益气活血解毒方药治疗冠心病气虚血瘀证有效性和安全性的Meta分析  

Efficacy and Safety of Invigorating Qi,Promoting Blood Circulation and Detoxification Recipe in the Treatment of Coronary Heart Disease with Qi Deficiency and Blood Stasis Syndrome:a Meta-analysis

作　　者：李丹丹[1] 周庆兵[1] 张淼 王碧晴 张艳 闫亚茹 徐凤芹[1] LI Dandan;ZHOU Qingbing;ZHANG Miao;WANG Biqing;ZHANG Yan;YAN Yaru;XU Fengqin(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,北京100091 [2]深圳市第二人民医院

出　　处：《中西医结合心脑血管病杂志》2021年第24期4209-4215,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.81973679)。

摘　　要：目的系统评价益气活血解毒方药治疗冠心病气虚血瘀证的有效性和安全性。方法检索中国知网、万方、维普、PubMed、Web of Science数据库中益气活血解毒方药治疗冠心病的随机对照试验(RCTs),并手工检索《世界中西医结合杂志》《中西医结合心脑血管病杂志》等10余种中西医结合杂志,检索时间为建库至2020年4月,根据纳入与排除标准由两位研究者独立筛选文献、提取资料并评估文献质量。采用RevMan 5.1软件进行Meta分析。结果共纳入20篇文献,涉及1669例病人。Meta分析结果显示:与对照组比较,观察组临床总有效率[RR=1.24,95%CI(1.18,1.30),Z=8.32,P<0.00001],中医证候疗效总有效率[RR=1.30,95%CI(1.22,1.47),Z=6.07,P<0.00001],心绞痛总有效率[RR=1.30,95%CI(1.12,1.51),Z=3.43,P=0.0006],心电图总有效率[RR=1.33,95%CI(1.09,1.62),Z=2.85,P=0.004]和硝酸甘油减停率[RR=1.47,95%CI(1.11,1.95),Z=2.69,P=0.007]提高,血清总胆固醇[SMD=-0.65,95%CI(-0.86,-0.44),Z=6.13,P<0.00001],低密度脂蛋白胆固醇[SMD=-0.86,95%CI(-1.06,-0.66),Z=8.54,P<0.00001]和三酰甘油水平[SMD=-0.64,95%CI(-0.88,-0.41),Z=5.40,P=0.00001]降低,高密度脂蛋白胆固醇水平[SMD=0.38,95%CI(0.17,0.58),Z=3.62,P=0.0003]升高。与对照组比较,观察组血清C反应蛋白[SMD=-0.31,95%CI(-0.59,-0.04),Z=2.24,P=0.02],超敏C反应蛋白水平[SMD=-1.66,95%CI(-2.93,-0.40),Z=2.58,P=0.01],高切变率下全血黏度[SMD=-1.57,95%CI(-2.51,-0.36),Z=3.27,P=0.001]降低。结论现有证据表明:益气活血解毒方药联合常规西药治疗冠心病气虚血瘀证在调节血脂、改善炎症和血液流变学方面均优于常规西药治疗,且未增加不良反应。Objective To systematically evaluate efficacy and safety of Invigorating Qi,Promoting Blood Circulation and Detoxification Recipe in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.Methods CNKI,Wanfang,VIP,PubMed,and Web of Science databases were searched to collect randomized controlled trials(RCTs)of Invigorating Qi,Promoting Blood Circulation and Detoxification Recipe in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome,and more than 10 journals of integrated traditional Chinese and western medicine were searched manually,such as World Journal of Integrated Traditional and Western Medicine and Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease from the establishment of the database to April 2020.According to inclusion and exclusion criteria,two researchers screened the literature,extracted the data,and evaluated the literature quality independently.According to the inclusion and exclusion criteria,two researchers screened the literatures,extracted the datas,and evaluated the quality of the literatures independently.RevMan 5.1 software was used for Meta-analysis.Results A total of 20 literatures were included,involving 1669 patients.The results of Meta-analysis showed that compared with the control group,the effective rate of clinical efficacy[RR=1.24,95%CI(1.18,1.30),Z=8.32,P<0.00001],the total effective rate of traditional Chinese medicine syndromes[RR=1.34,95%CI(1.22,1.47),Z=6.07,P<0.00001],the total response rate of angina pectoris[RR=1.30,95%CI(1.12,1.51),Z=3.43,P=0.0006],the total response rate of electrocardiogram[RR=1.33,95%CI(1.09,1.62),Z=2.85,P=0.004],and the nitroglycerin consumption[RR=1.47,95%CI(1.11,1.95),Z=2.69,P=0.007]in the observation group were increased,serum total cholesterol[SMD=-0.65,95%CI(-0.86,-0.44),Z=6.13,P<0.00001],low density lipoprotein cholesterol[SMD=-0.86,95%CI(-1.06,-0.66),Z=8.54,P<0.00001],triglyceride[SMD=-0.64,95%CI(-0.88,-0.41),Z=5.40,P=0.00001]in the observation group were decrea

关 键 词：冠心病 气虚血瘀证 益气活血解毒方药 血脂 炎性因子 血液流变学 META分析 

分 类 号：R54[医药卫生—心血管疾病]