速效救心丸与消心痛治疗冠心病心绞痛效果比较的Meta分析

Efficacy of Suxiaojiuxinwan vs.Isosorbide Dinitratein patients with angina pectoris: a meta-analysis

目的：采用Meta分析的方法评价速效救心丸与消心痛对比治疗冠心病心绞痛的疗效。方法检索数据库SinoMed、CNKI、VIP、万方、MEDLINE、EMBASE、Cochrane Library以及相关网站数据资源，截止检索日期为2014年8月31日。两名评价者平行独立筛选文献和提取信息，采用JADAD量表评价纳入文献质量，由第三人进行核查。采用Cochrane 协作网提供的Review Manager 5.3软件进行数据处理分析。结果符合纳入标准的文献共24篇，干预组总人数为1704人，对照组为1302人。Meta分析结果显示：速效救心丸治疗冠心病心绞痛患者的症状疗效总有效率优于消心痛（OR=2.84，95%CI：2.15~3.76， P＜0.05）；在心电图改善方面疗效速效救心丸也优于消心痛，有统计学意义（OR=1.67，95%CI：1.35~2.07，P＜0.05）。结论速效救心丸在缓解冠心病心绞痛症状以及心电图改善方面可能优于消心痛。但考虑文献质量和发表偏倚等因素，本系统评价的结果尚待大样本的随机双盲临床试验以及高质量的真实研究加以证实。

Objective To evaluate the efficacy of Suxiaojiuxinwanin comparison with IsosorbideDinitratein patients with angina pectoris. Methods Medline, Embase,the Cochrane library and four Chinese databases including VIP, SinoMed, CNKI and wanfang, were systematically searched from inception through August 31th, 2014 with the keywords including＂suxiaojiuxinwan＂for patients with angina of coronary heart disease. Relevant information was extracted and data was analyzed using random-effects model. Results 24eligible trials in total were included in our review, involving 1704 cases in intervention groups and 1302 cases incontrol groups. Theoverall incidence of symptom alleviationwassignificantly higher in the patients taking Suxiaojiuxinwanthan IsosorbideDin itrate（OR=2.84,95%CI：2.15~3.76, P〈0.05）.Significant difference was also found in theelectrocardiogram（ ECG）improvement between Suxiaojiuxinwan and IsosorbideDinitrate （OR=1.67, 95%CI：1.35~2.07,P〈0.05）. Conclusion The efficacy of Suxiaojiuxinwanmay be better than IsosorbideDinitrate in improving symptom and ECG among patients with angina pectoris.Due to probable publication bias and low quality of included articles, the conclusion of the systematic review need to be proved by large-scale clinical trials and comparative effectiveness researchof high methodological quality.