摘要
目的系统评价复方丹参滴丸联合西医常规治疗对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后临床疗效的系统评价。方法检索中国知网(CNKI)、万方数据库(Wan Fang)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library从建库始至2020年2月发表的有关复方丹参滴丸应用于急性心肌梗死PCI术后的随机对照试验(RCT),经逐层筛选最终纳入研究17个,总样本量2163例,包括实验组1081例,对照组1082例。应用RevMan 5.3软件对收集的数据进行Meta分析。结果西医常规治疗基础上,加用复方丹参滴丸在改善左室收缩末期内径[MD=-3.01;95%CI(-4.11,-1.91);P<0.000 01]、左室舒张末期内径[MD=-1.42;95%CI(-1.63,-1.20);P<0.000 01]、左室射血分数[MD=5.01;95%CI(4.29,5.72);P<0.000 01]、C-反应蛋白[SMD=-1.01;95%CI(-1.28,-0.75);P<0.000 01]、白介素6[MD=-6.59;95%CI(-6.75,-6.44);P<0.000 01]、肌酸激酶同工酶[MD=-0.47;95%CI(-0.75,-0.18);P=0.001]、B型脑利钠肽[SMD=-1.49;95%CI(-1.73,-1.25);P<0.000 01]、心肌肌钙蛋白l[MD=-0.09;95%CI(-0.11,-0.07);P<0.000 01]、血清一氧化氮[MD=13.73;95%CI(8.89,18.56);P<0.000 01]、内皮素[MD=-8.20;95%CI(-9.76,-6.64);P<0.000 01]及降低主要心血管不良反应发生率[RR=0.27;95%CI(0.17,0.42);P<0.000 01]等方面均优于西医常规治疗,差异有统计学意义。结论在西医常规治疗基础上联用复方丹参滴丸能进一步提升急性心肌梗死PCI术后患者心功能,抑制炎症反应,保护心肌细胞及血管内皮,降低主要心血管事件发生率。但由于纳入研究的样本量较小,方法学质量不高,研究结论的应用及推广需谨慎,有待后续开展更多高质量、大样本、多中心、双盲法的RCT进一步验证及完善。
Objective To systematically evaluate the clinical effect of Compound Danshen Dropping Pill (复方丹参滴丸) combined with Western medicine on patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI). Methods CNKI,Wan Fang,VIP,CBM,Pub Med,Cochrane were searched Library published a randomized controlled trial(RCT)on the application of Compound Danshen Dropping Pill to the patients with acute myocardial infarction after PCI from the establishment of the database to February 2020,which was finally included in 17 studies through layer by layer screening. The total sample size was 2163 cases,including 1081 cases in the experimental group and 1082 cases in the control group. The data collected were meta analyzed by Revman 5.3 software. Results On the basis of conventional Western medicine treatment,Compound Danshen Dropping Pill was used to improve the left ventricular end systolic diameter [MD=-3.01;95%CI(-4.11,-1.91);P<0.000 01],left ventricular end diastolic diameter [MD=-1.42;95%CI(-1.63,-1.20);P<0.000 01],left ventricular ejection fraction [MD=5.01;95%CI(4.29,5.72);P<0.000 01],C-reactive protein [SMD=-1.01;95%CI(-1.28,-[MD=13.73;95%CI(8.89,18.56);P<0.000 01],endothelin [MD=-8.20;95%CI(-9.76,-6.64);P<0.000 01] and reduce the incidence of major cardiovascular adverse events [RR=0.27;95%CI(0.17,0.42);P<0.000 01] and other aspects were superior to conventional western medicine treatment,the difference was statistically significant. Conclusion On the basis of conventional Western medicine,the combination of Compound Danshen Dropping Pill can further improve the cardiac function,inhibit the inflammatory reaction,protect the myocardial cells and vascular endothelium,and reduce the incidence of major cardiovascular events in patients with acute myocardial infarction after PCI. However,due to the small sample size and low quality of methodology,the application and promotion of research conclusions should be cautious,and more RCTs with high quality,large sample,multi center and double b
作者
高晟玮
刘志超
王振兴
王保和
GAO Shengwei;LIU Zhichao;WANG Zhenxing;WANG Baohe(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300150,China)
出处
《辽宁中医药大学学报》
CAS
2021年第2期111-117,共7页
Journal of Liaoning University of Traditional Chinese Medicine
基金
“重大新药创制”十三五科技重大专项(2018ZX09734-002)。
关键词
复方丹参滴丸
急性心肌梗死
PCI
Meta分析
系统评价
Compound Danshen Dropping Pill(复方丹参滴丸)
acute myocardial infarction
percutaneous coronary intervention
Meta analysis
systematic evaluation
