益气活血化瘀祛痰法治疗冠心病心绞痛疗效的Meta分析  

Meta-analysis of Efficacy on Angina Pectoris Treated by Supplementing Qi and Activating Blood Circulation, Removing Phlegm and Blood Stasis

作　　者：王俊岩[1] 郑思成[1] 何信用 陈文娜[1] 杨芳[2] 张林[1] 宋囡[1] 杜莹[1] 贾连群[1] 杨关林 WANG Junyan;ZHENG Sicheng;HE Xinyong;CHEN Wenna;YANG Fang;ZHANG Lin;SONG Nan;DU Ying;JIA Lianqun;YANG Guanlin(Key Laboratory of Ministry of Education for TCM Viscera-State Theory and Applications,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110034,Liaoning,China;Liaoning Province Cardiovascular Disease Translational Medicine Research Center of Treated by Dissolving Phlegm-Stasis,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学中医脏象理论及应用教育部重点实验室,辽宁沈阳110847 [2]辽宁中医药大学附属二院,辽宁沈阳110034 [3]辽宁省“痰瘀论治”心血管疾病转化医学研究中心,辽宁沈阳110847

出　　处：《中华中医药学刊》2018年第11期2647-2650,共4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);国家自然科学基金项目(81300229);辽宁省科学技术计划项目(2014225004);辽宁省高等学校优秀人才支持计划项目(LR2015041);辽宁中医药大学中医脏象理论及应用教育部重点实验室开放基金项目(zyzx1503,zyzx1602)

摘　　要：目的：运用Meta分析对应用益气活血化瘀祛痰法治疗冠心病心绞痛的疗效进行系统评价。方法：检索中国期刊全文数据库（CNKI）,维普中文期刊数据库（VIP）,中国生物医学文献光盘数据库（CBM disk）,万方数据库,纳入运用益气、活血、化瘀、祛痰中2种及以上为主要治疗方法,以中药为主要治疗药物,对照组采用西药治疗或中成药物治疗的随机对照试验。由2名研究者通过阅读文章题目和摘要,并结合全文,对文献进行资料提取,应用Revman 5.3软件对临床总有效率和心电图改变总有效率进行Meta分析。结果：共纳入研究文献12篇,Meta分析结果显示：在治疗冠心病心绞痛临床总有效率方面,以益气活血化瘀祛痰法为主要治疗方法与对照组比较具有统计学意义（OR=3.40,95%Cl=[2.43,4.76],Z=7.15,P〈0.000 01）;在心电图改善有效率方面,以益气活血化瘀祛痰法为主要治疗方法与对照组比较具有统计学意义（OR=2.61,95%Cl=[1.75,3.89],Z=4.69,P〈0.000 01）。结论：益气活血化瘀祛痰法治疗冠心病心绞痛临床疗效和心电图改善水平由于常规疗法,但本次纳入的文献质量一般,本次分析仍具有一定的局限性,仍需进一步进行合理的多中心随机双盲对照实验进行评价。Objective： To analyze the efficacy on angina pectoris treated by supplementing qi and activating blood circulation, removing phlegm and blood stasis,using the method of Meta-analysis. Methods： Search the literature on Chinese Journal Full-text Database（CNKI）, VIP Chinese periodical database（VIP）, Chinese Biomedical CD Database（CBM disk） and Wanfang Database, including the Chinese medicine used as the main therapeutic drug in the experiment group and western medicine or Chinese patent medicine of randomized controlled trials in the control group, with no less than 2 therapies of supplementing qi and activating blood circulation, removing phlegm and blood stasis. Read the titles and abstracts, also combined with the full text of the literature. Screen which were needed by two investigators and then analyzed the data of clinical total effective rate and total effective rate of ECG changes by the Revman 5.3. Results： Finally there were 12 articles meeting the inclusion criteria, and the Meta-analysis showed that the therapy of supplementing qi and activating blood circulation, removing phlegm and blood stasis could increase the total rate of clinic and ECG changes,with statistical significance as compared with the control group,respectively（OR=3.40, 95% Cl=[2.43,4.76], Z=7.15, P〈0.000 01）,and（OR=2.61,95% Cl=[1.75,3.89], Z=4.69, P〈0.000 01）. Conclusion： The therapy of supplementing qi and activating blood circulation, removing phlegm and blood stasis was much superior to the conventional ones, increasing the total rate of clinic and ECG changes. Since there were limitations on the analysis and the literature was not qualified enough,there still need further more reasonable randomized, double-blind, controlled trials.

关 键 词：益气活血 化瘀祛痰 冠心病心绞痛 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]