益气活血方药配伍治疗冠心病的Meta分析

Prescription for reinforcing qi and activating blood in treatment of coronary heart diseases: a meta-analysis

目的评价益气活血方药协同治疗冠心病的临床疗效、疗程及安全性。方法检索PubMed、MEDLINE、web of science(SCI)和CBM、CNKI、VIP等数据库,并手工检索相关文献。运用RevMan 5.3软件对提取的有效数据进行Meta分析。结果共纳入21项随机对照临床试验(RCT),合计3 306例研究对象。Meta分析结果显示:(1)中西结合组(益气活血方药联合西医常规治疗)与西医常规组(单纯的西医常规治疗)相比,其临床总疗效、心电图疗效和心绞痛疗效合并OR[95%CI]值分别为3.67[2.77,4.87]、1.86[1.42,2.44]和2.73[1.75,4.27],均优于西医常规组,差异存在统计学意义(P<0.05)。(2)以30 d为分界,疗程28~30 d的文献占50%,从结果分析发现28~30 d组临床总疗效与>30 d的总疗效相当。(3)对纳入研究的3 306例冠心病病例进行不良反应/事件观察,中西结合组共出现2例不良反应/事件,均为胃部不适感,而西医常规组出现4例不良反应/事件,多为头晕、头胀、面红等。结论在西医常规治疗基础上加用益气活血方药配伍治疗冠心病,在临床总疗效、心绞痛疗效和心电图疗效等方面,优于单纯的西医常规治疗,安全性较好。

AIM To evaluate the curative effect and safety of prescription for reinforcing qi and activating blood in treatment of coronary heart disease （CHD）. METHODS Studies were identified by searching PubMed, MEDLINE, and Web of Science （SCI）, CBM, CNKI and VIP databases. RevMan 5.3 software was used to extract the effective data for recta-analysis. RESULTS （）Twenty-one RCT studies were iden- tified, including 3 306 patients. Compared with the Western medicine group （conventional Western medi- cine treatment）, gross curative effect, electrocardiogram curative effect and angina pectoris curative effect with OR （95% CI） of the Chinese traditional medicine combined with the Westen medicine group （pre- scription for reinforcing qi and activating blood combined with conventional Western medicine treatment ） were 3.67[2. 77,4. 87J, 1.86[ 1.42,2. 44] and 2. 73[ 1.75,4. 27], respectively, which were statistically significant. Using 30 days as a separation time-point, the studies of the therapeutic period of 28 - 30 days accounted for 50%. Subgroup analyses of courses about gross curative effect showed that the therapeu- tic period of 28 -30 days was as effective as that of 〉 30 days in treating CHD. Adverse drug reactions/ events of the 3 306 patients enrolled with CHD were observed, with two cases of abdominal discomfort in the Chinese traditional medicine group combined with the Western medicine group vs. four cases mainlycharacterized by dizziness, headache, flushing, etc. in the Western medicine group. CONCLUSION Combination of reinforcing qi and activating blood prescription and basal conventional Western medicine in the treatment of CHD is superior to the latter alone in terms of total clinical efficacy and curative effects in angina peetoris and electrocardiogram as well as demonstrating a superior safety profile.