中药复方治疗颈动脉粥样硬化斑块临床疗效Meta分析  

Clinical Efficacy of Traditional Chinese Medicine in Treatment of Carotid Atherosclerotic Plaques: A Meta-Analysis

作　　者：胡楠[1,2] 张威 于睿[1,2] 付韵霏[3] HU Nan;ZHANG Wei;YU Rui;FU Yunfei(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;Shenyang No.2 High School,Shenyang 110016,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032 [3]沈阳市第二中学,辽宁沈阳110016

出　　处：《中华中医药学刊》2018年第9期2089-2093,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金指导项目(81703993);辽宁省自然科学基金指导计划项目(201602501)

摘　　要：目的：系统评价中药复方治疗颈动脉粥样硬化斑块的临床疗效及其安全性。方法：两个人独立地系统检索中药复方治疗颈动脉粥样硬化斑块的全部随机对照试验的文献,语种为中文和英文。中文数据库包括：中国学术文献总库（CNKI）、万方数据库、维普中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）,英文数据库有：The Cochrane Library数据库、Pub Med电子期刊全文数据库、Springer电子期刊全文数据库和Note Express电子数据库,检索年限自建库年至2017年5月。并由两个人独立地整理并提取资料,如遇分歧,请求第三方协助解决。同时运用Review Manager 5.3软件进行本研究的数据处理。结果：最终共纳入12篇RCT文献,共计1052名中药复方治疗颈动脉粥样硬化斑块患者。两组治疗前后临床疗效Meta分析显示：I2=0%,Z=4.88,OR=3.07[1.96,4.81],P〈0.000 01,试验组的临床疗效优于对照组。两组治疗前后颈动脉粥样硬化斑块Course积分的Meta分析显示：I2=0%,Z=14.56,OR=-0.96[-1.09,-0.83],P〈0.000 01,试验组在改善颈动脉粥样硬化斑块Course积分的疗效优于对照组。两组治疗前后颈动脉内膜-中层厚度（IMT）的Meta分析显示：I2=46%,Z=17.78,OR=-0.09[-0.10,-0.08],P〈0.000 01,试验组在改善IMT的疗效优于对照组。两组治疗前后颈动脉粥样硬化斑块面积的Meta分析显示：I2=98%,Z=12.57,OR=-0.20[-0.23,-0.17],P〈0.000 01,试验组在改善颈动脉粥样硬化斑块积的疗效优于对照组。两组治疗前后血脂的Meta分析显示：I2=76%,Z=7.27,OR=-0.08[-0.13,-0.02],P〈0.000 01,试验组在调节血脂方面疗效优于对照组。所有纳入试验均未报告严重不良反应。结论：中药复方治疗颈动脉粥样硬化斑块的临床疗效优于单纯西药治疗,在改善患者的斑块面积、斑块Course积分、血脂等方面具有明确的疗效,并且安全性较高。Objective： To evaluate the clinical efficacy and safety of traditional Chinese medicine in the treatment of carotid atherosclerotic plaques. Method： Two individuals independently searched the literature of randomized controlled trials of traditional Chinese medicine in the treatment of carotid atherosclerotic plaques patients. Language requirements：Chinese and English. Chinese databases included China academic literature database（ CNKI）,Wanfang database,VIP Chinese scientific journal database（ VIP） and China biomedical literature database（ CBM）. English databases included The Cochrane Library database,Pub Med electronic journal full-text database,Springer electronic journal full text database and Note Express database. The retrieval period was from the time of establishment to April 2017. Two individuals collated and extracted information independently. In case of disagreement,they requested the third party to help. Manager Review 5. 3 software was used. Result： A total of 12 articles were included in the RCT literature,with a total of 1052 patients with carotid atherosclerotic plaques. The comprehensive curative effect Meta-analysis before and after treatment showed that I2= 0%,Z = 4. 88,OR = 3. 07[1. 96,4. 81],P〈 0. 000 01. The Meta-analysis on carotid atherosclerosis,plaque and course score before and after treatment showed that I2= 0%,Z = 14. 56,OR =-0. 96[-1. 09,-0. 83],P〈 0. 000 01. The Meta-analysis on carotid intima-media thickness（ IMT） before and after treatment showed that I2=46%,Z = 17. 78,OR =-0. 09[-0. 10,-0. 08],P 〈0. 000 01. The Meta-analysis on carotid atherosclerotic plaque area before and after treatment showed that I2= 98%,Z = 12. 57,OR =-0. 20[-0. 23,-0. 17],P 〈0. 000 01. The Meta-analysis on blood fat analysis before and after treatment showed that I2= 76%,Z = 7. 27,OR =-0. 08[-0. 13,-0. 02],P 〈0. 000 01. No adverse reactions were reported in all trials. Conclusion： The clinical efficacy of Chinese herbal medicine in the treatment of carotid atheroscleroti

关 键 词：中药复方 颈动脉粥样硬化斑块 临床疗效 血脂 META分析 

分 类 号：R543.5[医药卫生—心血管疾病]