Sheng Mai San for Heart Failure

Sheng Mai San for Heart Failure

Heart failure is a major public health problem worldwide. Sheng Mai San, a traditional Chinese herbal medicine, has long been used as a complementary treatment for heart failure in China.

A meta analysis was conducted. The study  included randomised controlled trials (RCTs) of Sheng Mai San plus usual treatment for heart failure versus usual treatment alone, or Sheng Mai San versus placebo, irrespective of blinding status.

The study included a total of 14 RCTs (858 patients) in this review update, four of which were new trials. Of these 14 RCTs, 11 trials compared Sheng Mai San plus usual treatment with usual treatment alone, and three trials compared Sheng Mai San with placebo. Improvement of NYHA functional classification was more common in patients taking Shengmai plus usual treatment than in those receiving usual treatment alone (RR 0.37; 95% CI 0.26 to 0.51; 10 trials, 672 participants; low quality evidence). Beneficial effects of Sheng Mai San in treating heart failure were also observed in other outcomes, including exercise test, ejection fraction and cardiac output. The three RCTs (106 patients) comparing Sheng Mai San with placebo reported improvement in NYHA functional classification and in stroke volume. Three of the 14 RCTs reported a total of six patients with mild adverse effects and two were withdrawn due to the adverse effects. The adverse events rate was 1.21%.

The study conclude that Sheng Mai San may exert a positive effect on heart failure, especially for improving NYHA functional classification when Sheng Mai San plus usual treatment is used. The review results should be interpreted with caution due to the high risk of bias of the included studies (particularly regarding allocation concealment and blinding), the small sample size of these studies, and the significant heterogeneity in outcomes such as ejection function, cardiac output and stroke volume. There was no evidence available concerning the effect of Sheng Mai San on mortality, and more high quality studies with long-term follow-up are warranted.

Zhou Q, Qin WZ, Liu SB, Kwong JS, Zhou J, Chen J. Shengmai (a traditional Chinese herbal medicine) for heart failure. Cochrane Database Syst Rev. 2014 Apr 14;4.