摘要
目的系统评价中成药荷丹片对血脂异常患者血脂水平及炎症因子的影响。方法检索PubMed、中国知网、维普网、万方数据库、中国生物医学文献服务系统建库至2022年3月收录的荷丹片治疗血脂异常的临床随机对照试验。通过Rev Man 5.3分析软件和Stata 16.0软件对纳入文献的研究结果进行meta分析。结果共纳入15项临床随机对照研究,包括1227例患者。meta分析结果显示,试验组临床总有效率高于对照组(OR=0.28,95%CI:0.19~0.44,P<0.00001)。与试验组比较,对照组血清总胆固醇(MD=0.65,95%CI:0.16~1.14,P=0.01)、甘油三酯(MD=0.84,95%CI:0.45~1.23,P<0.00001)、低密度脂蛋白胆固醇(MD=0.76,95%CI:0.08~1.44,P=0.03)、C反应蛋白(SMD=2.60,95%CI:0.50~4.69,P=0.02)水平更高,高密度脂蛋白胆固醇水平更低(MD=-0.41,95%CI:-0.70~-0.12,P<0.00001)。两组不良反应总发生率比较,差异无统计学意义(OR=1.11,95%CI:0.71~1.72,P=0.65)。meta回归分析显示,发表时间、样本量大小、他汀种类和用药时间不影响荷丹片对血脂异常患者血脂水平及炎症因子的作用。敏感性分析结果显示meta分析结果稳定。漏斗图基本对称,无明显发表偏倚。结论荷丹片在改善血脂异常患者血脂及炎症反应指标方面优于单用西药,不增加不良反应,效果值得肯定。
Objective To systematically evaluate the effects of traditional Chinese patent medicines and simple preparations Hedan Tablets on blood-lipid levels and inflammatory factors in patients with dyslipidemia.Methods Clinical randomized controlled trials of Hedan Tablets in the treatment of dyslipidemia were retrieved from PubMed,CNKI,VIP,Wanfang Data,and China Biomedical Literature Service System from inception to March 2022.The meta-analysis of the results of the included literatures was performed by RevMan 5.3 analysis software and Stata 16.0 software.Results A total of 15 clinical randomized controlled trials were included,including 1227 patients.The results of meta-analysis showed that the total clinical effective rate of the experimental group was higher than that of the control group(OR=0.28,95%CI:0.19 to 0.44,P<0.00001).Compared with experimental group,serum levels of total cholesterol(MD=0.65,95%CI:0.16 to 1.14,P=0.01),triglyceride(MD=0.84,95%CI:0.45 to 1.23,P<0.00001),low density lipoprotein cholesterol(MD=0.76,95%CI:0.08 to 1.44,P=0.03),C-reactive protein(SMD=2.60,95%CI:0.50 to 4.69,P=0.02)were higher in the control group,and serum level of high-density lipoprotein cholesterol(MD=-0.41,95%CI:-0.70 to-0.12,P<0.00001)was lower in the control group.There was no significant difference in the total incidence of adverse reactions between the two groups(OR=1.11,95%CI:0.71 to 1.72,P=0.65).Meta-regression analysis showed that publication time,sample size,statin type,and medication duration did not affect the effects of Herdan Tablets on blood-lipid levels and inflammatory factors in patients with dyslipidemia.The results of sensitivity analysis showed that the meta-analysis was stable.The funnel plot was basically symmetrical and had no obvious publication bias.Conclusion Hedan Tablets is better than western medicine alone in improving blood-lipid and inflammatory response indexes in patients with dyslipidemia,and does not increase adverse reactions,the effect is worthy of affirmation.
作者
黄程新
孙元隆
王肖龙
李琳
赵哲俊
阮小芬
HUANG Chengxin;SUN Yuanlong;WANG Xiaolong;LI Lin;ZHAO Zhejun;RUAN Xiaofen(Institute of Cardiovascular Diseases,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Sub-center of National Center for Clinical Medical Research on Cardiovascular Diseases,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《中国医药导报》
CAS
2023年第16期87-92,共6页
China Medical Herald
基金
国家自然科学基金面上项目(82174152、82074222)
国家重点研发计划项目(2019YFC1709901)
上海市中医临床重点实验室项目(14DZ2273200)
上海市临床重点专科建设项目(shslczdzk05301)。
关键词
血脂异常
META分析
荷丹片
随机对照试验
Dyslipidemia
Meta-analysis
Hedan Tablets
Randomized controlled trial
