活血化瘀类中成药治疗阿司匹林抵抗疗效的网状Meta分析  

Bayesian Network Meta-Analysis of the Efficacy of Huoxuehuayu (活血化瘀) Chinese Patent Medicines on Aspirin Resistance

作　　者：郭红鑫 李兴渊[2] 朱明军[2] GUO Hongxin;LI Xingyuan;ZHU Mingjun(The First Clinical School of Henan University of Chinese Medicine,Zhengzhou 450000;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000)

机构地区：[1]河南中医药大学第一临床医学院,郑州450000 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《中药药理与临床》2024年第7期68-75,共8页Pharmacology and Clinics of Chinese Materia Medica

基　　金：国家重点研发计划重点专项课题(编号:2019YFC1710003、2019YFC1710000);国家自然科学基金重点项目(编号:82030120);河南省中医药科学研究专项课题(编号:2018JDZX009);河南省中原千人计划-中原名医项目。

摘　　要：目的:基于贝叶斯模型的网状Meta分析(NMA),比较活血化瘀类中成药治疗阿司匹林抵抗(AR)的疗效。方法:检索中国知网、PubMed等7个中英文数据库从建库起至2022年3月有关活血化瘀类中成药治疗AR的随机对照试验(RCT)。2位研究者独立进行文献筛选、资料提取和质量评价。采用R语言(4.1.2)中的GeMTC包进行贝叶斯模型的NMA。结果:共纳入24项RCT研究,包括1913例患者,涉及5种活血化瘀类中成药,分别为复方丹参滴丸、通心络胶囊、血府逐瘀胶囊、银杏叶片和三七通舒胶囊。NMA结果显示,复方丹参滴丸联合西药治疗在降低花生四烯酸诱导的血小板聚集率、二膦酸腺苷诱导的血小板聚集率和缺血事件发生率方面效果均最优,并且不增加出血风险;血府逐瘀胶囊在降低出血事件发生率方面表现最优。结论:在常规西药治疗基础上联合这5种中成药均可提高AR治疗的临床疗效,其中以复方丹参滴丸综合疗效最优。该研究尚存一定局限性,期待更多高质量的RCT研究予以验证。Objective:To compare the efficacy of Huoxuehuayu(活血化瘀) Chinese patent medicines in treating aspirin resistance(AR) based on Bayesian network Meta-analysis(NMA). Methods:Seven Chinese and English databases, including China National Knowledge Infrastructure(CNKI) and PubMed, were searched from database inception to March 2022 for randomized controlled trials(RCTs) investigating the treatment of AR with Huoxuehuayu Chinese patent medicines. Two investigators independently conducted literature screening, data extraction, and quality assessment. The GeMTC package in R software(version 4.1.2) was used for the Bayesian NMA model. Results:Twenty-four RCTs involving 1 913 patients were included, involving five types of Huoxuehuayu Chinese patent medicines, i.e.,Fufang Danshen(复方丹参) Dripping Pills, Tongxinluo(通心络) Capsules, Xuefu Zhuyu(血府逐瘀) Capsules, Ginkgo biloba leaf extracts, and Sanqi Tongshu(三七通舒) Capsules. The NMA results indicated that Fufang Danshen Dripping Pills combined with western medicine were the most effective in reducing platelet aggregation induced by arachidonic acid and adenosine diphosphate, as well as the occurrence of ischemic events, without increasing the risk of bleeding. Xuefu Zhuyu Capsules exhibited the best performance in reducing the occurrence of bleeding events. Conclusion:These five Chinese patent medicines combined with conventional western medicine treatment can enhance the clinical efficacy of AR therapy, with Fufang Danshen Dripping Pills showing the most optimal comprehensive efficacy. This study has certain limitations, and further high-quality RCTs are expected for validation.

关 键 词：阿司匹林抵抗 活血化瘀 中成药 网状meta分析 贝叶斯模型 

分 类 号：R285.6[医药卫生—中药学]