通脉降浊方治疗冠心病有效性及安全性的系统评价  

Efficacy and safety of Tongmai Jiangzhuo decoction in the treatment of coronary heart disease:a systematic review

作　　者：郑鑫 王凤荣[2] ZHENG Xin;WANG Fengrong(Graduate School of Liaoning University of Chinese Medicine,Shenyang 110847,Liaoning,China;First Department of Cardiology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学研究生院,辽宁沈阳110847 [2]辽宁中医药大学附属医院心内一科,辽宁沈阳110032

出　　处：《中国现代医生》2023年第26期113-118,133,共7页China Modern Doctor

基　　金：辽宁省中医药临床重点学(专)科服务能力建设项目(LNZYXZK201908)。

摘　　要：目的旨在系统评价通脉降浊方治疗冠心病的有效性及安全性。方法检索中国知网、万方数据知识服务平台、维普网、Pubmed、EMbase、Cochrane Library数据库,检索时限为数据库建库至2022年9月1日。共纳入16篇文献,合计1338例研究对象。根据Cochrane应用手册使用RoB2软件对纳入文献进行质量评价,应用Revman 5.4软件进行分析。结果通脉降浊方联合西医常规治疗(试验组)相较于西医常规治疗(对照组),试验组可以显著减少心绞痛发作情况[相对危险度(relative ratio,RR)=1.20,95%置信区间(confidence interval,CI):1.14~1.26,P<0.001],显著改善心电图缺血表现(RR=1.25,95%CI:1.13~1.37,P<0.001),提升高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)水平[均数差(mean difference,MD)=0.15,95%CI:0.11~0.20,P<0.001],降低低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平(MD=–0.40,95%CI:–0.63~–0.16,P=0.001),且具有良好的安全性。结论通脉降浊方联合西药标准化治疗,在减少心绞痛发作情况、改善心电图缺血表现、改善血脂水平方面优于单纯西药标准化治疗,且具有良好的安全性。Objective To evaluate the efficacy and safety of Tongmai Jiangzhuo decoction in the treatment of coronary heart disease.Methods The databases of CNKI,Wanfang,VIP,Pubmed,EMbase and Cochrane Library were searched until September 1,2022.A total of 16 literatures were included,including 1338 subjects.The quality of the included literatures was evaluated using RoB2 software according to the Cochrane Application Manual,and analyzed using Revman 5.4 software.Results Compared with conventional Western medicine(control group),Tongmai Jiangzhuo decoction combined with conventional Western medicine(experimental group)can significantly reduce angina attacks[relative ratio(RR)=1.20,95%CI:1.14-1.26),P<0.001]and significantly improve electrocardiogram ischemia(RR=1.25,95%CI:1.13-1.37,P<0.001),increased the level of high-density lipoprotein cholesterol(HDL-C)[mean difference(MD)=0.15,95%CI:0.11-0.20,P<0.001],reduced the level of low-density lipoprotein cholesterol(LDL-C)(MD=–0.40,95%CI:–0.63–0.16,P=0.001),and had good safety.Conclusion Tongmai jiangzhuo decoction combined with standardized Western medicine is better than standardized western medicine in reducing angina attacks,improving electrocardiogram ischemia and improving blood lipid levels,and has good safety.

关 键 词：通脉降浊方 冠状动脉粥样硬化性心脏病 随机对照试验 META分析 系统评价 

分 类 号：R259[医药卫生—中西医结合]