化痰活血法联合常规西医治疗颈动脉粥样硬化疗效的Meta分析

Clinical Effect of Huatan Huoxue Method Combined with Routine Western Medicine on Carotid Atherosclerosis:a Meta-analysis

目的系统评价化痰活血法联合常规西医治疗颈动脉粥样硬化的临床疗效。方法计算机检索1980年1月—2019年7月中国知网(CNKI)、万方数据知识服务平台、维普中文期刊数据库(VIP)、PubMed、Cochrane Library数据库,纳入临床随机对照试验(RCT),提取符合入选标准文献的数据,通过改良后的Jadad量表评价文献质量,并应用Review Manager 5.3进行Meta分析。结果最终纳入9项临床研究,总病例数775例。Meta分析结果显示,化痰活血法联合常规西医治疗颈动脉粥样硬化的临床有效率优于单纯西药治疗,差异有统计学意义[OR=4.56,95%CI(2.53,8.21),P<0.00001];颈动脉内膜中层厚度[MD=-0.10,95%CI(-0.17,-0.03),P=0.003]、Crouse斑块积分[MD=-0.60,95%CI(-0.89,-0.31),P<0.0001]低于单纯西药治疗,差异均有统计学意义;血清总胆固醇[MD=-0.36,95%CI(-0.69,-0.03),P=0.03]、三酰甘油[MD=-0.35,95%CI(-0.64,-0.05),P=0.02]、低密度脂蛋白胆固醇[MD=-0.53,95%CI(-0.75,-0.30),P<0.00001]低于单纯西药治疗,差异均有统计学意义;血清高密度脂蛋白胆固醇高于单纯西药治疗,差异有统计学意义[MD=0.20,95%CI(0.12,0.28),P<0.00001]。结论化痰活血法联合常规西药治疗颈动脉粥样硬化能提高病人的临床疗效,改善血脂,降低颈动脉内膜中层厚度和Crouse斑块积分。

Objective To systematic evaluate the clinical efficacy of Huatan Huoxue(HTHX)method combined with routine western medicine in the treatment of carotid atherosclerosis.Methods Chinese National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP Chinese Journal Database(VIP),and PubMed,and Cochrane Library were searched from January 1980 to July 2019.Randomized controlled trials(RCTS)that met the inclusion criteria were included.The quality of literatures were evaluated by advanced Jadad scoring method.Meta-analysis was carried out by Review Manager 5.3 software.Results Nine clinical studies were included,including 775 cases.Meta-analysis results showed that,the effective rate of HTHX method combined with routine western medicine in treating carotid atherosclerosis was higher than that of simple routine western medicine,the difference was statistically significant[OR=4.56,95%CI(2.53,8.21),P<0.00001];intima-media thickness(IMT)[MD=-0.10,95%CI(-0.17,-0.03),P=0.003]and Crouse plaque score[MD=-0.60,95%CI(-0.89,-0.31),P<0.0001]of HTHX method combined with routine western medicine in treating carotid atherosclerosis were lower than those of simple routine western medicine,the differences were statistically significant.Serum total cholesterol[MD=-0.36,95%CI(-0.69,-0.03),P=0.03],triglyceride[MD=-0.35,95%CI(-0.64,-0.05),P=0.02],low density lipoprotein cholesterol[MD=-0.53,95%CI(-0.75,-0.30),P<0.00001]of HTHX method combined with routine western medicine in treating carotid atherosclerosis were lower than those of simple routine western medicine,the differences were statistically significant;high density lipoprotein cholesterol of HTHX method combined with routine western medicine in treating carotid atherosclerosis was higher than that of simple routine western medicine[MD=0.20,95%CI(0.12,0.28),P<0.00001].Conclusion HTHX method combined with routine western medicine in the treatment of carotid atherosclerosis can effectively improve clinical effects,improve blood lipid,lower carotid IMT and Crouse plaque score.