Objectives To summarise clinical evidence of traditional Chinese medicine for the prevention and treatment of chronic heart failure systematically and comprehensively.
Methods Until to March 2012, following the strategy (theme = Chinese medicine OR proprietary Chinese medicines OR decoction) AND (theme = cardiac failure OR heart failure), the retrieval was done in the databases of WanFang database, full-text database of Chinese Academic Journal (CNKI), Chinese Scientific Journals Database (VIP), Chinese Biomedical Medicine Database (CBM), PubMed, Cochrane Library and so on. The qualifying results obtained in the databases above are summarised into the grading evidence including systematic reviews, randomised controlled trials, observational studies, case studies, basic research these five levels, and the characteristics of drug therapy and research findings are summarised for each researching type.
Results The amount of the researching articles involved are 413, among which there are 12 systematic reviews, 413 randomised controlled trials, 68 observational studies, 15 case reports and 187 fundamental researches. System evaluation results suggest that traditional Chinese medicine has the advantage in reducing mortality, reducing complications, improving ejection fraction, inhibition of ventricular remodelling (systolic and end-diastolic volume), improving heart function, and increasing the overall efficacy. The results of randomised controlled trials show that the use of Chinese medicine on the basis of conventional therapy can improve the efficacy of chronic heart failure and improve complications. Observational studies and case studies show that the dialectical use of traditional Chinese medicine has a good effect on chronic heart failure and its complications. Basic research results show that traditional Chinese medicine can be effective to prevent and treat chronic heart failure by the methods of multi-channel, multi-level, multi-target, and its working mechanism are regulating of inflammatory cytokines, inhibiting of cardiomyocyte apoptosis, improving cardiac contractility and diastolic function, reducing the organ congestion, correcting the the neuroendocrine hormone releasing imbalance, inhibiting of extracellular matrix remodelling and resisting myocardial fibrosis, ventricular remodelling.
Conclusions Basing on the clinical evidence on each level, it can be concluded that adding Chinese medicine to the treatment of using conventional Western medicine treatment to prevent and treat chronic heart failure is greatly efficient.