摘要
目的:系统评价中药复方联合尼可地尔改善微血管性心绞痛的有效性和安全性。方法:计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、the Cochrane Library、EMbase等数据库中公开发表的中药复方联合尼可地尔治疗微血管性心绞痛的随机对照试验,检索时限为建库至2022年9月。由两名研究者独立进行文献筛选、资料提取和质量评价,应用RevMan 5.4及TSA 0.9Beta版软件进行Meta分析和试验序贯分析。结果:共纳入13项临床研究,涉及1134例病人。Meta分析结果显示:治疗组提高临床总有效率[RR=1.23,95%CI(1.15,1.31),P<0.00001],减少心绞痛发作频率[SMD=-2.51,95%CI(-3.51,-1.52),P<0.00001]和持续时间[SMD=-1.10,95%CI(-1.36,-0.85),P<0.00001],提高血清一氧化氮浓度[SMD=2.53,95%CI(1.77,3.30),P<0.00001],降低内皮素-1[SMD=-1.89,95%CI(-2.09,-1.70),P<0.00001]、超敏C反应蛋白[MD=-2.38,95%CI(-2.72,-2.03),P<0.00001]、白细胞介素-1[MD=-33.81,95%CI(-46.65,-20.97),P<0.00001]和白细胞介素-6[SMD=-5.20,95%CI(-5.89,-4.51),P<0.00001]均优于对照组,未增加药物不良反应[RR=0.88,95%CI(0.26,3.01),P=0.84],具有一定的安全性。结论:现有证据表明,中药复方联合尼可地尔治疗微血管性心绞痛具有较好的临床疗效和一定的安全性。
Objective:To systematically evaluate the efficacy and safety of Chinese herbal compound with nicorandil for the treatment of microvascular angina.Methods:The randomized controlled trials of Chinese herbal compound with nicorandil in the treatment of microvascular angina were searched in the CNKI,WanFang,VIP,China Biomedical Literature Database,PubMed,the Cochrane Library,EMbase,and other databases from the establishment of the database to September 2022.Literature screening,data extraction,and quality assessment were conducted independently by two researchers,RevMan 5.4 and TSA 0.9Beta software were used for Meta-analysis and sequential analysis.Results:A total of 13 literatures were included,including 1134 patients.The results of Meta-analysis showed that compared with the control group,the clinical efficacy(RR=1.23,95%CI 1.15-1.31,P<0.00001)was better in the treatment group,the frequency of angina attacks(SMD=-2.51,95%CI-3.51--1.52,P<0.00001)and duration(SMD=-1.10,95%CI-1.36--0.85,P<0.00001)decreased,serum nitric oxide concentration(SMD=2.53,95%CI 1.77-3.30,P<0.00001)increased,endothelin-1(SMD=-1.89,95%CI-2.09--1.70,P<0.00001),hypersensitive C-reactive protein(MD=-2.38,95%CI-2.72--2.03,P<0.00001),interleukin-1(MD=-33.81,95%CI-46.65--20.97,P<0.00001)and interleukin-6(SMD=-5.20,95%CI-5.89--4.51,P<0.00001)decreased,without increasing adverse drug reactions(RR=0.88,95%CI 0.26-3.01,P=0.84),with a certain degree of safety.Conclusion:The current evidence suggested that Chinese herbal compound with nicorandil in the treatment of microvascular angina showed better clinical efficacy and definite safety had better clinical efficacy and safety.
作者
周莉君
杨洛琦
余林波
谢连娣
ZHOU Lijun;YANG Luoqi;YU Linbo;XIE Liandi(Beijing University of Medicine,Beijing 100029,China)
出处
《中西医结合心脑血管病杂志》
2023年第24期4475-4482,共8页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
国家自然科学基金项目(No.81273692)。
