养心氏片治疗冠心病PCI术后有效性的系统评价及GRADE评价  

Systematic Evaluation and GRADE Evaluation of Yangxinshi Tablets in Treatment of Coronary Heart Disease After PCI

作　　者：彭广操[1] 郭红鑫 朱明军[1] 李兴渊[1] PENG Guangcao;GUO Hongxin;ZHU Mingjun;LI Xingyuan(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450003;Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450003 [2]河南中医药大学,河南郑州450046

出　　处：《中医学报》2022年第4期895-900,共6页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项项目(2018JDZX0 09);河南省创新型科技团队项目(C20130050);河南省高校科技创新团队支持计划项目(13IRTSTHN012)。

摘　　要：目的:系统评价养心氏片治疗冠心病经皮冠状动脉介入术(percutaneous coronary intervention, PCI)术后的有效性。方法:检索国内外6个数据库(中国知网、中国生物医学文献数据库、万方数据库、维普中文科技期刊数据库、循证医学数据库、PubMed),时间从建库起至2020年11月,收集养心氏片治疗冠心病PCI术后的随机对照研究。筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析,并按照GRADE标准进行证据质量评价。结果:纳入6项符合标准的研究,纳入研究对象共504例。Meta分析显示:相对于对照组,养心氏片试验组能显著改善心绞痛疗效[RR=1.42,95%CI(1.21,1.66),P<0.000 1],对中医证候[RR=1.57,95%CI(0.89,2.78),P=0.12]及6分钟步行距离(6-MWT)[MD=32.33,95%CI(-1.83,66.49),P=0.06]无影响,对主要心血管不良事件(major adverse cardiovascular events, MACE)发生率、西雅图心绞痛量表(seattle angina questionnaiire, SAQ)进行描述性分析,提示养心氏片可降低MACE发生率、提高SAQ积分,差异有统计学意义(P<0.05)。GRADE证据评级显示结局指标的证据质量评级为极低级。结论:常规西药治疗加用养心氏片可以降低冠心病PCI术后MACE发生率,提高治疗有效率,减少心绞痛症状,提高生活质量。Objective: To systematically evaluate the efficacy of Yangxinshi tablets in the treatment of coronary heart disease after PCI.Methods: Six domestic and foreign databases(CNKI,CBM,Wan Fang, VIP,The Cochrane Library, PubMed) were searched from the establishment of the databases to November 2020,and randomized controlled studies on Yangxinshi tablets in the treatment of coronary heart disease after PCI were collected.After selecting the literature, extracting the data, and evaluating the bias risk of included studies, Meta analysis was conducted with RevMan 5.3 software and evidence quality evaluation was conducted according to GRADE standards.Results: Six studies that met the criteria were included, including 504 subjects in total.Meta-analysis shows that: Compared with the control group, Yangxinshi group can significantly improve the angina pectoris curative effect[RR=1.42,95%CI(1.21,1.66),P<0.0001],And had no effect on the TCM syndrome(RR=1.57,95%CI(0.89,2.78),P=0.12) and 6 minutes walking distance(6 MWT)[MD=32.33,95%CI(1.83,66.49),P=0.06].Descriptive analysis of the incidence of major adverse cardiovascular events(MACE) and the Seattle Angina Pectoris Scale(SAQ) indicated that Yangxinshi Tablet could reduce the incidence of MACE and increase the SAQ score, and the difference was statistically significant(P<0.05).The GRADE evidence rating shows a very low evidence quality rating for outcome measures.Conclusion: Conventional western medicine combined with Yangxinshi tablets can reduce the incidence of MACE after PCI in coronary heart disease, improve the effective rate of treatment, reduce angina symptoms, and improve the quality of life.

关 键 词：冠心病PCI术后 养心氏片 META分析 系统评价 GRADE评价 

分 类 号：R259[医药卫生—中西医结合]