血府逐瘀胶囊治疗冠心病心绞痛的Meta分析

Treatment of angina pectoris of coronary heart disease with Xuefu Zhuyu Capsules: a Meta-analysis

目的评价血府逐瘀胶囊治疗冠心病心绞痛的疗效和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library（2015年第11期）、CBM、CNKI、VIP和WanFang Data数据库,搜集血府逐瘀胶囊治疗冠心病心绞痛的随机对照试验（RCT）,检索时限均为从建库至2015年11月。由2位研究者独立按纳入排除标准进行文献筛选、资料提取和方法学质量评价,然后采用Stata 12.0软件进行Meta分析。结果最终纳入26个RCT,共2122例冠心病心绞痛患者。Meta分析结果显示,在心绞痛临床疗效方面,血府逐瘀胶囊联合西医常规治疗优于西医常规治疗（总有效率：RR=1.24,95%CI：1.17-1.32;显效率：RR=1.29,95%CI：1.11-1.51）,血府逐瘀胶囊联合硝酸酯类优于单用硝酸酯类（总有效率：RR=1.26,95%CI：1.15-1.38;显效率：RR=1.43,95%CI：1.07-1.91）,单用血府逐瘀胶囊优于单用硝酸酯类（总有效率：RR=1.11,95%CI：1.02-1.20;显效率：RR=1.28,95%CI：1.06-1.55）和单用复方丹参片（总有效率：RR=1.30,95%CI：1.18-1.44;显效率：RR=1.66,95%CI：1.20-2.30）;在心电图疗效方面,血府逐瘀胶囊联合西医常规治疗优于西医常规治疗（总有效率：RR=1.29,95%CI：1.17-1.42;显效率：RR=1.53,95%CI：1.23-1.91）,血府逐瘀胶囊联合硝酸酯类优于单用硝酸酯类（总有效率：RR=1.42,95%CI：1.19-1.70;显效率：RR=1.57,95%CI：1.07-2.31）,单用血府逐瘀胶囊优于单用复方丹参片（总有效率：RR=1.59,95%CI：1.34-1.88;显效率：RR=1.56,95%CI：1.11-2.18）,单用血府逐瘀胶囊与单用硝酸酯类的差异无统计学意义（总有效率：RR=1.05,95%CI：0.88-1.24;显效率：RR=1.60,95%CI：0.89-2.87）。试验组均未发现明显不良反应。结论血府逐瘀胶囊单用或联合西药可显著改善冠心病心绞痛患者的临床症状,且安全性好。由于纳入研究的质量和样本量的限制,该结论仍需进一步开展研究加以验证。

Objective To review the curative effect and safety of Xuefu Zhuyu Capsules in the treatment of angina pectoris of coronary heart disease（CHD）. Methods The databases of PubMed, EMbase, Cochrane Library（Issue 11, 2015）, CBM, CNKI, VIP and Wan Fang Data were retrieved with computer for collecting the randomized controlled trials（RCT） about the treatment of CHD angina pectoris with Xuefu Zhuyu Capsules from database establishment time to Nov. 2015. The literature was screened and data was extracted and given methodological quality evaluation by 2 researchers independently according to inclusion and exclusion criteria. The data was given a Meta-analysis by using Stata 12.0 software. Results There were totally 26 RCT included involved 2122 patients. The results of Meta-analysis showed that in curative effect on angina pectoris, Xuefu Zhuyu Capsules combining conventional therapy of Western medicine was superior to conventional therapy of Western medicine（total effective rate： RR=1.24,95%CI：1.17-1.32 and effective rate： RR=1.29,95%CI：1.11-1.51）; Xuefu Zhuyu Capsules combining nitrate esters drugs was superior to simple nitrate esters drugs（total effective rate： RR=1.26,95%CI：1.15-1.38 and effective rate： RR=1.43,95%CI：1.07-1.91）; and simple Xuefu Zhuyu Capsules was superior to simple nitrate esters drugs（total effective rate： RR=1.11,95%CI：1.02-1.20 and effective rate： RR=1.66,95%CI：1.20-2.30）, and to simple Fufang Danshen Pian（total effective rate： RR=1.30,95%CI：1.18-1.44 and effective rate： RR=1.66,95%CI：1.20-2.30）. Xuefu Zhuyu Capsules combining nitrate esters drugs was superior to simple nitrate esters drugs in ECG manifestations（total effective rate： RR=1.29,95%CI：1.17-1.42 and effective rate： RR=1.53,95%CI：1.23-1.91）; Xuefu Zhuyu Capsules combining nitrate esters drugs was superior to simple nitrate esters drugs（total effective rate： RR=1.42,95%CI：1.19-1.70 and effective rate： RR=1.57,95%CI：1.07-2.31）, and Simple Xuefu Zhuyu Capsules was superior to simple Fufang Danshen Pian（total effective rate： RR=1.59,95%CI：1.34-1.88 and effective rate： RR=1.56,95%CI：1.11-2.18）. The difference between simple Xuefu Zhuyu Capsules and simple nitrate esters drugs had no statistical significance（total effective rate： RR=1.05,95%CI：0.88-1.24 and effective rate： RR=1.60,95%CI：0.89-2.87）. There were no adverse reactions observed in all test groups. Conclusion Simple Xuefu Zhuyu Capsules or Xuefu Zhuyu Capsules combining Western drugs can significantly relieve clinical symptoms in patients with CHD angina pectoris with higher safety. As this analysis has limited quantity and quality in RCT, more studies are needed to verify the conclusion further.