地奥心血康胶囊治疗心绞痛有效性与安全性的Meta分析

Meta analysis on efficacy and safety of Di'ao Xinxuekang Capsules for treatment of angina pectorisby

应用Meta分析法评价地奥心血康胶囊(心血康)治疗心绞痛的有效性与安全性。检索中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数字化全文数据库(Wan Fang)、中国生物医学文献数据库(CBM)、EMBASE、Cochrane Library数据库及Pubmed相关文献,以总疗效、心电图疗效、不良反应发生率为结局指标筛选文献,最终纳入24项随机对照试验(RCT),合计3 313例患者,采用Review Manager 5.3进行Meta分析。结果显示单用心血康治疗心绞痛的总有效率、心电图有效率高于常规治疗药物(常规药物),差异有统计学意义(P总疗效=0.000 4,P心电图疗效<0.005);常规药物联合心血康(联合用药)治疗心绞痛的总有效率、心电图有效率均高于常规药物,差异有统计学意义(P总疗效<0.000 01,P心电图疗效<0.000 01);单用心血康较常规药物相比,不良反应发生率有降低趋势(P=0.07),联合用药与常规药物相比无明显差异(P=0.43)。提示单用心血康或联合用药对心绞痛疗效较常规药物更佳,且单用心血康安全性可能更好。但受纳入研究样本数量和质量的限制,还需要更多高质量RCT来进一步予以验证。

To evaluate the efficacy and safety of Di＇ao Xinxuekang Capsules（Xinxuekang） for the treatment of angina pectoris, CNKI datebase, VIP datebase, Wan Fang datebase, CBM datebase, EMBASE, Cochrane Library, and Pubmed were searched on the internet in June 2017 to find all articles about Xinxuekang for angina pectoris. All articles were filtered using total effect, electrocardiogram effect, and adverse reaction rate were outcome indicators. Totally 24 randomized controlled trials（RTC） with 3 313 patients were included. Meta analysis on all the data are carried out with Rev Man 5.3 software. The results of Meta analysis showed that there were significant differences in total effect（P = 0.000 4） and electrocardiogram effect（P〈0.005） between Xinxuekang and conventional drugs; Xinxuekang combined with conventional medicines had significant improvement in total effect（P〈 0.000 01） and electrocardiogram effect（P 〈0.000 01） when compared with conventional medicines; Comparing with conventional drugs, the rate of adverse reactions tended to decrease with Xinxuekang alone（P = 0.07）, and there were no significant differences between drug combination（Xinxuekang combined with conventional drugs） and conventional drugs（P = 0.43）. The above results demonstrated that the therapy of single Xinxuekang or combined Xinxuekang with conventional drugs had significant advantages for the treatment of angina patients, and using Xinxuekang singly may show a better safety than conventional medicines. However, due to the limitation of the quality and quantity of included literatures, more high-quality RCT are needed to further confirm the safety and efficacy of Xinxuekang.