google Scholar]
  • [28].Wu Q, Zhao W, Chen G, et al. Relevant effects of Taohong Siwu decoction on isolated rat aortic ring dependent on endothelium nitric oxide-cGMP pathway. Pak J Pharm Sci. 2019;32(1(Supplementary):261–8. [PubMed] [Google Scholar]
  • [29].Derosa G, Maffioli P. Drug safety evaluation of amlodipine. Expert Opin Drug Saf. 2011;10:795–804. [DOI] [PubMed] [Google Scholar]
  • [30].Pontremoli R, Leoncini G, Parodi A. Use of nifedipine in the treatment of hypertension. Expert Rev Cardiovasc Ther. 2005;3:43–50. [DOI] [PubMed] [Google Scholar]
  • [31].Kizilirmak P, Üresin AY. Hypertension and valsartan. Anadolu Kardiyol Derg. 2014;14(Suppl 2):S20–4. [DOI] [PubMed] [Google Scholar]
  • [32].Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36:1953–2041. [DOI] [PubMed] [Google Scholar]
  • [33].Nguyen HC, Qadura M, Singh KK. Role of the fatty acid binding proteins in cardiovascular diseases: a systematic review. J Clin Med. 2020;9:3390. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [34].Spitler KM, Davies BSJ. Aging and plasma triglyceride metabolism. J Lipid Res. 2020;61:1161–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [35].Mc Auley MT. The interplay between cholesterol metabolism and intrinsic ageing. Subcell Biochem. 2018;90:99–118. [DOI] [PubMed] [Google Scholar]

Articles from Medicine are provided here courtesy of Wolters Kluwer Health

RESOURCES