麝香保心丸改善冠心病血流介导内皮舒张功能(FMD)系统综述与Meta分析

Meta Analysis of Improving Flow-Mediated Dilation(FMD) of Coronary Heart Disease with Shexiang Baoxin Pill

[背景]麝香保心丸治疗冠心病疗效确切。[目的]采用Meta分析方法评价麝香保心丸改善冠心病患者FMD疗效及安全性及对内皮功能的影响。[检索策略]计算机检索Pubmed、Wanfang、CNKI、CBM、VIP等数据库。检索时限均为建库至2016年9月30日。[纳入标准](1)研究设计:麝香保心丸治疗冠心病临床随机对照试验(RCT),语言限于中、英文。(2)观察对象:明确诊断冠心病,符合《慢性稳定性心绞痛诊断与治疗指南》。(3)干预措施:对照组按慢性稳定性心绞痛治疗指南抗血小板、调脂、抗缺血等常规治疗;实验组加服麝香保心丸。(4)结局指标:FMD。[数据收集与分析]由2名评价者按照纳入标准和排除标准独立选择试验、提取资料,交叉核对并评估文献质量,不同之处交流解决。采用资料提取表,提取内容:基线情况、干预措施、疗程等。[主要结果]初筛共获得文献201篇,逐层筛选,最终纳入文献共8篇。森林图显示麝香保心丸组FMD改善优于对照组(P<0.00001)。漏斗图分析显示对称,提示发表性偏倚较小。[问题与展望]现有证据显示麝香保心丸对内皮功能改善临床疗效显著,不良反应少。纳入文献Juni评分较低,期待更多设计严格的RCT进一步评价。

[Background] Shexiang Baoxin Pill is effective in treating coronary heart disease. [Objective] To prove Shexiang baoxin pill improve endothelial function by evaluating the efficacy and safety in improving FMD of coronary heart disease. [Retrieval strategy] Computer retrieval the Pubmed/Wan fang Date/CNKI/ CBM/VIP by September 30, 2016. [Inclusion criteria]（1）research design： Clinical Randomized Controlled Trials （RCT） of Shexiang Baoxin Pill cure Coronary Heart Disease, Language Limited to Chinese and English.（2）observation object： Clear diagnosis of coronary heart disease, in line with ＂chronic stable angina diagnosis and treatment guidelines＂.（3）Intervention measures ： The control group according to the guidelines for the treatment of chronic stable angina antiplatelet, lipid, anti-ischemic and other conventional treatment; The experimental group plus Shexiang Baoxin Pill.（4）outcome indicators： FMD. [Data collection and analysis] 2 evaluators according to include and exclude standard independent choice test, extract data, and cross check the quality of literature evaluation,communicating in differences. Extract content： baseline, interventions, treatment and so on by data extraction table. [Major results] A total of 201 articles were screened , and 8 were finally included in the literature. The results showed that the improvement of FMD was better than that of the control group （e〈0.00001）. The funnel diagram shows symmetry, suggesting that the publication bias is small. [Problems and prospects] The available evidence shows that Shexiang Baoxin Pill has a significant clinical effect on endothelial function improvement and less adverse reactions. Incorporated Juni scored lower and looked forward to more rigorous RCTs for further evaluation.