活血化瘀中药改善阿司匹林抵抗的Meta分析  

Clinical Efficacy of Blood-activating and Stasis-removing Chinese Medicines on Aspirin Resistance:a Meta-analysis

作　　者：官宝怡 高洁[1] 马晓娟[1] 史大卓[1] GUAN Baoyi;GAO Jie;MA Xiaojuan;SHI Dazhuo(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091,China)

机构地区：[1]中国中医科学院西苑医院

出　　处：《中西医结合心脑血管病杂志》2020年第1期6-12,共7页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金项目(No.81774141)

摘　　要：目的系统评价活血化瘀中药改善阿司匹林抵抗的临床有效性。方法计算机检索在中国期刊全文数据库(CNKI)、万方数据知识服务平台、维普中文期刊数据库(VIP)、中国生物医学文献数据库(CBM)以及PubMed、EMbase、Cochrane数据库收录的有关活血化瘀中药改善阿司匹林抵抗临床疗效的随机对照试验。在数据提取和质量评价后,采用RevMan5.3软件进行Meta分析。结果共纳入9篇文献(包含1055例病人)。Meta分析结果显示:活血化瘀中药可有效降低阿司匹林抵抗发生率[RR=0.41,95%CI(0.32,0.52),P<0.00001]以及二磷酸腺苷诱导的血小板最大聚集率[MD=-6.20,95%CI(-7.83,-4.57),P<0.00001]、花生四烯酸诱导的血小板最大聚集率[MD=-4.80,95%CI(-8.16,-1.44),P=0.005];亚组分析结果显示,在治疗疗程方面,无论是治疗≤30 d[RR=0.47,95%CI(0.34,0.63),P<0.00001]还是治疗>30 d[RR=0.34,95%CI(0.23,0.49),P<0.00001],活血化瘀中药均能降低阿司匹林抵抗发生率。结论当前证据表明:活血化瘀中药可改善阿司匹林抵抗。Objective To systematically evaluate the clinical efficacy of blood-activating and stasis-removing Chinese medicines on aspirin resistance.Methods Studies were identified by searching CNKI、WanFang、VIP、CBM、PubMed、Embase,and Cochrane library.The literatures investigating the clinical efficacy of additional use of blood-activating and stasis-removing Chinese medicines on aspirin resistance were included.Statistical analysis was performed by Revman 5.3.Results Nine studies involving a total of 1055 patients were included.The results of meta-analysis showed that,additional use of blood-activating and stasis-removing Chinese medicines significantly reduces the incidence of aspirin resistance[RR=0.41,95%CI(0.32,0.52),P<0.00001],adenosine diphosphateinduced platelet aggregation rate[MD=-6.20,95%CI(-7.83,-4.57),P<0.00001],and arachidonic acid-induced platelet aggregation rate[MD=-4.80,95%CI(-8.16,-1.44),P=0.005].Subgroup analysis showed no significant difference of the efficacy of additional blood-activating and stasis-removing Chinese medicines on incidence of aspirin resistance between≤30 d treatment[RR=0.47,95%CI(0.34,0.63),P<0.00001]and>30 d treatment[RR=0.34,95%CI(0.23,0.49),P<0.00001].Conclusion Additional use of blood-activating and stasis-removing Chinese medicines may improve aspirin resistance.

关 键 词：阿司匹林抵抗 阿司匹林 活血化瘀中药 二磷酸腺苷 花生四烯酸 META分析 

分 类 号：R973[医药卫生—药品] R289.5[医药卫生—药学]