PCI术后益气活血中成药联用西药患者心血管相关指标Meta分析

A Meta-analysis of the influence of Yiqihuoxue-Chinese-medicine combined with western medicine to the cardiovascular indicators in treatment of coronary heart disease after pecutaneous coronary intervention

目的系统评价益气活血中成药联合西药治疗冠心病经皮冠状动脉介入(PCI)后患者的心血管指标变化,为冠心病PCI术后患者的临床治疗提供指导意见。方法采用Meta分析对数据库中从建库时间至2016年5月发表的益气活血中成药联合西药治疗冠心病PCI术后患者的随机对照试验进行系统评价。评价指标包括血管再狭窄例数和检测指标[心肌钙蛋白I(CTn I),氨基末端B型利钠肽原(NTpro-BNP),总胆固醇(TC),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C)]。结果纳入27篇文献,共4 873例患者。各研究基线资料具有可比性,均报道为随机方法。荟萃分析结果显示,益气活血中成药联合常规西药治疗组患者的下列指标明显优于常规西药单独治疗组:再狭窄发生例数[OR=0.61,95%CI(0.46,0.81),Z=3.2.82,P=0.005],NTpro-BNP[MD=-202.6,95%CI(-294.20,-111.72),Z=4.36,P<0.0001],TC[MD=-0.59,95%CI(-0.81,-0.36),Z=5.05,P<0.00001],TG[MD=-0.37,95%CI(-0.68,-0.06),Z=2.34,P=0.02],HDLC[MD=0.09,95%CI(-0.01,0.19),Z=1.72,P=0.09],LDLC[MD=-0.62,95%CI(-0.97,-0.27),Z=3.49,P=0.0005]。结论益气活血中成药联合西药明显优于常规西药单独治疗冠心病PCI术后患者。

Objective To systematically evaluate the clinical effects of Yiqihuoxue - Chinese - medicine in treatment of coronary heartdisease after pecutaneous coronary intervention （PCI）. Methods All the randomized controlled trials （RCT） on treatment of coronary heart diseaseafter PCI were retrieved from the data base. Several medical indicators were analyzed by Meta - analysis, including restenosis rate and cardiovascularindicators （ CTnl, NTpro - BNP, TC , TG, HDL - C , LDL - C）. Results 27 papers and 4 873 patients were enrolled in the study. Meta- analysis results significant rate of restenosis rate [ OR - 0 .6 1 ,9 5 % C I（0 .4 6 ,0 .8 1 ）,Z - 3 .4 5 ,P - 0. 0006] , CTnI[ MD - - 0. 44 , 95%Cl （ -0 .7 5 , -0 .1 4 ） , Z -2 .8 2 , P -0 .0 0 5] , NTpro - BNP[MD - -2 0 2 .6 , 95% Cl （ -2 9 4.20 , -1 1 1.72 ） , Z -4 .3 6 , P 〈 0.0001],TC[M D- -0 .5 9 , 95% Cl （ -0 .8 1 , -0 .3 6 ） , Z -5 .0 5 , P 〈0.00001] , TG[M D- -0 .3 7 , 95%CI （ -0 .6 8 , -0 .0 6 ） , Z -2 .3 4 , P -0.02] , HDLC[M D-0.09, 95% Cl （ -0 .0 1 , 0.19） , Z - 1.72, P -0 .0 9 ] , LDLC[MD- -0 .6 2 , 95% Cl （ -0 .9 7 , -0 .2 7 ） , Z -3 .4 9 ,P = 0. 0005 ]. Conclusion The combination of Yiqihuoxue - Chinese - medicine with western medicine was significantly effective than westernmedicine alone in the treatment of coronary heart disease after PCI patients.