摘要
目的系统评价单片复方制剂Polypill对心血管疾病危险因素的干预效果和安全性。方法分别对Embase、Cochrane图书馆、Pub Med、Web of Science、中国知网、万方、中国生物医学文献数据库进行文献检索,检索时间均为建库至2015年5月。查找有关Polypill对心血管疾病危险因素的干预效果与安全性的随机对照试验,采用Rev Man 5.2软件进行数据分析。结果共纳入6篇外文文献,1 155例患者采用Polypill治疗,1 149例患者采用安慰剂或单个或部分药物组成的治疗。Meta分析结果显示:采用Polypill治疗后收缩压、舒张压、血清总胆固醇、低密度脂蛋白下降幅度均大于对照组,差异有统计学意义[收缩压:WMD=-9.39 mm Hg(1 mm Hg=0.133 k Pa),95%CI(-14.44,-4.33)mm Hg,P=0.000 3;舒张压:WMD=-5.32 mm Hg,95%CI(-8.10,-2.55)mm Hg,P=0.000 2;血清总胆固醇:WMD=-1.11 mmol/L,95%CI(-1.48,-0.74)mmol/L,P<0.000 01;低密度脂蛋白:WMD=-0.91 mmol/L,95%CI(-1.25,-0.57)mmol/L,P<0.000 01];然而,使用Polypill治疗的人群更容易出现治疗中断[OR=1.49,95%CI(1.19,1.87),P=0.000 5];而在药物的不良反应方面,两组试验数据的差异无统计学意义[OR=1.47,95%CI(0.67,3.25),P=0.34]。结论 Polypill对心血管疾病危险因素的干预效果明显,能有效降低血压、血脂水平;在药物的依从性方面,Polypill治疗的人群更倾向于发生治疗中断;在药物安全性方面,Polypill治疗对不良反应的发生无明显影响。
Objective To systematically evaluate the efficacy and safety of Polypill on cardiovascular risk factors. Methods Such databases as Embase, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastracture, WanFang, and China Biology Medicine Disc were searched from theft establishment to May 2015 for randomized controlled trials on the efficacy and safety of Polypillon on cardiovascular risk factors. Meta-analyses were performed by using the RevMan 5.2 software. Results Six studies were included which all came from overseas including 1 155 patients treated with Polypill and 1 149 treated with placebo or single or combined medicaiton. The meta-analysis showed that： when compared with the controls, Polypills could significantly reduce systolic blood pressure [WMD=-9.39 mm Hg （1 mm Hg=0.133 kPa）, 95%CI （-14.44, -4.33） mm Hg, P=0.000 3], diastolic blood pressure [WMD=-5.32 mm Hg, 95%CI （-8.10, -2.55） mm Hg, P=0.000 2], total cholesterol [WMD=-I.ll mmol/L, 95%CI （-1.48, -0.74） mmol/L, P 〈 0.000 01], and low density lipoprotein [WMD=-0.91 mmol/L, 95%CI （-1.25, -0.57） retool/L, P 〈 0.000 01]. However, those who took Polypill were easier to discontinue medication [OR=1.49, 95%CI （1.19, 1.87）, P=0.000 5]. In the respect of adverse effects, there was no significant difference between the two groups [0R=1.47, 95%CI （0.67, 3.25）, P=0.34]. Conclusions The efficacy of Polypill on cardiovascular risk factors is obvious. Polypills can significantly reduce blood pressure and lipids. Tolerability is lower in those taking Polypills, but the difference is minor. There is no significant difference in the respect of adverse effects.
出处
《华西医学》
CAS
2015年第6期1054-1059,共6页
West China Medical Journal
