中药治疗痰瘀互结型冠心病临床疗效的Meta分析

Clinical Efficacy of Traditional Chinese Medicine in the Treatment of Coronary Heart Disease with Phlegm-blood Stasis:a Meta-analysis

目的采用Meta分析法评价中药治疗痰瘀互结型冠心病的临床疗效。方法计算机检索中国期刊全文数据库(CNKI)、万方数据库、维普中文期刊数据库(VIP)。由两名研究员独立按照设定的纳入与排除标准提取文献,应用GRADE系统进行证据级别推荐,采用RevMan 5.3软件进行Meta分析。结果本研究共纳入文献27篇。Meta分析结果显示:中药联合西医常规治疗冠心病临床疗效优于单独运用西医常规治疗,差异有统计学意义[OR=3.54,95%CI(2.85,4.39),P<0.00001];中药联合西医常规治疗冠心病心电图疗效优于单独运用西医常规治疗,差异有统计学意义[OR=3.09,95%CI(2.32,4.12),P<0.00001];中药联合西医常规治疗冠心病中医证候疗效优于单独运用西医常规治疗,差异有统计学意义[OR=3.69,95%CI(2.64,5.15),P<0.00001]。结论现有证据表明,中药治疗痰瘀互结型冠心病,可有效改善冠心病临床疗效、心电图疗效及中医证候疗效。但由于文献质量有待提高,分析结果具有一定局限性,仍需多中心、大样本随机双盲对照试验进一步证实结论。

Objective To evaluate the clinical efficacy of traditional Chinese medicine in the treatment of coronary heart disease with phlegm-blood stasis by Meta-analysis.Methods China Journal Full-Text Database(CNKI),VIP Database(VIP)and Wanfang database were searched by computer.Two researchers independently extracted the literatures according to the set inclusion and exclusion criteria,applied the GRADE rating for evidence level recommendation.The study results of the included literatures were analyzed by RevMan 5.3.Results Twenty-seven literatures were included.The results of Meta-analysis showed that the clinical efficacy of traditional Chinese medicine combined with western medicine in the treatment of coronary heart disease was better than that of western medicine[OR=3.54,95%CI(2.85,4.39),P<0.00001],the clinical electrocardiogram efficacy of traditional Chinese medicine combined with western medicine in the treatment of coronary heart disease was better than that of western medicine alone[OR=3.09,95%CI(2.32,4.12),P<0.00001],traditional Chinese medicine syndrome efficacy of traditional Chinese medicine combined with western medicine in the treatment of coronary heart disease was better than that of western medicine alone[OR=3.69,95%CI(2.64,5.15),P<0.00001].Conclusion Current evidence showed that traditional Chinese medicine could effectively improve the clinical efficacy,electrocardiogram efficacy and traditional Chinese medicine syndrome efficacy of coronary heart disease.However,the quality of the literatures needed be improved,the analysis results had certain limitations,and more centers and large sample randomized double-blind controlled trials.