瓜蒌薤白半夏汤加减联合化学药对比单用化学药治疗冠心病稳定型心绞痛有效性的Meta分析

Meta-analysis of the Effectiveness of Modified Gualou Xiebai Banxia Decoction Combined with Chemical Drugs versus Chemical Drugs Alone in the Treatment of Stable Angina Pectoris of Coronary Heart Disease

目的:系统评价瓜蒌薤白半夏汤加减联合化学药对比单用化学药治疗冠心病稳定型心绞痛的有效性,为临床治疗提供循证参考。方法:计算机检索Pub Med、EMBase、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库、万方数据,收集瓜蒌薤白半夏汤加减联合化学药(试验组)对比单用化学药(对照组)治疗冠心病稳定型心绞痛的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,并采用Cochrane 5.1.0质量评价工具进行质量评价后,采用Rev Man 5.3统计软件进行Meta分析(心绞痛疗效总有效率、心电图改善总有效率、血脂水平)。结果:共纳入10项RCT,合计820例患者。Meta分析结果显示,试验组患者在心绞痛疗效总有效率[RR=1.25,95%CI(1.17,1.35),P<0.001]、心电图改善总有效率[RR=1.35,95%CI(1.19,1.53),P<0.001]、降低血脂水平中的低密度脂蛋白水平[MD=-0.45,95%CI(-0.71,-0.19),P<0.001]等方面均显著优于对照组,且无明显不良反应发生。结论:瓜蒌薤白半夏汤加减联合化学药对比单用化学药治疗冠心病稳定型心绞痛在心绞痛疗效总有效率、心电图改善总有效率、降低低密度脂蛋白水平方面均较好。

OBJECTIVE:To systematically review the efficacy of modified Gualou xiebai banxia(GLXBBX)decoction combined with chemical drugs versus chemical drugs alone in the treatment of stable angina pectoris(SAP)of coronary heart disease,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from PubMed,EMBase,Cochrane library,CJFD,VIP and Wanfang database,RCTs about therapeutic efficacies of GLXBBX decoction combined with chemical drugs(experimental group)versus chemical drugs alone(control group)in the treatment of SAP were collected.Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction of clinical studies met inclusion criteria and quality evaluation with Cochrane 5.1.0 quality evaluation tool(total response rate of angina pectoris efficacy and ECG improvement,blood lipid level).RESULTS:There were totally 10 RCTs,involving 820 patients.The results of Meta-analysis showed that the total response rate of angina pectoris efficacy[RR=1.25,95%CI(1.17,1.35),P<0.001],total response rate of ECG improvement[RR=1.35,95%CI(1.19,1.53),P<0.001],decrease LDL improvement[MD=-0.45,95%CI(-0.71,-0.19),P<0.001]in experimental group were significantly better than control group.There was no significant ADR.CONCLUSIONS:For SAP of coronary heart disease,modified GLXBBX decoction combined with chemical drugs is better than chemical drugs alone in total response rate of angina pectoris efficacy,total response rate of ECG improvement,and decrease LDL improvement.