丹红注射液对冠心病心绞痛患者血液流变学影响的系统评价

Systematic Review of the Effect of Danhong Injection on Hemorheology in Patients with Angina Pectoris in Coronary Heart Disease

目的:系统评价丹红注射液对冠心病心绞痛患者血液流变学的影响,以为临床治疗提供循证参考。方法:计算机检索Pub Med、EMBase、Medline、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库和万方数据库,并手工检索相关文献,收集常规治疗加用丹红注射液对比常规治疗对冠心病心绞痛患者血液流变学影响的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取和质量评价后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入12项RCT,合计1 160例患者。Meta分析结果显示,在常规治疗的基础上加用丹红注射液能更有效地改善冠心病心绞痛患者全血高切黏度[MD=-0.87,95%CI(-1.24,-0.50),P<0.001]、全血低切黏度[MD=-2.43,95%CI(-3.99,-0.87),P=0.002]、红细胞比容[MD=-0.05,95%CI(-0.10,-0.00),P=0.04]、血浆黏度[MD=-0.58,95%CI(-0.78,-0.38),P<0.001]及纤维蛋白原水平[MD=-1.06,95%CI(-1.65,-0.47),P<0.001],与常规治疗比较,差异均有统计学意义。结论:在常规治疗基础上加用丹红注射液对冠心病心绞痛患者血液流变学相关指标有改善作用。受纳入研究的方法学质量和样本量限制,该结论有待更多设计严格、长期随访的大样本RCT加以验证。

OBJECTIVE： To systematically review the effect of Danhong injection on hemorhelogy in patients with angina pec- toris in coronary heart disease （CHD）, and provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed, EMBase, Medline, Cochrane Library, CJFD, VIP database, Wanfang database, and retrieved relevant literatures manual- ly, the randomized controlled trials （RCT） about the effect of Danhong injection on hemorhelogy in patients with angina pectoris in CHD were collected. After the quality evaluation and information collection of clinical studies with inclusion criteria, Meta-analy- sis was conducted by using Rev Man 5.2 software. RESULTS： A total of 12 RCT were enrolled, involving 1 160 patients. Results of Meta-analysis showed the conventional treatment of Danhong injection could more effectively improve the high blood viscosity [MD = -- 0.87,95 % CI （ -- 1.24, -- 0.50 ）, P〈 0.001 ], low blood viscosity[MD = -- 2.43,95 % CI （ -- 3.99, -- 0.87 ）, P = 0.002], hemato- crit value[MD = -- 0.05,95 % CI （ -- 0.10, -- 0.00）, P= 0.04], plasma viscosity[MD = -- 0.58,95 % CI （ -- 0.78, -- 0.38 ）, P〈 0.001 ] and fibrinogen level[MD = -- 1.06,95 % CI （ -- 1.65, -- 0.47）, P〈 0.001], compared with convertional treatment, there were significant dif- ferences. CONCLUSIONS： Based on the conventional treatment, Danhong injection has improvement effect on the related indica- tors of hemorhelogy in patients with angina pectoris in CHD. Due to the limit of methodological quality and sample size, it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.