祛风通络法联合西医常规治疗冠心病的Meta分析

Treatment of coronary heart disease with therapy of expelling wind and freeing collateral vessels combined with routine therapy of Western medicine:a Meta-analysis

目的使用Meta分析系统评价祛风通络法治疗冠状动脉粥样硬化性心脏病(冠心病)的有效性和安全性。方法计算机检索中国医学文献数据库(SinoMed)、维普数据库(VIP)、中国期刊全文数据库(CNKI)和万方数据库(WanFang Data)以及英文数据库PubMed、Cochrane Library、Web of Science,收集祛风通络法治疗冠心病的相关随机对照试验(RCT),检索时限均从建库至2020年2月。由2名研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入9个RCT,包括668例患者(分为试验组和对照组)。Meta分析结果显示:与对照组相比,试验组的心绞痛有效率(RR=1.38,95%CI:1.25~1.52,P<0.00001)、心电图有效率(RR=1.40,95%CI:1.19~1.64,P<0.0001)更高。与对照组相比,试验组主要心血管不良事件(RR=0.31,95%CI:0.15~0.63,P=0.001)、中医证候积分(MD=-2.58,95%CI:-3.73~-1.42,P<0.0001)明显降低。在不良反应方面,试验组与对照组均未见严重明显不良反应。结论祛风通络法可有效改善冠心病患者的临床症状,且安全性较高。受纳入研究的数量和质量的限制,本研究结论尚需开展更多高质量研究予以证实。

Objective To review the efficacy and safety of therapy of expelling wind and freeing collateral vessels in treatment of coronary heart disease(CHD)by applying Meta-analysis.Methods The databases of SinoMed,VIP,CNKI,WanFang Data,PubMed,Cochrane Library and Web of Science were retrieved for collecting the randomized controlled trial(RCT)related to treatment of CHD with therapy of expelling wind and freeing collateral vessels from database establishment time to Feb.2020.The literature was screened,data was extracted and risk of bias in included studies was reviewed by 2 researchers independently,and then a Meta-analysis was conducted by using RevMan5.3 software.Results There were totally 9 RCT included involved 668 patients(divided into test group and control group).The results of Meta-analysis showed that the effective rates of therapy of expelling wind and freeing collateral vessels in treating angina pectoris(RR=1.38,95%CI:1.25~1.52,P<0.00001)and improving ECG(RR=1.40,95%CI:1.19~1.64,P<0.0001)were higher in test group than those in control group.The incidence rate of MACE(RR=0.31,95%CI:0.15~0.63,P=0.001)and syndrome integrals of Chinese medicine(MD=-2.58,95%CI:-3.73~-1.42,P<0.0001)decreased significantly in test group compared with control group.There were no significant adverse reactions in test group and control group.Conclusion The therapy of expelling wind and freeing collateral vessels can effectively relieve clinical symptoms with higher safety in CHD patients.The conclusion needs to be verified further with more high-quality studies as the limitation of quantity and quality in included RCT.