Chinese Herbal Medicine for Aspirin Resistance: A Systematic Review of Randomized Controlled Trials

Table 1

Basic characteristics of the included studies.

Included trials	Type of disease (𝑛)	Eligibility criteria of AR	Study designs	Interventions		Sample and characteristics  (male/female; age)		Outcome index	Intergroup differences
				Trial	Control	Trial	Control
Peng et al. 2011 [33]	Coronary heart disease (37)	AA# and ADP#	RCT (method unreported) and controlled nonblinded three-group design study	Huoxue capsule 12 pieces tid for 3 month	No treatment	12 —	13 —	Platelet aggregation rate	𝑃>0.05
				Huoxue capsule 12 pieces tid + aspirin 100 mg qd for 3 month	Huoxue capsule	12 —	12	Platelet aggregation rate	𝑃<0.05
				Huoxue capsule + aspirin	No treatment			Platelet aggregation rate	𝑃<0.05
Ma et al. 2012 [34]	Acute cerebral infarction (80)	AA# and ADP#	RCT (method unreported) and controlled nonblinded parallel study	Sodium ferulate100 mg,  tid + aspirin 100 mg qd for 4 weeks	Aspirin 100 mg qd + dipyridamole 150 mg qd for 4 weeks	40 (M: 23, F: 17) Mean age: 63 y	40 (M: 21, F: 19) Mean age: 65 y	(1) Platelet aggregation rate (2) TXB2	(1) 𝑃<0.05 (2) 𝑃<0.05
Su 2012 [35]	Cardio/  Cerebrovascular disease (60)	AA# and ADP#	RCT (random number table) and controlled nonblinded parallel study	Diao Xin Xue kang 1.6 g, tid for 4 weeks	Aspirin 300 mg qd for 4 weeks	30 (M: 15, F: 15) Mean age: 62 y	30 (M: 13, F: 17)  Mean age: 61.2 y	(1) Platelet aggregation rate (2) TXB2 (3) 6-K-PGF 1α (4) TXB2/6-K-PGF 1α (5) Clinical effective rate (6) Adverse events	(1) 𝑃<0.05 (2) 𝑃<0.05 (3) 𝑃<0.05 (4) 𝑃<0.05 (5) 𝑃<0.05 (6) 𝑃<0.01
Guo 2012 [36]	High risk hypertensive patients (103)	ADP#	RCT (method unreported) and controlled nonblinded parallel study	CDDP 270 mg tid + aspirin 100 mg qd for 1 month	Aspirin 100 mg qd for 1 month	50 —	53 —	(1) Platelet aggregation rate  (2) Acute myocardial infarction  (3) Cerebral infarction  (4) Bleeding events	(1) 𝑃<0.01  (2) 𝑃<0.05  (3) 𝑃<0.05  (4) 𝑃>0.05
Chai et al. 2008 [37]	Cardiovascular disease (30)	AA# and ADP#	RCT (method unreported) and controlled nonblinded three-group design study	CDDP 10 pieces tid for 2 weeks	Aspirin 100 mg qd for 2 weeks	10 (M: 3, F: 7) Mean age: 67.70±12.791 y	10 (M: 4, F: 6) Mean age:  12.31±17.61 y	(1) ADP-induced platelet aggregation rate  (2) AA-induced platelet aggregation rate	(1) 𝑃<0.05   (2) 𝑃>0.05
				CDDP 10 pieces tid + aspirin 100 mg qd for 2 weeks	CDDP	10 (M: 3, F: 7) Mean age: 67.4±14.7 y		Platelet aggregation rate	𝑃<0.05 or 𝑃<0.01
				CDDP + aspirin	Aspirin			Platelet aggregation rate	𝑃<0.01
Chen et al. 2008 [38]	Coronary heart disease (34)	AA#	RCT (random number table)  and controlled nonblinded parallel study	Qishenyiqi pill 0.5 g tid + aspirin 100 mg qd for 4 weeks	Qishenyiqi Pill 0.5 g tid for 4 weeks	17 (M: 12, F: 22) Mean age: 53.4±9.2 y	17	(1) Platelet aggregation rate (2) TG, VLDL (3) Adverse events	(1) 𝑃<0.05 (2) 𝑃>0.05 (3) 𝑃>0.05
Zhang et al. 2010 [39]	Cerebral infarction (60)	ADP#	RCT (random number table) and controlled nonblinded three-group design study	TXLC 4 pieces tid + aspirin 100 mg qd for 1 month	Aspirin 100 mg qd for 1 month	20 (M: 20, F: 40) —	20 —	(1) Platelet aggregation rate (2) TXB2	(1) 𝑃<0.05 (2) 𝑃<0.05
				TXLC + Aspirin	Cilostazol 100 mg qd + aspirin 100 mg qd for 1 month		20 —	(1) Platelet aggregation rate (2) TXB2	(1) 𝑃>0.05 (2) 𝑃>0.05
				Cilostazol + aspirin	Aspirin			(1) Platelet aggregation rate (2) TXB2	(1) 𝑃<0.01 (2) 𝑃<0.01
Yin et al. 2010 [40]	Coronary heart disease (89)	ADP# and COL#	RCT (random number table) and controlled nonblinded three-group design study	TXLC 3 pieces tid for 1 month	Aspirin 100 mg qd for 1 month	30 (M: 19, F: 11) Mean age: 66.69±10.56 y	29 (M: 17, F: 12) Mean age:  66.93±10.75 y	(1) Platelet aggregation Rate (2) Adverse events	(1) 𝑃<0.05 (2) 𝑃>0.05
				TXLC 1 piece tid + aspirin 100 mg qd for 1 month	Aspirin	30 (M: 3, F: 7) Mean age: 67.4±14.7 y		(1) Platelet aggregation rate (2) Adverse events	(1) 𝑃<0.05 (2) 𝑃>0.05
				TXLC + aspirin	TXLC			(1) Platelet aggregation rate (2) Adverse events	(1) 𝑃>0.05 (2) 𝑃>0.05
Song et al. 2008 [41]	Acute coronary syndrome (70)	AA# and ADP#	RCT (method unreported) and controlled nonblinded three-group design study	TXLC 4 pieces tid + aspirin 100 mg qd for 1 month	Aspirin 100 mg qd for 1 month	24 (M: 20, F: 50)	23	(1) Platelet aggregation rate (2) TXB2 (3) CRP	(1) 𝑃<0.05 (2) 𝑃<0.05 (3) 𝑃<0.05
				TXLC + aspirin	Clopidogrel 75 mg qd + aspirin 100 mg qd for 1 month		23 —	(1) Platelet aggregation rate (2) TXB2 (3) CRP	(1) 𝑃>0.05 (2) 𝑃>0.05 (3) 𝑃>0.05
				Clopidogrel + aspirin	Aspirin			(1) Platelet aggregation rate (2) TXB2 (3) CRP	(1) 𝑃<0.05 (2) 𝑃<0.01 (3) 𝑃<0.05
Wu 2012  [43]	Cardiovascular disease (60)	AA# and ADP#	RCT (method unreported) and controlled nonblinded parallel study	Xuefuzhuyutang 1 dose/d + aspirin 100 mg qd for 4 weeks	Aspirin 100 mg qd for 4 weeks	30 (M: 38, F: 22) Mean age: 35–80 y	30	Platelet aggregation rate	𝑃<0.05
Liu 2010 [67]	Ischemic stroke (72)	AA# or ADP#	RCT  (method unreported)  and controlled nonblinded parallel study	Gingko  biloba 2 pieces, tid + aspirin 100 mg qd for 1 month	Dipyridamole 150 mg qd + aspirin 100 mg qd for 1 month	36 (M: 21, F: 15) Mean age: 65 y	36 (M: 18, F: 18) Mean age: 67 y	(1) Platelet aggregation rate (2) Clinical effective rate (3) Adverse events	(1) 𝑃<0.01 (2) 𝑃<0.05 (3) 𝑃<0.01
Liu 2008 [45]	Cerebral infarction (80)	ADP#	RCT  (method unreported)  and controlled nonblinded parallel study	Zhuyu Tongmai capsule 2 pieces tid + aspirin 100 mg qd for 1 month	Dipyridamole 150 mg qd + aspirin 100 mg qd for 1 month	40 (M: 21, F: 19)Mean age: 38–72 y	40 (M: 23, F: 17)  Mean age: 41–75 y	Platelet aggregation rate	𝑃<0.01
Cheng et al. 2010 [46]	Chronic coronary disease (52)	AA# and ADP#	RCT  (method unreported)  and controlled nonblinded parallel study	Fufang Danshen injection 20 ml + aspirin 100 mg qd for 2 weeks	Fufang Danshen injection 20 ml for 2 weeks	26 (M: 14, F: 12) Mean age: 65±9 y	26 (M: 14, F: 12) Mean age: 66±8 y	Platelet aggregation rate	𝑃<0.05
Liu et al. 2006 [47]	Coronary heart disease (64)	AA# > 30%	RCT (method unreported) and controlled nonblinded parallel study	TXLC 4 pieces tid + aspirin 100 mg qd for 3 weeks	TXLC 4 pieces tid for 3 weeks	32 (M: 44, F: 20) Mean age: 69.4±11.2 y	32	(1) Platelet aggregation rate (2) Clinical effective rate (3) Adverse events	(1) 𝑃<0.05 (2) 𝑃<0.05 (3) 𝑃>0.05
Sun et al. 2009 [48]	Coronary heart disease (60)	AA# and ADP#	RCT  (method unreported) and controlled nonblinded parallel study	Lumbrokinase enteric-coated capsules 60 wan IU tid + aspirin 100 mg qd for 1 month	Lumbrokinase enteric-coated capsules 60 wan IU tid for 1 month	30 (M: 16, F: 14) Mean age: 68.1±14.7 y	30 (M: 13, F: 17) Mean age: 62.31±17.61 y	Platelet aggregation rate	𝑃<0.01
Luo et al. 2012 [49]	Cardio/ Cerebrovascular  disease (60)	AA# and ADP#	RCT (method unreported) and controlled nonblinded parallel study	Zhilonghuoxuetongyu capsule 1.6 g, tid for 4 weeks	Aspirin 300 mg qd for 4 weeks	30 (M: 15, F: 15) Mean age: 43–70 y	30 (M: 13, F: 17) Mean age: 41–70 y	(1) Platelet aggregation rate (2) TXB2 (3) 6-K-PGF 1α (4) TXB2/6-K-PGF 1α (5) Clinical effective rate (6) Adverse events	(1) 𝑃<0.05 (2) 𝑃>0.05 (3) 𝑃<0.05 (4) 𝑃>0.05 (5) 𝑃<0.05 (6) 𝑃<0.01

AA#: arachidonic acid induced platelet aggregation rate > 20%; ADP#: adenosine diphosphate induced platelet aggregation rate > 70%; COL#: collagen induced platelet aggregation rate > 30%; CDDP: compound Danshen dripping pill; TXB2: thromboxane B2; 6-K-PGF 1𝛼: 6-keto-prostaglandin F1a; TG: triglyceride; VLDL: very-low-density lipoprotein; CRP: C response protein; TXLC: Tongxinluo capsule.