阿司匹林联合活血化瘀类中药对阿司匹林抵抗疗效的Meta分析

Aspirin Combined Kind of Chinese Traditional Medicine for Activating Blood Circulation and Removing Stasis to Aspirin Resistance Effect of Meta Analysis

目的系统评价阿司匹林联合活血化瘀中药治疗阿司匹林抵抗的有效性和安全性。方法检索有关阿司匹林联合活血化瘀中药与单独使用阿司匹林治疗阿司匹林抵抗的随机对照试验(randomized controlled trials,RCTs);筛选符合纳入标准的RCTs,依据Jadad评分进行文献的质量评价,并采用Rev Man5.3软件进行Meta分析。结果共纳入6篇文献,Meta分析结果显示:在改善ADP诱导的血小板聚集率方面,[SMD=-1.78,95%(-2.95,-0.61),P<0.003];在改善AA诱导的血小板聚集率方面,[SMD=-2.31,95%(-3.41,-1.21),P<0.0001];在不良反应方面,[R=0.26,95%(0.02,3.13),P>0.05];在终点事件方面,[R=0.26,95%(0.05,1.35),P>0.05]。结论联合活血化瘀中药较单独使用阿司匹林可显著降低血小板聚集率,改善患者的阿司匹林抵抗,且安全性好。

Objective To systematically review the efficacy and safety of aspirin combined kind of Chinese traditional medicine for activating blood circulation and removing stasis for aspirin resistance（AR）. Methods All the randomized controlled trials（RCTs） that used aspirin combined kind of Chinese traditional medicine for activating blood circulation and removing stasis and aspirin only for aspirin resistance（AR） were retrieved. Jadad score was used for quality evaluation. Rev Man 5.3 was applied for analysis. Results Sis RCTs met the inclusion criteria. The result of meta-analysis showed in the terms of rate of the platelet aggregation induced by ADP, [SMD=-1.78,95%（-2.95,-0.61）,P〈0.003],in the terms of rate of the platelet aggregation induced by AA, [SMD=-2.31,95%（-3.41,-1.21）,P〈0.0001],in terms of the adverse reaction, [R=0.26,95%（0.02,3.13）,P〉0.05],and in terms of the endpoint of events, [R=0.26,95%（0.05,1.35）,P〉0.05]. Conclusion The present meta-analysis suggests that combining kind of Chinese traditional medicine for activating blood circulation and removing stasis is helpful to reduce the platelet agggation rate and improve AR with reliable safety.