通心络和他汀类药物治疗颈动脉粥样硬化斑块疗效的Meta分析  

The Treatment Efficacy of Tongxinluo and Statins in the Patients with Carotid Atherosclerotic Plaque: A Meta Analysis

作　　者：孙善美 徐瑞[2] 霍岩[2,1] 贠琳[3] 李国华[2] 闫素华[2] 张琪[2,1] 宋鲁成[2] 

机构地区：[1]山东中医药大学,山东省济南市250014 [2]山东大学附属千佛山医院心内二科 [3]济南市妇幼保健院内科,山东省济南市250001

出　　处：《中国动脉硬化杂志》2016年第3期289-296,共8页Chinese Journal of Arteriosclerosis

基　　金：山东省科技发展计划项目(2014GSF118055);山东省医药卫生科技发展计划项目(2013WS0130)

摘　　要：目的系统评价通心络和他汀类药物治疗颈动脉粥样硬化斑块的临床疗效。方法计算机检索中外数据库,检索日期为从建库起至2015年5月1日,收集通心络和他汀类药物治疗颈动脉粥样硬化斑块疗效的相关随机对照研究。采用Rev Man 5.2软件进行Meta分析。结果共纳入23篇文献,包括2355名患者,平均研究周期为20±7周,其中单用通心络和他汀类药物改善患者颈动脉内膜中膜厚度(IMT)及血脂水平的疗效无明显差别(MD为-0.06,95%CI为-0.17~0.05,P=0.26和MD为0.19,95%CI为-0.00~0.38,P=0.05),但单用通心络在改善患者甘油三酯(TG)水平上较他汀类药物更有优势(MD为-0.28,95%CI为-0.44^-0.11,P=0.001),通心络联合他汀类药物在改善患者IMT及斑块面积、斑块积分以及血脂水平和C反应蛋白(CRP)上比单用他汀类药物更有优势(P<0.01),而单用通心络比单用他汀类药物所表现的不良反应明显减少(OR为0.44,95%CI为0.27~0.73,P=0.001)。结论治疗颈动脉粥样硬化斑块的最佳治疗方案是通心络联合他汀类药物的使用。Aim To investigate the treatment efficacy of Tongxinluo compared with statins in patients with carotid atherosclerotic plaques. Methods We systematicly and exhaustively retrieved the Chinese and foreign language databases from their establishment date to May 1,2015 to collect the randomized,controlled and clinical trials about the treatment efficacy of Tongxinluo compared with statins in patients with carotid atherosclerotic plaques,and then the Rev Man 5. 2soft ware was used for Meta analysis. Results A total of 23 randomized controlled trials were included,involving2355 patients with mean duration of 20 ± 7 weeks. The results of Meta analysis showed the single use of Tongxinluo and statins in improving carotid artery intima-media thickness（ IMT） and blood lipid levels had no significant difference（ MD was- 0. 06,95% CI was-0. 17 ~ 0. 05,P = 0. 26 and MD was 0. 19,95% CI was- 0. 00 ~ 0. 38,P = 0. 05）. But the single use of Tongxinluo had more advantages than statins in improving triglyceride（ triglyceride,TG） level（ MD was-0. 28,95% CI was- 0. 44 ^- 0. 11,P = 0. 001）. Tongxinluo combined with statins had more advantages than single using statins in the improvement of patients with IMT,plaque area,plaque score,blood lipid level and C-reactive protein（ CRP）（ P〈0. 01）. However,as to evaluate the adverse reactions,Tongxinluo had less percentage than statins（ OR was 0. 44,95% CI was 0. 27 ~ 0. 73,P = 0. 001）. Conclusion In the treatment of patients with carotid atherosclerotic plaques,Tongxinluo combined with statins is the best therapeutic scheme in our study.

关 键 词：通心络 他汀类药物 颈动脉粥样硬化斑块 META分析 

分 类 号：R18[医药卫生—流行病学]