脑心通胶囊辅助治疗不稳定型心绞痛的疗效与安全性的Meta分析  

Meta-analysis of Efficacy and Safety of Adjuvant Treatment with Naoxintong Capsules for Unstable Angina Pectoris

作　　者：冯娟 闫奎坡[2] 朱翠玲[2] 孙彦琴[2] 徐亚洲[2] 郭雨晴 曹园圆 FENG Juan;YAN Kui-Po;ZHU Cui-Ling;SUN Yan-Qin;XU Ya-Zhou;GUO Yu-Qing;CAO Yuan-Yuan(Henan University of Chinese Medicine,Zhengzhou 450000 Henan,C hina;Heart Center,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000 Henan,China)

机构地区：[1]河南中医药大学,河南郑州450000 [2]河南中医药大学第一附属医院心脏中心,河南郑州450000

出　　处：《广州中医药大学学报》2021年第6期1282-1292,共11页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金项目(编号:81303073);河南中医学院第一附属医院院内博士项目(编号:2012KJ32);河南中医学院省属科研业务专项(编号:2014KYYWF-YQ12);河南省科技攻关重点项目(编号:112102310317);河南省高校科技创新团队支持计划(编号:13IRTSTHN012);河南省中医药防治心血管疾病创新型科技团队(编号:C20130050);国家人社部留学人员资助项目(人社函[2010]412号);河南省首批青苗人才培养项目[豫中医科教(2018)16号];河南省科技攻关项目(编号:192102310161,182102310291);河南省中医药科学研究专项课题(编号:2017ZY2017)。

摘　　要：【目的】系统评价脑心通胶囊辅助治疗不稳定型心绞痛的疗效与安全性。【方法】全面检索中国知网(CNKI)、维普网(VIP)、万方数据库(Wanfang)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、EMBase数据库中的脑心通胶囊辅助治疗不稳定型心绞痛的随机对照试验,由2名研究者独立筛选文献、提取资料并评价纳入研究的文献质量评价后,采用RevMan 5.3软件进行Meta分析。【结果】共纳入24项研究,涉及2 403名受试者。Meta分析结果显示,在西药常规治疗基础上加用脑心通胶囊治疗不稳定型心绞痛患者,能进一步提高心绞痛疗效[RR=0.31,95%CI(0.23,0.40)]、心电图疗效[RR=0.52,95%CI(0.42,0.64)]和临床总疗效[RR=0.42,95%CI(0.29,0.60)],其在减少心绞痛发作次数[SMD=-1.02,95%CI(-1.24,-0.80)]和心绞痛持续时间[MD=-2.94,95%CI(-4.63,-1.25)],降低总胆固醇[MD=-0.69,95%CI(-0.73,-0.65)]、甘油三酯[MD=-0.31,95%CI(-0.33,-0.29)]、低密度脂蛋白胆固醇LDL[MD=-0.50,95%CI(-0.53,-0.47)]水平,改善血液流变学指标如全血高切黏度[MD=-0.93,95%CI(-1.60,-0.26)]、全血低切黏度[MD=-1.94,95%CI(-3.26,-0.62)]、血浆黏度[MD=-0.30,95%CI(-0.45,-0.15)]和红细胞比容[MD=-0.03,95%CI(-0.05,-0.01)]等方面均优于对照组(P <0.01),且亚组分析提示疗程可能与改善血脂指标相关。【结论】系统评价结果提示脑心通胶囊联合西药能显著改善患者临床疗效,减少心绞痛发作次数和持续时间,具有降脂、降低血液黏度,改善血液流变学指标作用,且无明显的不良反应。Objective To systematically evaluate the efficacy and safety of adjuvant treatment with Naoxintong Capsules for the treatment of unstable angina pectoris. Methods The randomized controlled trials(RCTs) of adjuvant treatment with Naoxintong Capsules for the treatment of unstable angina pectoris were retrieved from the CNKI,VIP,Wanfang,CBM,PubMed,Cochrane Library,and EMBase database. Two reviewers performed the independent screening of the literature,extraction of the data and assessment of the risk of bias of the included studies. And then the meta-analysis was carried out with RevMan 5.3 software. Results A total of 24 RCTs were included,including 2 403 subjects. The results of meta-analysis showed that Naoxintong Capsules combined with conventional western medicine treatment enhanced the therapeutic effect for angina pectoris [RR = 0.31,95%CI(0.23,0.40)],efficacy for ECG [RR = 0.52,95%CI(0.42,0.64)] and total clinical efficacy [RR = 0.42,95%CI(0.29,0.60)]. And Naoxintong Capsules combined with conventional western medicine treatment were more effective on reducing the onset frequency of angina pectoris [SMD =-1.02,95%CI(-1.24,-0.80)],shortening the duration of angina pectoris [MD =-2.94,95%CI(-4.63,-1.25)],decreasing the total cholesterol(TC) level[MD=-0.69,95%CI(-0.73,-0.65)],triglyceride(TG)level [MD =-0.31,95%CI(-0.33,-0.29)] and low-density lipoprotein cholesterol(LDL-C)level [MD =-0.50, 95% CI(-0.53,-0.47)], and improving the hemorheology indicators such as whole blood high-shear viscosity [MD =-0.93,95%CI(-1.60,-0.26)],whole blood low-shear viscosity [MD =-1.94, 95%CI(-3.26,-0.62)], plasma viscosity [MD =-0.30, 95%CI(-0.45,-0.15)] and hematocrit [MD =-0.03,95%CI(-0.05,-0.01)] than conventional western medicine treatment alone(P < 0.01). The subgroup analysis suggested that the course of treatment may be correlated with the improvement of blood lipid indexes. Conclusion The evaluation results indicated that Naoxintong Capsules combined with conventional western medicine treatment can enhance the clinical ef

关 键 词：脑心通胶囊 不稳定型心绞痛 心绞痛发作次数 心绞痛持续时间 血脂 血液流变学 META分析 

分 类 号：R256.22[医药卫生—中医内科学] R541.4[医药卫生—中医学]