养心通脉法治疗冠心病Meta分析及试验序贯分析

Meta-Analysis on Yangxin Tongmai Method for Coronary Heart Disease and Trial Sequential Analysis

目的:系统评价养心通脉法治疗冠心病的疗效。方法:检索PubMed、Cochrane library、Medline、Embase、中国知网(CNKI)、维普数据库(VIP)、万方及中国生物医学文献数据库(CBM),检索时间限定为建库至2020年3月1日,检出所有养心通脉法治疗冠心病的有关文献,对纳入文献进行质量评价和信息提取。分别采用RevMan5.3软件和TSA v0.9软件进行Meta分析和试验序贯分析。结果:共纳入17篇文献。Meta分析结果显示,观察组心绞痛改善情况优于对照组(RR=1.22,95%CI[1.17,1.28],Z=8.21,P<0.00001);观察组心电图改善情况优于对照组(RR=1.30,95%CI[1.22,1.40],Z=7.49,P<0.00001);观察组临床症状改善情况优于对照组(RR=1.31,95%CI[1.12,1.52],Z=3.46,P=0.0005)。而试验序贯分析显示Meta分析得到了一个假阳性的结果。结论:养心通脉法治疗冠心病的疗效有待更严谨的随机对照试验进一步证明。

Objective:To systematically evaluate the curative effect of Yangxin Tongmai method for coronary heart disease.Methods:All the relevant literature about Yangxin Tongmai method treating coronary heart disease from the establishment date of the database to March 1,2020 was detected in PubMed,Cochrane library,Medline、Embase,CNKI,VIP,Wangfang and CBM.The enrolled literature was given quality evaluation and information extraction.Metaanalysis and trial sequential analysis were carried out by RevMan5.3 software and TSAv0.9 software respectively.Results:There were 17 literature included.According to the Meta-analysis result:the improvement of angina pectoris in the observation group was better than that in the control group(RR=1.22,95%CI[1.17,1.28],Z=8.21,P<0.00001);the improvement of electrocardiogram in the observation group was better than that in the control group(RR=1.30,95%CI[1.22,1.40],Z=7.49,P<0.00001);the improvement of clinical symptoms in the observation group was better than that in the control group(RR=1.31,95%CI[1.12,1.52],Z=3.46,P=0.0005).The trial sequential analysis showed that the Metaanalysis got a false positive result.Conclusion:The curative effect of Yangxin Tongmai method in treating coronary heart disease needs to be further proved by more rigorous randomized controlled trials.