摘要
目的:系统评价麝香保心丸对冠心病心绞痛患者心肌血管内皮功能的影响。方法:检索The Cochrane Library、PubMed、中国生物医学文献数据库(CBM)、维普中文科技期刊全文数据库(VIP)、中国学术期刊全文数据库(CNKI)、万方期刊数据库(WanFang),检索时限均从建库至2020年2月,收集麝香保心丸联合西医常规与西医常规比较治疗的随机对照试验。由2名研究者独立根据纳排标准筛选文献、提取资料,使用Cochrane评价手册中的风险偏倚评估工具进行文献质量评价,采用RevMan5.3软件对主要疗效指标肱动脉血流介导的血管舒张功能(flow-mediated vasodilation,FMD)以及次要疗效指标内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)、一氧化氮合酶(nitric oxide synthase,NOS)、超氧化物歧化酶(superoxide dismutase,SOD)、临床有效率进行Meta分析。结果:共纳入10项研究,包括786例患者。Meta分析结果显示,与对照组(西医常规治疗)相比,试验组(麝香保心丸+西医常规治疗)患者的FMD(WMD=2.38,95%CI[1.55,3.20],P<0.00 001)和临床有效率(OR=4.86,95%CI[2.49,9.50],P<0.00 001)明显改善,同时血清内的ET含量(WMD=-19.22,95%CI[-22.44,-16.00],P<0.00 001)降低,NO(WMD=50.84, 95%CI[32.24,69.45],P<0.00 001)、NOS(WMD=14.38,95%CI[11.67,17.09],P<0.00 001)、SOD(WMD=16.64,95%CI[15.17,18.11],P<0.00 001)含量升高。纳入的研究均未报告由麝香保心丸引起的频繁或严重不良反应。结论:长期服用麝香保心丸可以明显改善冠心病心绞痛患者心肌血管内皮功能,从而降低患者心绞痛的发作次数及发作时间并改善心电图。但鉴于该系统评价所纳入文献数量较少,故仍需开展更大规模、更严谨的随机对照试验来确定长期服用麝香保心丸辅助治疗冠心病心绞痛在改善患者心肌血管内皮功能的疗效。
Objective:This systematic review aims to evaluate the effect of Shexiang Baoxin pills on myocardial vascular endothelial function in patients with coronary heart disease and angina pectoris. Methods:Databases,such as The Cochrane Library, PubMed, CBM, VIP, CNKI and WanFang, were searched from the establishment of the database to February 2020. The randomized controlled trials of Shexiang Baoxin pills combined with western medicine and western medicine were collected. The two researchers independently screened the literature and extracted the data according to the criteria, and used the risk bias assessment tool in the Cochrane evaluation manual to evaluate the quality of the literature. RevMan5.1 was used to evaluate the main efficacy indicators of brachial artery flow-mediated vasodilation and the secondary efficacy indicators of endothelin, nitric oxide and nitric oxide synthase, superoxide dismutase and clinical effective rate were analyzed by Meta.Results:A total of 10 studies were included, including 786 patients. The results of Meta-analysis showed that, compared with the control group(western medicine routine treatment), the patients in the observation group(Shexiang Baoxin pills + western medicine routine treatment) had a significant improvement in FMD(WMD=2.38,95%CI [1.55,3.20,P<0.00 001) and clinical effective rate(OR=4.86,95%CI [2.49,9.50,P<0.00001), while the serum ET content was decreased(WMD=-19.22,95%CI [-22.44,-16.00], P<0.00001). The contents of NO(WMD=50.84,95%CI,P<0.00 001), NOS(WMD=14.38,95%CI,P<0.00 001) and SOD(15.17,18.11,P<0.00 001) were increased. No frequent or serious adverse reactions caused by Shexiang Baoxin pills have been reported in all studies included.ConclusionShexiang Baoxin pills can significantly improve the myocardial vascular endothelial function in patients with angina pectoris after long-term use, thus reduce the attack times and time of angina pectoris for improving ECG. However, in view of the small number of the literature included in the systematic review, it is stil
作者
李亥辰
李若阳
陈柏君
熊磊
郜发宝
Li Haichen;Li Ruoyang;Chen Bojun;Xiong Lei;Gao Fabao(Basic Medical School,Yunnan University of Chinese Medicine,Kunming 650500;Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041;Molecular Imaging Laboratory,West China Hospital,Sichuan University,Chengdu 610041)
出处
《中药药理与临床》
CAS
CSCD
北大核心
2020年第4期173-179,共7页
Pharmacology and Clinics of Chinese Materia Medica
基金
国家自然科学基金资助项目(编号:81520108014、81930046)
郜发宝专家工作站(编号:2015IC027,云南省科技厅)
云南省高校芳香中药重点实验室(云教科[2016]37号)。
关键词
冠心病心绞痛
麝香保心丸
血管内皮功能
META分析
Coronary heart disease and angina pectoris
Shexiang Baoxin pills
Vascular endothelial function
Meta-analysis
