基于Meta分析的中药穴位贴敷治疗冠心病不稳定型心绞痛临床疗效评价  

Meta-analysis on Efficacy of Acupoint Sticking Therapy for Unstable Angina Patients with Coronary Artery Disease

作　　者：隋吉峰 陈岩 张哲 李芹 

机构地区：[1]辽宁中医药大学附属医院

出　　处：《中华中医药学刊》2018年第3期562-568,共7页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2013CB531704);辽宁省卫计委项目(zyzx1501)

摘　　要：目的：系统评价中药穴位贴敷治疗不稳定型心绞痛的临床疗效及安全性。方法：计算机检索Pubmed、Medline、Cochrane library、中国生物医学文献数据库（CBM）、中国期刊网全文数据库（CNKI）、万方数据库、维普数据（VIP）等,检索时间为从各数据库建库至2017年4月,搜集西药常规加中药穴位贴敷与单纯西药常规比较治疗冠心病不稳定型心绞痛的临床随机对照试验。按照纳入标准与排除标准筛选文献,应用风险评估工具对纳入研究的质量进行评价,采用Rev Man 5.3软件进行Meta分析。结果：共纳入16项研究,合计1081例患者。Meta分析结果显示,西药常规加中药穴位贴敷与单纯西药常规比较治疗比较：能显著改善心绞痛患者症状,提高心绞痛改善有效率[RR=1.23,95%CI（1.15,1.32）],改善心电图缺血[RR=1.23,95%CI（1.12,1.36）],减少硝酸甘油用量[RR=1.34,95%CI（1.19,1.51）],改善中医症状[RR=1.29,95%CI（1.19,1.41）],调节血脂（总胆固醇[MD=-0.41,95%CI（-0.65,-0.17）]和甘油三酯[MD=-0.29,95%CI（-0.46,-0.11）]）,提高SAQ评分,但是贴敷疗法可能出现皮肤瘙痒、红疹、水泡等不良反应。结论：西药常规加中药穴位贴敷较单纯西药常规治疗不稳定型心绞痛可能进一步提高临床疗效,但是纳入研究数量偏少、质量偏低,期待有更多高质量的临床对照试验纳入Meta分析以提高证据级别。Objective： To evaluate effectiveness and safety of treating unstable angina pectoris with acupoint sticking therapy. Methods： Relevant studies of acupoint sticking therapy for unstable angina were collected from databases including Pubmed,Medline,Cochrane library,CNKI,Wanfang,VIP and CBM. The search time was from the database creation to April 2017. The quality of trials was evaluated by using risk evaluation tool,and the data was extracted and analyzed by using Rev Man 5. 3 software. Results： Compared with control group,acupoint sticking therapy based on the conventional western medicine treatment could improve the symptoms as unstable angina pectoris [RR = 1. 23,95% CI（ 1. 15,1. 32） ]and ECG [RR = 1. 23,95% CI（ 1. 12,1. 36） ],reduce the usage of nitroglycerin [RR = 1. 34,95% CI（ 1. 19,1. 51） ],improve the therapeutic effect of TCM [RR = 1. 29,95% CI（ 1. 19,1. 41） ],regulate blood lipids of patients { TC [MD =-0. 41,95% CI（-0. 65,-0. 17） ],TG [MD =-0. 29,95% CI（-0. 46,-0. 11） ]},and increase the score of SAQ. But there were some adverse reactions caused by acupoint sticking therapy,such as skin itching,rash,blisters. 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. Meanwhile,the outcome of this system was not perfect. And more high quality randomized controlled trials are needed to verify the effect of the therapy.

关 键 词：穴位贴敷 不稳定型心绞痛 随机对照试验 系统评价 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]