从气血论治中成药改善X综合征冠脉微循环疗效的Meta分析  

The effect of Traditional Chinese Medicine Improving Coronary Microcirculation in Patients with X Syndrome from Qi and Blood:A Meta-Analysis

作　　者：冯娟 闫奎坡[2] 朱翠玲[2] 孙彦琴[2] 郭雨晴 刘刚[2] 徐亚洲[2] 谢梦欣 FENG Juan;YAN Kuipo;ZHU Cuiling;SUN Yanqin;GUO Yuqing;LIU Gang;XU Yazhou;XIE Mengxin(Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;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,河南郑州450000

出　　处：《实用中医内科杂志》2022年第8期26-30,I0013-I0018,共11页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家自然科学基金青年基金(81303073);国家人社部留学人员支助项目(人社函[2010]412);河南中医学院一附院院内博士项目(2012KJ32);河南中医学院省属科研业务专项(2014KYYWF-YQ12);河南省科技攻关重点项目(112102310317);河南省高校科技创新团队支持计划(13IRTSTHN012);河南省中医药防治心血管疾病创新型科技团队(C20130050);河南省首批青苗人才培养项目(豫中医科教(2018)16);河南省科技攻关项目(192102310161、182102310291);河南省中医药科学研究专项(2017ZY2017)。

摘　　要：目的系统评价中成药从气血论治X综合征患者冠脉微循环的疗效与安全性。方法检索CNKI、WanFang、VIP、CBM、Pubmed、Cochrane Library、EMBase数据库从建库至2020年12月发表的中成药治疗X综合征的随机对照试验。2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行Meta分析。结果纳入28篇文献,2628例受试者;Meta分析显示,X综合征患者在西药常规治疗基础上加用中成药后,能进一步改善患者心绞痛疗效[RR=0.44,95%CI(0.35,0.55)]和心电图疗效[RR=0.68,95%CI(0.58,0.79)],减少心绞痛发作次数[SMD=-1.29,95%CI(-1.71,-0.88)]和持续时间[MD=-1.95,95%CI(-2.88,-1.01)],增加FMD[MD=2.48,95%CI(1.93,3.03)]和CFR[MD=0.50,95%CI(-0.12,1.11)],降低IMR[MD=-8.02,95%CI(-14.08,-1.95)]、ET-1[MD=-19.43,95%CI(-25.57,-13.29)]和hs-CRP[MD=-1.09,95%CI(-1.59,-0.60)],升高NO水平[MD=11.04,95%CI(6.47,15.60)]。结论中成药从气血论治X综合征安全有效,能显著改善微血管内皮功能,改善冠脉微循环,增加冠脉血流储备,提高患者运动耐量,减少心绞痛发作次数和持续时间,缓解临床症状,且无明显不良反应。Objective To evaluate the efficacy and safety of traditional Chinese medicine improving coronary microcirculation in patients with X syndrome from Qi and Blood.Methods The computer retrieved the CNKI,WanFang,VIP,CBM,Pubmed,Cochrane Library,EMBase database for the randomized controlled trials of traditional Chinese medicine on X syndrome from the establishment of the database to December 2020.Two reviewers independently screened literature,extracted data and assessed risk of bias of included studies,then,Meta-analysis was performed by RevMan 5.3 software.Results 28 articles were included,including 2628 subjects;Meta analysis showed traditional Chinese medicine combined with conventional treatment can better improve the effect of angina pectoris[RR=0.44,95%CI(0.35,0.55)]and ECG[RR=0.68,95%CI(0.58,0.79)],reduce the number of angina pectoris attacks[SMD=-1.29,95%CI(-1.71,-0.88)]and the duration[MD=-1.95,95%CI(-2.88,-1.01)],increase FMD[MD=2.48,95%CI(1.93,3.03)]and CFR[MD=0.50,95%CI(-0.12,1.11)],reduce IMR[MD=-8.02,95%CI(-14.08,-1.95)],ET-1[MD=-19.43,95%CI(-25.57,-13.29)]and hs-CRP[MD=-1.09,95%CI(-1.59,-0.60)],increase NO[MD=11.04,95%CI(6.47,15.60)].Conclusion Traditional Chinese medicine is safe and effective in the treatment of X syndrome based on Qi and Blood,can improve the microvascular endothelial function and coronary microcirculation,increase the blood flow reserve of coronary artery,improve the exercise tolerance of patients,reduce the number and duration of angina,relieve the clinical symptoms and have no obvious adverse reactions.

关 键 词：中成药 X综合征 冠脉微循环 气血论治 META分析 

分 类 号：R259[医药卫生—中西医结合]