瓜蒌皮注射液联合常规用药治疗心绞痛的系统评价

Pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris:a meta-analysis

目的系统评价瓜蒌皮注射液联合常规用药治疗心绞痛的有效性和安全性。方法计算机检索CBM、CNKI、Wan Fang Data、VIP、Pub Med、The Cochrane Library(2017年2期)和Web of Science数据库,搜集瓜蒌皮注射液联合常规用药治疗心绞痛的随机对照试验(RCT),检索时限均从建库至2017年2月20日。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行数据分析。结果共纳入10个RCT,涉及1 004名心绞痛患者。Meta分析结果显示:联合瓜蒌皮注射液在改善心绞痛症状[RR=1.24,95%CI(1.15,1.33),P<0.000 01]和静息心电图[RR=1.30,95%CI(1.15,1.45),P<0.000 1]方面优于对照组。与对照组相比,联合治疗组的不良反应发生更少,程度更轻。结论瓜蒌皮注射液联合常规治疗与常规治疗相比,可改善心绞痛症状及心电图指标。由于纳入文献质量普遍较低,证据强度不足,上述结论仍需要通过多中心、大样本、双盲随机对照试验研究提供高级别证据予以验证。

Objective To systematically review the efficacy and safety of combined with conventional western medicine for angina pectoris. Methods pericarpium trichosanthis injection Databases including CBM, CNKI, WanFang Data, VIP, PubMed, The Cochrane Library and Web of Science were searched from inception to February 20th 2017 to collect randomized controlled trials （RCTs） about pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 10 RCTs involving 1 004 patients were included. The results of meta-analysis showed that： the effective rate of angina symptoms （RR=1.24, 95%CI 1.15 to 1.33, P〈0.000 01） and resting ECG （RR=I.30, 95%CI 1.15 to 1.45, P〈0.000 1） in pericarpium trichosanthis injection combined with conventional western medicine group were superior to the conventional western medicine group. And the adverse reaction was rare and could be more tolerated in pericarpium trichosanthis injection combined with conventional western medicine group. Conclusion Pericarpium trichosanthis injection combined with conventional western medicine can improve the symptoms of angina pectoris and objective indicator of ECG. However, due to the low quality of included studies and lack of evidence, the above results are needed to be validated by further well-designed multicenter, large scale, double blind RCTs.