从“络瘀”论改善冠心病血管内皮功能的Meta分析

Meta Analysis on the Improvement of Vascular Endothelial Function in Coronary Heart Disease Based on the Theory of “Collateral Stagnation”

目的系统评价从"络瘀"论改善冠心病血管内皮功能的有效性。方法检索Pub Med、Embase、中国知网(CNKI)、重庆维普数据库(VIP)、万方数据库(Wan Fang Data)中活血化瘀通络法改善冠心病血管内皮功能的临床随机对照试验的文献,对符合纳入标准的文献,提取资料及评价质量后,采用Rev Man5.3软件进行Meta统计分析。结果按照相关标准共筛选出随机临床试验9项,纳入患者891例。Meta分析结果显示:活血化瘀通络组在降低冠心病患者血浆内皮素水平[WMD=-11.48,95%CI(-14.13,-8.84),P<0.000 01],降低血浆内皮素-1水平[WMD=-8.11,95%CI(-9.06,-7.16),P<0.000 01],和提高血浆一氧化氮水平[WMD=6.03,95%CI(2.32,9.73),P=0.001]方面均优于对照组,差异具有统计学意义。结论现有证据显示,活血化瘀通络法可有效改善冠心病患者血管内皮功能,但需更多高质量的多中心大样本随机双盲对照试验加以验证。

Objective To review systematically the effectiveness of the improvement of vascular endothelial function of coronary heart disease based on the theory of＂collateral stagnation＂. Methods The literatures were retrieved from Pub Med,Embase,CNKI,VIP and Wanfang Data on the clinical randomized controlled trials（ RCTs） for the improvements of vascular endothelial function of coronary heart disease with the therapy for activating blood circulation,resolving stasis and promoting the circulation in collaterals. The data were extracted and assessed from the literatures which met the inclusive criteria. Afterwards,Rev Man5. 3 software was used for Meta analysis statistically. Results According to the relevant criteria,a total of 9 RCTs were screened,including 891 patients. Meta analysis showed in the group with the treatment for activating blood circulation,resolving stasis and promoting the circulation in collaterals,the plasma endothelin level[WMD=-11. 48,95% CI（-14. 13,-8. 84）,P 0. 000 01],the plasma endothelin-1[WMD =-8. 11,95% CI（-9. 06,-7. 16）,P 0. 000 01]were reduced,the level of plasma nitric oxide[WMD = 6. 03,95% CI（ 2. 32,9. 73）,P = 0. 001]was increased. These results were better than the control group,indicating the significant differences. Conclusion The evidences show that the therapy for activating blood circulation,resolving stasis and promoting the circulation in collaterals effectively improves the vascular endothelial function in the patients of coronary heart disease. But,more high-quality,multi-central,large-sample and double-blinded RCTs are required for further verification.