中成药治疗不稳定型心绞痛的网状Meta分析

Network Meta-analysis of Chinese patent medicine in treatment of unstable angina pectoris

运用网状Meta分析对比治疗不稳定型心绞痛中成药的疗效及安全性。计算机全面检索PubMed,Cochrane Library,CNKI,Wanfang,VIP等数据库,检索时间均为建库至2020年6月。检索有关中成药治疗不稳定型心绞痛的临床随机对照试验。2名研究者依据纳排标准独立筛选文献并提取资料。依据Cochrane系统评价员手册推荐的偏倚风险评估工具对纳入的RCT进行质量评价,应用Stata 13.0软件进行数据分析及绘图。通过筛选,最终纳入28项符合标准的研究,样本量2885例,涉及8种中成药。网状Meta分析结果显示,中成药对心绞痛症状改善总有效率排序依次为:参芍胶囊>脑心通胶囊>银杏酮酯滴丸>复方丹参滴丸>银杏叶片>麝香保心丸>通心络胶囊>银丹心脑通软胶囊;对心电图疗效总有效率排序依次为:银杏酮酯滴丸>复方丹参滴丸>通心络胶囊>参芍胶囊>麝香保心丸>银丹心脑通软胶囊;对超敏-C反应蛋白疗效排序依次为:通心络胶囊>参芍胶囊>银杏叶片>复方丹参滴丸>麝香保心丸>脑心通胶囊>银丹心脑通软胶囊>银杏酮酯滴丸。结果表明,在常规治疗基础上联合中成药可提升不稳定型心绞痛的临床疗效,但由于不同中成药纳入研究的质量和数量存在差异,其排序结果有待进一步验证。

Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris.PubMed,Cochrane Library,CNKI,Wanfang,VIP and other databases were retrieved by computers from the establishment of the databases to June 2020.Randomized controlled trials(RCTs)of Chinese patent medicines for the treatment of unstable angina pectoris were collected.Two investigators independently screened out the literatures,and extracted data according to the inclusion and exclusion criteria.The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual,and the Stata 13.0 software was used for data analysis and mapping.Through screening,28 eligible studies were finally included,with the sample size of 2885 cases,involving 8 Chinese patent medicines.The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement,the order was as follows:Shenshao Capsules>Naoxintong Capsules>Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills>Ginkgo Leaf Tablets>Shexiang Baoxin Pills>Tongxinluo Capsules>Yindan Xinnaotong Soft Capsules;in terms of total effective rate for ECG curative effect,the order was as follows:Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills>Tongxinluo Capsules>Shenshao Capsules>Shexiang Baoxin Pills>Yindan Xinnaotong Soft Capsules;in terms of hypersensitivity-C-reactive protein curative effect,the order was as follows:Tongxinluo Capsules>Shenshao Capsules>Ginkgo Leaf Tablets>Compound Danshen Dropping Pills>Shexiang Baoxin Pills>Naoxintong Capsules>Yindan Xinnaotong Soft Capsules>Ginkgo Ketone Ester Dropping Pills.Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris.Due to the differences in the quantity and quality of the included studies,the order results of Chinese patent medicines need to be further verified.