益气活血类中成药治疗冠心病心绞痛的网状Meta分析

Network Meta-analysis of Yiqi Huoxue Chinese patent medicine for coronary heart disease with angina pectoris

基于网状Meta分析方法,比较益气活血类中成药治疗冠心病心绞痛的疗效。计算机检索CNKI、万方、维普、CBM数据库,检索时间为建库至2018年7月,纳入7种益气活血类中成药治疗冠心病心绞痛的随机对照试验(RCT)。按预先制定的纳入与排除标准由2名研究者独立进行文献筛选和资料提取,并对纳入的RCTs进行质量评价。采用Win BUGS软件进行数据分析,采用STATA软件进行绘图。最终纳入114个RCT,涉及7种益气活血类中成药,共计11 775例患者。网状Meta分析结果显示,AP症状改善总有效率共产生7个直接比较和21个间接比较,其中8个比较具有统计学意义,心电图改善情况共产生7个直接比较和21个间接比较,其中7个比较具有统计学意义。在AP症状改善总有效率方面,疗效排序依次为:参松养心胶囊>麝香保心丸>芪参益气滴丸>通心络胶囊>稳心颗粒>芪参胶囊>脑心通胶囊;在心电图改善情况方面,疗效排序依次为:麝香保心丸>通心络胶囊>脑心通胶囊>芪参益气滴丸>稳心颗粒>参松养心胶囊>芪参胶囊。结果表明,参松养心胶囊、麝香保心丸在益气活血法治疗冠心病心绞痛方面具有一定优势。由于个别纳入研究数目及样本量较小,证据的强度需更多研究进一步验证。

To assess the clinical efficacy of Yiqi Huoxue Chinese patent medicine for coronary heart disease with angina pectoris by using network Meta-analysis method. The relative randomized controlled trials( RCTs) of Yiqi Huoxue Chinese patent medicine for coronary heart disease with angina pectoris were retrieved from China National Knowledge Infrastructure( CNKI),Wan Fang,VIP and Chinese Biomedical Literature Database( CBM) in July 2018. Two researchers independently completed the literature screening,data extraction and quality evaluation according to the pre-determined inclusion and exclusion criteria,and the results were cross-checked.The data were analyzed by Win Bugs,and STATA software was used for plotting. Finally,114 RCTs were included,involving 7 Yiqi Huoxue Chinese patent medicines and 11 775 patients. Network Meta-analysis showed that the total effective rate for improvement in AP symptoms had 7 direct comparisons and 21 indirect comparisons,8 of which were statistically significant. The ECG improvement had 7 direct comparisons and 21 indirect comparisons,7 of which were statistically significant. In terms of the total effective rate of improvement in AP symptoms,the order of efficacy was as follows: Shensong Yangxin Capsules > Shexiang Baoxin Pills > Qishen Yiqi Dropping Pills > Tongxinluo Capsules > Wenxin Granules > Qishen Capsules > Naoxintong Capsules. In terms of ECG improvement,the order of efficacy was as follows: Shexiang Baoxin Pills > Tongxinluo Capsules > Naoxintong Capsules > Qishen Yiqi Dropping Pills> Wenxin Granules > Shensong Yangxin Capsules > Qishen Capsules. The results showed that Shensong Yangxin Capsules and Shexiang Baoxin Pills had certain advantages in the treatment of coronary heart disease with angina pectoris. Due to the small sample size,more studies were required to further verify the evidences.