Backgroud Thousands of randomized controlled trials (RCT) on Chinese patent medicines treating coronary heart disease (CHD) angina pectoris have not been systematically reviewed according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). This study aims to evaluate the efficacies of those medicines, including shexiang baoxin pill (BXP), compound danshen pill (DSP), compound danshen tablet (DST), isosorbide dinitrate (ISDN), suxiao jiuxin pill (JXP), naoxintong jiaonang(NXT), qishen yiqi pill (QSP), wenxin keli (WXP), and di’ao xinxuekang (XXK). Methods Conventional meta-analysis was conducted to select RCT of the same study design, evaluate the RCT study quality, and estimate the efficacies of specific Chinese patent medicines. Subgroup, sensitivity, meta-regression and publication bias analyses were also performed. Direct and indirect network meta-analysis were customized to compare efficacies of these medicines. Results This study included 230 RCT with 25096 participants. Direct meta-analysis found that specific Chinese patent medicines (BXP, DSP, JXP, NXT, QSP, TXL, WXP and XXK) were more effective than ISDN. An efficacy ranking was found by direct and indirect network meta-analysis: BXP, WXP, NXT, TXL, QSP, JXP, DSP, XXK, ISDN and DST (in descending order). Conclusion Direct and indirect network meta-analysis are useful to evaluate multiple medicines simultaneously, although indirect network meta-analysis should be used with cautions.

背景：已有数千篇关于药物治疗冠心病心绞痛的临床随机对照实验发表，但并没 有遵循 PRISMA 声明的原则进行系统评价。本篇文章主要目的在于通过直接比 较和间接比较网络荟萃评价包括麝香保心丸(BXP)、复方丹参滴丸(DSP)、复方 丹参片(DST)、消心痛(ISDN)、速效救心丸(JXP)、脑心通胶囊(NXT)、芪参益气 滴丸(QSP)、通心络胶囊(TXL)、稳心颗粒(WXP)和地奥心血康(XXK)在内的药物 临床疗效。 方法：荟萃分析用来筛选相同的具有可比性的 RCT、评价纳入 RCT 的质量以及 评估选定中成药的疗效，然后进行亚组分析、敏感性分析、荟萃回归分析和发表 偏倚分析。直接比较和间接比较网络荟萃分析比较选定药物的疗效。 结果：包括 25096 名参与者的 230 篇文献纳入研究。直接比较荟萃分析发现麝香 保心丸、复方丹参滴丸、速效救心丸、脑心通胶囊、芪参益气滴丸、通心络胶囊、 稳心颗粒和地奥心血康的疗效优于消心痛。直接比较和间接比较网络荟萃分析发 现十种药物的疗效优先顺序依次是麝香保心丸、稳心颗粒、脑心通胶囊、通心络 胶囊、芪参益气滴丸、复方丹参滴丸、地奥心血康、消心痛和复方丹参片。 结论：直接比较和间接比较网络荟萃分析同时评估多种药物是适合的，但是间接 比较网络荟萃分析需谨慎使用。 关键字：冠心病，心绞痛，中成药，系统评价，网络荟萃分析