麝香保心丸降低急性冠脉综合征患者血清炎性因子的Meta分析

Meta-analysis of Shexiang Baoxin Pill in Reducing Serum Inflammatory Factor in Patients with Acute Coronary Syndrome

目的系统评价麝香保心丸对急性冠脉综合征(ACS)患者血清炎性因子的影响。方法计算机检索PubMed、The Cochrane Library、EMbase、Web of Science、CBM、WanFang Data、VIP、CNKI,检索时间均从建库至2019年3月,纳入有关麝香保心丸治疗ACS的随机对照试验,按照Cochrane系统评价方法进行文献数据提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果最终纳入29个RCT,共计3203例患者。Meta分析结果显示:1)临床疗效(OR=2.92,95%CI=[2.31,3.70],I2=0%,P<0.00001);2)CRP[WMD=-4.70,95%CI(-7.03,-2.38),P<0.00001];3)hs-CRP[SMD=-1.45,95%CI(-2.04,-0.85),P<0.00001];4)IL-6[SMD=-1.41,95%CI(-1.62,-1.20),P<0.00001];5)CK-MB[WMD=-43.17,95%CI(-57.24,-29.10),P<0.00001]。以上方面麝香保心丸联合西医常规优于单纯西医治疗,差异均具有统计学意义。结论麝香保心丸联合西医常规治疗可以显著提高ACS患者的临床疗效,降低ACS患者CRP、hs-CRP、IL-6、CK-MB水平,从而抑制炎性反应,保护心肌。

Objective:To evaluate the effect of Shexiang Baoxin Pill on serum inflammatory factors in patients with acute coronary syndrome(ACS).Methods:PubMed,The Cochrane Library,EMbase,Web of Science,CBM,WanFang Data,VIP and CNKI were searched for RCTs,which meeting the inclusion criteria were included.The data extraction and quality assessment were conducted with Cochrane System Evaluation Method,and Meta-analysis was performed with RevMan5.3 software.Results:A total of 29 RCTs involving 3203 patients were included.The results of meta-analyses showed that in the aspect of clinical efficacy(OR=2.92,95%CI=[2.31,3.70]),I2=0%,P<0.00001);CRP[WMD=-4.70,95%CI(-7.03,-2.38),P<0.00001];hs-CRP[SMD=-1.45,95%CI(-2.04,-0.85),P<0.00001]and IL-6[SMD=-1.41,95%CI(-1.62,-1.20),P<0.00001];CK-MB[WMD=-43.17,95%CI(-57.24,-29.10),P<0.00001],Shexiang Baoxin Pill combined with routine Western medicine was superior to simple Western medicine treatment;the difference is statistically significant.Conclusion:Shexiang Baoxin Pill combined with routine Western medicine treatment can significantly improve the clinical efficacy,and reduce the levels of CRP,hs-CRP,IL-6 and CK-MB in ACS patients,so as to inhibit inflammatory response and protect myocardium.These conclusions still need to be verified by more high quality RCTs.