中西医结合治疗冠状动脉慢血流的Meta分析  

Meta-analysis of Integrated Chinese and Western Medicine in the Treatment of Coronary Slow Flow

作　　者：刘用 吴旸[1] 李蒙 李金根 褚国洁 肖狄 张立晶[2] LIU Yong;WU Yang;LI Meng;LI Jinggen;CHU Guojie;XIAO Di;ZHANG Lijing(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医药大学东直门医院,北京100700

出　　处：《中西医结合心脑血管病杂志》2023年第1期1-9,共9页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家重点研发计划“中医药现代化研究”重点专项(No.2017YFC1700402);北京中医药大学重点攻关项目(No.2020-JYB-ZDGG-116)。

摘　　要：目的:系统评价中西医结合治疗冠状动脉慢血流(CSF)的临床疗效。方法:全面检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMbase、the Cochrane Library等数据库。检索中西医结合治疗冠状动脉慢血流的随机对照临床试验文献,时间设定为2003年1月1日—2021年12月31日。根据Cochrane系统评价员手册标准对纳入文献进行质量评价。采用Stata 17.0进行数据分析。结果:最终纳入15项随机对照临床试验,涉及957例病人。Meta分析结果显示,与单纯西药治疗相比,中西医结合治疗可提高症状疗效[OR=3.00,95%CI(2.32,3.88),P<0.05]、心电图疗效[OR=2.50,95%CI(1.58,3.95),P<0.05],有效降低超敏C反应蛋白(hs-CRP)水平[SMD=-1.37,95%CI(-1.84,-0.90),P=0.002]及内皮素-1(ET-1)水平[SMD=-1.83,95%CI(-2.67,-0.99),P=0.025],升高一氧化氮(NO)水平[SMD=0.80,95%CI(0.45,1.15),P=0.021]。结论:现有证据表明,中西医结合治疗冠状动脉慢血流相较于单纯西药治疗,在缓解临床症状、提高心电图疗效、改善内皮功能及降低炎性因子方面具有明显的优势。Objective:To evaluate the clinical efficacy of integrated Chinese and western medicine in the treatment of coronary slow flow.Methods:A comprehensive search was performed in databases such as China National Knowledge Infrastructure(CNKI),WanFang,VIP,China Biomedical Literature Database(CBM),PubMed,EMbase,and the Cochrane Library.The randomized controlled clinical trials of integrated traditional Chinese and western medicine in the treatment of coronary slow flow was searched,from January 1,2003 to December 31,2021.The quality of the included studies were assessed according to the Cochrane Manual of Systematic Reviewers Criteria.Data analysis was performed using Stata 17.0.Results:Fifteen randomized controlled clinical trials with 957 subjects were finally included.Meta-analysis results showed that integrated Chinese and western medicine treatment could significantly improve the clinical symptoms of coronary slow flow patients[OR=3.00,95%CI(2.32,3.88),P<0.05],improve the efficacy of electrocardiogram[OR=2.50,95%CI(1.58,3.95),P<0.05],effectively reduce the level of hypersensitive C-reactive protein[SMD=-1.37,95%CI(-1.84,-0.90),P=0.002]and endothelin-1[SMD=-1.83,95%CI(-2.67,-0.99),P=0.025],elevated nitric oxide levels[SMD=0.80,95%CI(0.45,1.15),P=0.021].Conclusion:Existing evidence shows that,compared with the simple western medicine treatment,the combination of Chinese and western medicine in the treatment of coronary slow flow shows obvious advantages in relieving clinical symptoms,improving the efficacy of electrocardiogram and endothelial function,and reducing inflammatory factors.

关 键 词：冠状动脉慢血流 中西医结合 随机对照试验 超敏C反应蛋白 内皮素-1 一氧化氮 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]