通心络胶囊联合曲美他嗪治疗不稳定型心绞痛的Meta分析

Tongxinluo capsule combined with trimetazidine for treating unstable angina pectoris: a meta-analysis

目的评价通心络胶囊联合曲美他嗪治疗不稳定型心绞痛的疗效和安全性。方法计算机检索Pub Med、MEDLINE、Cochrane图书馆、CNKI、万方医学数据库、维普中文科技期刊数据库等从1990到2014年收入的文献,对其中通心络胶囊联合曲美他嗪治治疗不稳定型心绞痛的随机对照试验进行质量评价后采用Rev Man5.1软件进行Meta分析。结果共纳入9篇符合条件文献702例。经异质性检验发现各研究结果具有同质性(P=0.98,I2=0),故选择固定效应模型合并进行两组疗效的Meta分析。Meta分析结果显示,试验组临床疗效优于对照组,总效应Z=6.28(P<0.01),OR及其95%可信区间4.12(2.65,6.41)。漏斗图分析结果显示两组疗效Meta分析结果存在偏倚的可能性较小。其中2篇文献进行了心电图评价,试验组心电图改善情况优于对照组,总效应Z=2.69(P=0.007),OR及95%可信区间2.14(1.78,4.76)。Meta分析结果显示两组治疗不稳定型心绞痛药物不良反应发生率无明显差别。结论在常规治疗基础上联合应用通心络胶囊和曲美他嗪可明显改善心绞痛症状,且两组药物不良反应发生率相似。

Objective To evaluate the effectiveness and safety of tongxinluo capsule combined with trimeta-zidine in treating unstable angina pectoris. Methods Randomized controlled trials （RCT） about tongxinluo capsule combined with trimetazidine in treating unstable angina pectoris between the year 1990 and 2014 were collected from the database of PubMed, MEDLINE, Cochrane library, CNKI, Wan Fang medicine database and VIP full-text data-base. And meta-analysis were performed after the quality assessment of the RCTs. Results A total of 9 literatures with 702 cases were selected. The heterogeneity inspection showed that the research findings were homogeneous （P=0.98, I2=0）, therefore the fixed effects model merging two groups of curative effect were choosed for meta-analysis. The meta-analysis showed that the curative effect of experimental group was better than that of control group. The to-tal effect was Z=6.28 （P〈0.01）, OR and 95%CI=4.12 （2.65, 6.41）. And the funnel chart analysis showed that the me-ta-analysis results were less likely to be biased. Two literatures showed that the improvement of electrocardiogram in experimental group were better than that of control group, with the total effect Z=2.69 （P=0.007）, OR and 95%CI=2.14 （1.78, 4.76）. Meta-analysis showed that there were no significant differences between the incidence of adverse drug reactions of two groups. Conclusion The administration of tongxinluo capsule and trimetazidine on the basis of routine treatment for unstable angina pectoris can obviously improve the symptoms of angina pectoris, with similar in-cidence of adverse drug reactions.