川芎嗪对心肌缺血再灌注损伤防治作用的系统评价与Meta分析

Preventive and therapeutic effects of ligustrazine on myocardial ischemia-reperfusion injury: a systematic review and Meta-analysis

目的：系统评价川芎嗪对心肌缺血再灌注损伤防治作用的疗效和安全性。方法计算机检索CBM、CNKI、维普数据库和谷歌学术搜索，收集川芎嗪对心肌缺血再灌注防治作用的随机对照试验（RCT），检索时限均为建库至2014年1月。由两名研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后，采用RevMan 5.2软件进行Meta分析。结果最终纳入23个RCT共1984例患者。Meta分析结果显示：川芎嗪组对心肌缺血再灌注损伤所致临床症状改善明显优于对照组3.01倍（OR=3.01，95%CI：2.35-3.86）。有5个RCT报道了川芎嗪组发生了不良事件，主要是腹胀、恶心、凝血时间延长等，12个RCT明确提及无严重不良事件发生，6个RCT未报道药物不良反应的相关信息。结论基于当前证据，川芎嗪具有防治心肌缺血再灌注损伤作用，且严重不良反应少。受纳入研究质量与数量限制，上述结果尚待更多和更高质量研究进一步证实。

Objective To review systematically the preventive and therapeutic effects of ligustrazine on myocardial ischemia-reperfusion injury.Methods The databases of CBM, CNKI, VIP Database and Google Scholar were retrieved for collecting the randomized controlled trials （RCT） about the preventive and therapeutic effects of ligustrazine on myocardial ischemia-reperfusion injury from database establishment time to Jan. 2014. The data was screened according to inclusion and exclusion criteria, extracted and given quality reviewe by 2 researchers independently, and then given Meta-analysis by applying RevMan 5.2 software.Results There were totally 23 RCT included involving 1984 cases, and the results of Meta-analysis showed that the relieving rate of clinical symptoms was increased by 3.01 times in ligustrazine group than that in control group [OR=3.01, 95%CI=（2.35-3.86）]. In ligustrazine group, 5 RCT reported adverse events including mainly abdorminal distention, nausea and prolonged thrombin time, 12 RCT denied serious adverse events, and 6 RCT did not report drug adverse reactions.Conclusion Based on present evidence, ligustrazine has preventive and therapeutic effects on myocardial ischemia-reperfusion injury. As this analysis has limited quantity and quality, more large-sample RCT with higher quality are required for further identifying the results.