中药注射液辅助治疗不稳定性心绞痛临床疗效的网状Meta分析

Network Meta-analysis of clinical efficacy of Chinese herbal injection in adjuvant treatment of unstable angina pectoris

运用网状Meta分析方法评价中药注射液治疗不稳定性心绞痛的疗效。计算机检索Pub Med、Cochrane Library、Web of Science、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)、万方(Wanfang)中有关中药注射液辅助治疗不稳定性心绞痛的随机对照试验。所有研究人员均独立筛选文献、提取资料、质量评价,对符合质量标准的研究采用Open BUGS软件和Stata软件进行分析。共纳入58项研究,涉及20种干预措施。在有效率方面,灯盏细辛注射液、血塞通注射液、丹参注射液等16种注射液联合常规西医治疗具有显著优势;在心电图疗效方面,葛根素注射液、银杏达莫注射液、灯盏花素注射液等8种注射液联合常规西医治疗均优于单纯常规西医治疗;在心绞痛发作次数方面,丹参酮ⅡA磺酸钠注射液、银杏达莫注射液和大株红景天注射液联合常规西医治疗均优于单纯常规西医治疗;在心绞痛持续时间方面,参麦注射液联合常规西医治疗优于单纯常规西医治疗。结果表明,灯盏细辛注射液、血塞通注射液、丹参注射液、灯盏花素注射液、丹参川芎嗪注射液联合常规西医治疗疗效显著,推荐临床使用,同时也要结合患者病情特点选择适宜的干预措施。受纳入研究质量的限制,所得结论仍待进一步验证。

The present study evaluated the curative efficacy of Chinese herbal injection on unstable angina pectoris(UAP)by network Meta-analysis.The databases,including Pub Med,Cochrane Library,Web of Science,CNKI,CBM,VIP and Wanfang were searched for randomized controlled trial(RCT)of Chinese herbal injection in the treatment of UAP.All researchers independently screened the articles,extracted the data and evaluated the quality.Open BUGS and Stata were employed for the analysis of the trials that met the quality standards.Fifty-eight studies were finally included in this study,involving 20 intervention measures.In terms of the effective rate,16 injections such as Dengzhan Xixin Injection,Xuesaitong Injection and Danshen Injection combined with western medicine exhibited significant efficacy.In terms of ECG,Puerarin Injection,Ginkgo Leaf Extract and Dipyridamole Injection(GDI),Breviscapine Injection combined with western medicine were superior to western medicine.In terms of the reduction of the angina attack times,Sodium Tanshinone Ⅱ_(A) Sulfonate Injection,GDI and Dazhu Hongjingtian Injection combined with western medicine showed better effects than western medicine.In terms of shortening the angina duration,Shenmai Injection combined with western medicine was superior to western medicine.As revealed by the results,Dengzhan Xixin Injection,Xuesaitong Injection,Danshen Injection,Breviscapine Injection,Danshen Ligustrazine Injection combined with western medicine displayed prominent curative efficacy,which were recommended for clinical application.Meanwhile,appropriate intervention measures should be selected according to individual conditions.Limited by the quality of the included trials,the conclusions still need to be further verified.