通心络联合他汀治疗不稳定型心绞痛血脂异常有效性和安全性的系统评价  

Systematic Evaluation of the Efficacy and Safety of Tongxinluo Combined with Statin for the Treatment of Unstable Angina Pectoris Dyslipidemia

作　　者：张辰浩[1] 王佳 任如画 刘一颖 高美丽 王铭[2] ZHANG Chenhao;WANG Jia;REN Ruhua;LIU Yiying;GAO Meili;WANG Ming(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]重庆市中医院,重庆400021

出　　处：《中西医结合心脑血管病杂志》2025年第7期983-990,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：首都卫生发展科研专项(No.2022-1-4161)。

摘　　要：目的:系统评价通心络联合他汀治疗不稳定型心绞痛血脂异常的有效性和安全性。方法:检索中国知网(CNKI)、万方(WanFang Data)、中国科技期刊数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、 the Cochrane Library、EMbase、Web of Science等数据库,收集关于通心络联合他汀治疗不稳定型心绞痛血脂异常的随机对照试验(RCT)。由2名研究人员独立提取数据,并根据Cochrane系统评价手册对所纳入研究进行质量评价,采用RevMan 5.3软件进行Meta分析。结果:最终纳入17项RCT研究,涉及1 694例病人,其中试验组849例,对照组845例。Meta分析结果显示,试验组在降低总胆固醇[MD=1.03,95%CI(0.55,1.51),P<0.000 1]、三酰甘油[MD=0.41,95%CI(0.23,0.59),P<0.000 1]、低密度脂蛋白胆固醇[MD=0.57,95%CI(0.29,0.85),P<0.000 1]、超敏C-反应蛋白[MD=3.49,95%CI(2.07,4.90),P<0.000 01]水平方面效果优于对照组,在升高高密度脂蛋白胆固醇[MD=0.18,95%CI(0.08,0.28),P=0.000 5]方面也优于对照组。试验组临床疗效总有效率高于对照组[RR=1.21,95%CI(1.16,1.27),P<0.000 01]。不良反应主要为胃肠道症状,无严重不良心脏事件发生。结论:现有证据表明,通心络联合他汀治疗不稳定型心绞痛血脂异常疗效优于单用他汀,且安全性较好。由于纳入研究存在数量少、样本量小、方法学质量较低等局限,该研究结果尚需高质量的临床试验证实。ObjectiveObjective:To evaluate the efficacy and safety of Tongxinluo combined with statin for the treatment of unstable angina pectoris dyslipidemia.MethodsMethods:Randomized controlled trials(RCT)of Tongxinluo combined with statin for the treatment of unstable angina pectoris dyslipidemia were collected by searching China National Knowledge Infrastructure(CNKI),WanFang Database,Chinese Science and Technology Journal Database(VIP),SinoMed,PubMed,the Cochrane Library,EMbase,and Web of Science,etc.Data were extracted independently by two researchers and the quality of the included studies was evaluated according to the Cochrane systematic evaluation manual.Meta-analysis was performed using RevMan 5.3 software.ResultsResults:Finally,17 RCT were included,involving 1694 patients,including 849 patients in the experimental group and 845 patients in the control group.The results of meta-analysis showed that in the experimental group decrease of total cholesterol(MD=1.03,95%CI 0.55-1.51,P<0.0001),triacylglycerol(MD=0.41,95%CI 0.23-0.59,P<0.0001),low density lipoprotein cholesterol(MD=0.57,95%CI 0.29-0.85,P<0.0001)and hypersensitive C-reactive protein(MD=3.49,95%CI 2.07-4.90,P<0.00001)were better than those of the control group.The experimental group was also better than the control group in raising HDL cholesterol(MD=0.18,95%CI 0.08-0.28,P=0.0005).The total effective rate of the experimental group was higher than that of the control group(RR=1.21,95%CI 1.16-1.27,P<0.00001).The adverse reactions were mainly gastrointestinal symptoms,and there were no serious adverse cardiac events.ConclusionConclusion:Existing evidence shows that Tongxinluo combined with statin is better than statin alone for the treatment of unstable angina pectoris dyslipidemia,with better safety.Due to the limited number of included studies,small sample size and low methodological quality,the results of this study need to be confirmed by high-quality clinical trials.

关 键 词：不稳定型心绞痛 血脂异常 通心络 他汀 血脂 系统评价 

分 类 号：R259[医药卫生—中西医结合]