中医药治疗急性心肌梗死后心室重构疗效的Meta分析

Meta-analysis of the Efficacy of Traditional Chinese Medicine in the Treatment of Ventricular Remodeling after Acute Myocardial Infarction

目的:评价中医药联合西药常规治疗急性心肌梗死(AMI)后心室重构的疗效及安全性。方法:选取并检索中国知网、万方数据库、维普网、Pub Med、Cochrane图书馆各建库日期至2018年8月,比较中医药联合西药常规治疗与单纯西药常规治疗AMI后心室重构的临床随机对照试验,按照Cochrane评价纳入文献质量,采用Revman5. 3软件进行Meta分析,再用Grade Pro软件对主要结局指标进行证据等级评价。结果:共纳入17项研究,共计1 501例患者。Meta分析显示联合治疗可减少左室舒张末容积(SMD=-0. 37[-0. 63,-0. 12]),减小左室质量指数(SMD=-0. 41[-0. 76,-0. 07]),升高左室射血分数(SMD=0. 79[0. 58,1. 00]),且治疗有效率高于单纯常规治疗(OR=4. 56[2. 27,9. 17])。结论:中药能安全有效地减轻AMI后患者心室重构的程度。

Objective:To evaluate the efficacy and safety of traditional Chinese medicine (TCM) combined with western medicine in the treatment of ventricular remodeling after acute myocardial infarction (AMI).Methods:The literatures of Chinese National Knowledge Infrastructure (CNKI),Wanfang Journal Database,PubMed,and Cochrane Library from date of their establishment to August 2018 were searched for the randomized controlled trials of compared TCM combined with western medicine and western medicine alone for ventricular remodeling after AMI.The quality of the literature included was evaluated according to the Cochrane,and the Revman 5.3 software was used to perform the Meta-analysis,and Grade Pro software to evaluate the evidence level of the main outcome indicators.Results:A total of 17 studies were included,accounted for a total of 1501 patients.Meta-analysis showed that combination therapy reduced left ventricular end-diastolic volume (SMD=-0.37[-0.63,-0.12]),decreased left ventricular mass index (SMD=-0.41[-0.76,-0.07]),increased left ventricular ejection fraction (SMD=0.79[0.58,1.00]).Treatment efficiency was higher than conventional treatment (OR=4.56[2.27,9.17]).Conclusion:TCM can safely and effectively reduce the degree of ventricular remodeling in patients after AMI.