瓜蒌皮注射液治疗心绞痛安全性和有效性的Meta分析

Efficacy and safety of Trichosanthes kirilowii Maxim Injections in the treatment of coronary heart disease

目的评价瓜蒌皮注射液用于治疗心绞痛的安全性和有效性。方法计算机检索中国知网(CNKI)数据库,万方(Wanfang)数据库,维普(VIP)数据库,PubMed数据库和Medline数据库,采用Cochrane Handbook推荐的标准对纳入文献进行质量评价;使用RevMan 5.1进行Meta分析。选取心绞痛治疗显效率、心绞痛发作次数和持续时间、心电图疗效结果、心电图ST-T段改变、不良反应作为观察指标。结果本研究纳入10项随机对照临床试验,共1 345例。心绞痛治疗显效率[OR=2.03,95%CI(1.60,2.57),P<0.01],心电图显效率[OR=1.64,95%CI(1.10,2.42),P=0.01],心绞痛发作次数[MD=-0.59,95%CI(-0.74,-0.44),P<0.01],心电图ST段下移[MD=-0.68,95%CI(-1.28,-0.09),P=0.02]治疗组均优于对照组,心绞痛持续时间[MD=2.56,95%CI(-0.11,5.22),P=0.06]和不良反应[OR=1.06,95%CI(0.56,2.00),P=0.85]差异无统计学意义。结论瓜蒌皮注射液改善心绞痛症状显著,对心电图改善亦有一定的效果。鉴于纳入研究质量低、样本量小,上述结论需严格设计的大样本随机对照试验证实。

Objective To evaluate the efficacy and safety of Trichosanthes kirilowii Maxim Injections in the treatment of coronary heart disease.Methods Wanfang,VIP,CNKI,PubMed and Medline database were searched and analyzed.The quality of included trials was evaluated by the criterion in Cochrane Handbook.Meta-analysis was conducted by using RevMan 5.1.The results of angina symptoms,ECG ST-T period of change,the change of hemorheology and adverse reactions were recorded.Results The study included 10 randomized controlled clinical trials,a total of 1 345 cases of patients.In the respect of angina significant efficiency[OR=2.03,95% CI（1.60,2.57）,P〈0.01],ECG significant efficiency[OR=1.64,95% CI（1.10,2.42）,P=0.01],angina frequency[MD=-0.59,95% CI（-0.74,-0.44）,P〈0.01],and ST segment down[MD=-0.68,95% CI（-1.28,-0.09）,P=0.02],the treatment group was better than the control group.The duration of angina was[MD=2.56,95% CI（-0.11,5.22）,P=0.06]and the adverse reactions[OR=1.06,95% CI（0.56,2.00）,P=0.85]showed no statistically significant.Conclusion Trichosanthes kirilowii Maxim Injections improves the symptoms of angina significantly and also has a certain effect on the improvement of electrocardiogram.