血浆同型半胱氨酸与冠心病痰浊血瘀证候相关性研究的Meta分析

Meta-analysis of Research on Correlation of Homocysteine with Phlegm Turbidity and Blood Stasis Syndrome of Coronary Heart Disease

目的:综合评价同型半胱氨酸(Hcy)与冠心病中医辨证中痰浊、血瘀的关系,为研究冠心病中医证型客观化指标提供参考。方法:计算机检索中国期刊网全文数据库、中国生物医学文献数据库、维普数据库、万方数据库,以及Pub Med数据库、Medline数据库等公开发表的文献或收录的学位论文中有关冠心病中医证型痰浊证、血瘀证与Hcy关系的病例对照研究。采用Rev Man5.0软件进行Meta分析。结果:共纳入9个研究,包括969例研究对象。结果显示血瘀证组Hcy水平明显高于正常对照组,差异有统计学意义[WMD=9.19,95%CI(7.49,10.89),P<0.01];痰浊证组Hcy水平明显高于正常对照组,差异有统计学意义[WMD=8.61,95%CI(7.90,9.31),P<0.01]。结论:冠心病痰浊证和血瘀证与高水平Hcy有密切相关性。受原始研究诊断标准不统一,纳入原始研究质量和数量的限制,上述结论需进一步高质量大样本研究予以验证。

Objective：To comprehensively evaluate the correlation of homocysteine（Hcy）with phlegm turbidity and blood stasis of coronary heart disease in syndrome differentiation of Chinese medicine in order to provide a reference for Chinese medicine syndrome objective index of coronary heart disease.Methods：Searched published literature or included dissertations for case-control studies on correlation of phlegm turbidity syndrome and blood stasis syndrome in Chinese medicine syndrome of coronary heart disease with Hcy in Chinese Journal Full-test Database,Chinese Biological Medical Disc,VIP Database,Wanfang Database,PubMed Database,Medline Database and so on.Meta-analysis was conducted via RevMan5.0 software.Results：Nine studies were included,including 969 cases of study subjects.The result showed that Hcy levels in the blood stasis syndrome group were obviously higher than those in the normal control group,the difference being significant[WMD=9.19,95% CI（7.49,10.89）,P 0.01].Hcy levels in the phlegm turbidity syndrome group were obviously higher than those in the normal control group,the difference being significant[WMD=8.61,95% CI（7.90,9.31）,P 0.01].Conclusion：The phlegm turbidity syndrome and blood stasis syndrome of coronary heart disease have a close correlation with Hcy of high level.Limited by the discordance of criteria in original studies and by the quality and quantity of original selected studies,the above conclusions need to be further verified by large sample studies of higher quality.