Comprehensive evidence mapping of Chinese medicine for the treatment of pulmonary heart disease: A systematic assessment of efficacy and challenges.

BACKGROUND: This study aims to assess the quality of evidence regarding the use of traditional Chinese medicine (TCM) interventions in pulmonary heart disease (PHD) through a systematic review and meta-analysis of relevant literature. METHODS: A comprehensive search was performed across both Chinese and English databases, including CNKI, Wanfang, VIP, PubMed, Web of Science, and Cochrane Library, covering studies published up to April 2024. Eligible studies on TCM interventions for cor pulmonale were included. The methodological quality of the studies was evaluated using the AMSTAR 2 tool. An evidence map was constructed to visualize key characteristics such as study population, sample size, and intervention modalities. RESULTS: A total of 39 studies were included, comprising systematic reviews, meta-analyses, and network meta-analyses on TCM interventions for PHD. The most common interventions were TCM injections, followed by decoctions and proprietary Chinese medicines. Treatment strategies primarily involved blood activation, tonification, blood stasis resolution, and meridian dredging (Tongluo). The AMSTAR 2 assessments identified several methodological weaknesses, including lack of protocol registration, absence of a list of excluded studies, and insufficient analysis of heterogeneity and risk of bias. According to the evidence map, 36 studies reported beneficial effects and 3 indicated likely benefit, suggesting a potentially positive role of TCM in managing PHD. CONCLUSION: While most studies suggest that TCM interventions may be beneficial for PHD, the overall methodological quality of the evidence is very low. Therefore, the findings should be interpreted with caution. TCM shows promise as a therapeutic option for PHD; however, high-quality systematic reviews are needed to validate these preliminary results.