柴胡加龙骨牡蛎汤治疗冠心病合并焦虑抑郁的Meta分析  

Meta-analysis of Chaihu Plus Longgu Muli Decoction in the Treatment of Coronary Heart Disease Combined with Anxiety and Depression

作　　者：欧阳嘉慧 张淼 于燕乔 白瑞娜[3] 李立志[3] OUYANG Jiahui;ZHANG Miao;YU Yanqiao;BAI Ruina;LI Lizhi(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院研究生院 [3]中国中医科学院西苑医院,北京100091

出　　处：《中西医结合心脑血管病杂志》2021年第15期2524-2531,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金项目(No.81603489);国家“重大新药创制”科技重大专项(No.2019ZX09201005-002-006);北京市中医药科技发展资金项目(No.JJ-2020-79);国家十二五科技支撑计划(No.2013BAI02B01)。

摘　　要：目的系统评价柴胡加龙骨牡蛎汤治疗冠心病合并焦虑抑郁的有效性及安全性。方法使用计算机检索中国知网数据库(CNKI)、万方数据库(WanFang)、维普中文科技期刊数据库(VIP)、PubMed、EMbase、Cochrane Library数据库,检索时限均从建库至2020年7月1日,搜集柴胡加龙骨牡蛎汤治疗冠心病合并焦虑抑郁的随机对照试验(RCT);由两位研究者根据纳入与排除标准独立筛选文献、提取资料和进行方法学质量评价,采用Review Manager 5.3软件行Meta分析。结果共纳入RCT 16篇,包括1174例病人,其中试验组587例,对照组587例。Meta分析结果提示:与对照组相比,试验组治疗冠心病合并焦虑抑郁在提高心绞痛有效缓解率[RR=1.29,95%CI(1.21,1.38),P<0.00001]、改善焦虑情绪[MD=-8.13,95%CI(-12.72,-3.53),P=0.0005]和改善抑郁情绪[MD=-6.85,95%CI(-13.16,-0.54),P=0.03]方面均有优势,两组比较差异有统计学意义;与对照组相比,试验组可降低不良反应发生率[RR=0.76,95%Cl(0.16,3.67),P=0.73],但两组比较差异无统计学意义。结论现有证据表明,在常规治疗基础上,加用柴胡加龙骨牡蛎汤治疗冠心病合并焦虑抑郁,可进一步改善心绞痛症状、改善焦虑抑郁状态,但其安全性有待进一步研究。Objective To somplicated evaluate the clinical efficacy and safety of Chaihu plus Longgu Muli Deccoction in the treatment of coronary heart disease(CHD)sompliacted with anxiety and depression.Methods The randomized controlled trials(RCTs)of Chaihu plus Longgu Muli Deccoctionin in the treatment of CHD sompliacted with anxiety and depression were collected from the establishment of the database to July 1,2020 from China National Knowledge Infrastructure(CNKI),Wanfang datebase,Weipu Chinese Science and Technology Periodical Database(VIP),PubMed,EMbase,and Cochrane Library.According to the inclusion and exclusion criteria,two researchers independently screened the literatures,extracted the data,and evaluated the methodological quality.Review Manager 5.3 software was used for Meta-analysis.Results A total of 16 literatures were included,involving 1174 patients,587 cases in the control group and 587 cases in the experimental group.Meta-analysis results showed that compared with the control group,the treatment of coronary heart disease sompliacted with anxiety and depression in the experimental group increased the effective relieving rate of angina pectoris[RR=1.29,95%CI(1.21,1.38),P<0.00001],improved the anxiety mood[MD=-8.13,95%CI(-12.72,-3.53),P=0.0005],and improved depression status[MD=-6.85,95%CI(-13.16,-0.54),P=0.03].Compared with the control group,the incidence of adverse reactions in the experimental group was decreased[RR=0.76,95%Cl(0.16,3.67),P=0.73],but the difference between two groups was not statistically significant.Conclusion Current evidence showed that on the basis of conventional treatment,Chaihu plus Longgu Muli Deccoction in the treatment of coronary heart disease sompliacted with anxiety and depression could further improve the symptoms of angina pectoris and the state of anxiety and depression,but its safety remained to be further studied.

关 键 词：冠心病 柴胡加龙骨牡蛎汤 焦虑 抑郁 中医药 META分析 

分 类 号：R54[医药卫生—心血管疾病]