摘要
目的:系统评价养心氏片联合西药治疗冠心病的疗效。方法:电子检索PubMed、Cochrane library、Embase、CNKI、VIP、万方和CBM,检索时间限定为自建库至2017年9月25日,检出所有养心氏片联合西药治疗冠心病的有关文献,由2名研究员各自独立严格进行纳入研究的质量评价和资料提取,用RevMan5.3软件进行Meta分析,用TSA v0.9软件进行试验序贯分析。结果:共纳入15个RCT包括1 232例患者。Meta分析结果:养心氏片联合西药与单纯使用西药对比,可以明显改善心绞痛临床症状[OR=3.84,95%CI(2.31,6.39),P<0.000 01];心电图改善率[OR=3.12,95%CI(2.09,4.64),P<0.000 01];在调节血脂方面,能改善总胆固醇[MD=-0.84,95%CI(-1.27,-0.41),P=0.000 1]、甘油三酯[MD=-0.65,95%CI(-1.16,-0.15),P=0.01]和低密度脂蛋白[MD=-0.84,95%CI(-1.53,-0.16),P=0.02]。试验序贯分析显示心绞痛改善和心电图改善纳入的研究均穿过了TSA界值和预期样本量(178,151),提示养心氏片联合西药治疗冠心病临床疗效证据确切。结论:养心氏片联合西药治疗冠心病疗效显著,且不良反应较少,但因现有研究质量偏低,且数量较少,需要更多高质量多中心的双盲试验来进一步验证其疗效。
OBJECTIVE To systematically review the efficacy of Yangxinshi tablets combined with western medicine against coronary heart diseases（CHD）.METHODS Databases as PubMed,Cochrane library,Embase,CNKI,VIP,Wanfang data and CBM were searched to collect literatures about Yangxinshi tablets combined with western medicine in the treatment of CHD on the deadline to September 25,2017.All the studies searched were strictly evaluated.Literatures were independently screened by two researchers according to the inclusion and exclusion criteria,and the methodological quality of included studies was evaluated.A Meta-analysis and TSA analysis were performed by using RevMan5.3 and TSA v0.9,respectively.RESULTS The results of Meta analysis suggested that：compared with the western medicine,the method of Yangxinshi tablets combined with western medicine significantly improved the clinical symptoms in patients with coronary heart disease and angina pectoris[OR=3.84,95%CI（2.31,6.39）,P〈0.000 01],electrocardiogram improvement rate [OR=3.12,95%CI（2.09,4.64）,P〈0.000 01].In terms of blood liquids,the method of Yangxinshi tablets combined with western medicine significantly improved the total cholesterol[MD=-0.84,95%CI（-1.27,-0.41）,P=0.000 1],triglyceride [MD=-0.65,95%CI（-1.16,-0.15）,P=0.01]and low density lipoprotein cholesterin[MD=-0.84,95%CI（-1.53,-0.16）,P=0.02].The TSA analysis showed that the studies included in the improvement of angina and improvement of electrocardiogram all passed TSA threshold and expected sample size,so the evidence was definite.CONCLUSION The Yangxinshi tablets combined with western medicine in treating coronary heart disease is effective and can reduce adverse reactions.However,the quality of existing research is low and the number is too small,which requires more high-quality,multi-center and double-blind clinical trials for further validation.
作者
梁家华
姜晨光
江晓涛
温俊茂
吴伟
LIANG Jia-hua;JIANG Chen-guang;JINAG Xiao-tao;WEN Jun-mao;WU Wet(The First Clinical College,Guangzhou University of Chinese Medicine,Guangdong Guangzhou 510405,China;The First Affiliated Hospital,Guan gzhou University of Chinese Medicine,Guangdong Guangzhou 510405,China)
出处
《中国医院药学杂志》
CAS
北大核心
2018年第14期1514-1519,共6页
Chinese Journal of Hospital Pharmacy
基金
国家自然科学基金资助项目(编号:8167150719)
国家中医药管理局资助项目(项目:JDZX2015241)
关键词
养心氏片
冠心病
META分析
试验序贯分析
Yangxinshi tablets
coronary heart disease
Meta-analysis
trial sequential analysis
