穴位贴敷联合西药治疗冠心病心绞痛有效性及安全性的系统评价  

Systematic review on effectiveness and safety of treating angina pectoris with acupoint sticking therapy combined with western medicine

作　　者：张泽[1] 白瑞娜[2] 陈民[1] 张立[1] 齐文诚[1] 李博[2] 

机构地区：[1]辽宁中医药大学附属医院,沈阳110032 [2]中国中医科学院西苑医院,北京100091

出　　处：《中华中医药杂志》2015年第10期3531-3536,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81303051);国家"重大新药创制"创新药物研究开发技术平台建设项目(No.2012ZX09303-010-002)~~

摘　　要：目的:评价穴位贴敷联合西药治疗冠心病心绞痛的疗效及安全性。方法:检索国内外主流医学数据库,按照预先设定的纳入标准与排除标准筛选临床试验,应用风险评估工具进行研究质量评价,提取数据并运用Rev Man 5.2软件进行Meta分析。结果:与对照组比较,在常规西药治疗的基础上加用穴位贴敷,可进一步改善患者心绞痛症状{亚组疗程1-2周(RR=1.24,95%CI[1.16,1.33]),亚组疗程>2周(RR=1.07,95%CI[1.01,1.12]}、改善心电图缺血(RR=1.15,95%CI[1.09,1.22]),减少硝酸甘油用量(RR=1.27,95%C[1.02,1.79]),同时还可进一步提高中医证候疗效(RR=1.14,95%CI[1.04,1.25]),调节血脂{胆固醇(MD=-0.37,95%CI[-0.73,-0.01]),甘油三酯(MD=-0.31,95%CI[-0.49,-0.13]},但是贴敷疗法有6例出现皮肤瘙痒、胃肠道不适以及过敏等不良反应。结论:在西医常规药物的基础上加用穴位贴敷治疗冠心病心绞痛,其效果优于西医常规药物治疗。但由于纳入研究存在潜在偏倚,研究结论仍需要更多高质量随机对照试验以提高证据级别。Objective：To evaluate effectiveness and safety of treating angina pectoris with acupoint sticking therapy combined with western medicine.Methods：The clinical trials in mainstream medicine databases both at home and abroad were retrieved according to the inclusion criteria and exclusion criteria defined beforehand.The quality of trials was evaluated by using risk evaluation tool,and the data was extracted and analyzed by using RevMan 5.2 software.Results：Compared with control group,acupoint sticking therapy based on the conventional western medicine treatment could improve the symptoms as angina pectoris（sub gruop treatment one to two weeks,RR=1.24,95%CI[1.16,1.33],sub group treatment over 2 weeks,RR=1.07,95%CI[1.01,1.12]） and ECG（RR=1.15,95%CI[1.09,1.22]）,reduce the usage of nitroglycerin（RR=1.27,95%CI[1.02,1.79]）,improve the therapeutic effect of TCM（RR=1.14,95%CI[1.04,1.25]）,and regulate blood lipids of patients ulteriorly{TC（MD=- 0.37,95%CI[- 0.73,- 0.01]）,TG（MD=- 0.31,95%CI[- 0.49,- 0.13]）],but there were some adverse reactions caused by acupoint sticking therapy,such as cutaneous pruritus,gastrointestinal discomfort and anaphylactic reactions.Conclusion：The curative effect of treating angina pectoris with acupoint sticking therapy based on the conventional western medicine treatment is superior to that of conventional western medicine treatment.Because of the study bias,the research conclusion needs to be proved by more high quality randomized controlled trials.

关 键 词：冠心病 心绞痛 穴位贴敷 META分析 系统评价 随机对照试验 

分 类 号：R541.4[医药卫生—心血管疾病]