气血同治法辅助治疗微血管性心绞痛的系统评价与Meta分析

Systematic Review and Meta Analysis of Treating Both Qi and Blood Method in Adjuvant Treatment of Microvascular Angina Pectoris

目的:系统评价气血同治法辅助治疗微血管性心绞痛的有效性和安全性。方法:通过中英文文献检索系统全面检索气血同治法辅助治疗微血管性心绞痛的临床试验资料,检索时限均为各数据库建库至2020年5月。各随机对照试验(RCT)根据Cochrane系统评价其研究方法学质量,并利用Revman 5.3及Stata 12.0软件完成数据分析。结果:最终纳入18个研究,共计1371例患者,Meta分析结果显示气血同治法辅助治疗相比单纯西药组更具有优势。①临床有效率,RR=1.27,95%CI[1.20,1.34],P<0.00001;②血管内皮功能指标:血清一氧化氮为SMD=2.26,95%CI[1.42,3.11],P<0.00001,血清血管内皮素-1为SMD=-1.47,95%CI[-1.87,-1.07],P<0.00001;③血清超敏C反应蛋白,SMD=-1.23,95%CI[-1.87,-0.59],P<0.00001;④不良反应发生率,RR=0.71,95%CI[0.40,1.26],P=0.24。结论:与单纯西药治疗比较,中药气血同治辅助治疗对微血管性心绞痛疗效更优,且无显著不良反应。

Objective:To systematically evaluate the effectiveness and safety of treating both qi and blood method in the adjuvant treatment of microvascular angina pectoris.Methods:The clinical trial data of treating both qi and blood method in the adjuvant treatment of microvascular angina pectoris were comprehensively searched by Chinese and English literature retrieval system.The retrieval time limit was from the establishment of the database to May 2020.The randomized controlled trial(RCT)literatures were evaluated according to the Cochrane system evaluation method,and the data was analyzed using Revman 5.3 and Stata 12.0 software.Results:Total 18 studies were finally included,with a total of 1371 patients.Meta-analysis results showed that the adjuvant treatment of treating both qi and blood method was more advantageous than the simple western medicine group.①Clinical effective rate,RR=1.27,95%CI[1.20,1.34],P<0.00001;②Vascular endothelial function index:serum nitric oxide,SMD=2.26,95%CI[1.42,3.11],P<0.00001;serum vascular endothelin-1,SMD=-1.47,95%CI[-1.87,-1.07],P<0.00001;③High sensitivity C-reactive protein,SMD=-1.23,95%CI[-1.87,-0.59],P<0.00001;④The incidence of adverse reactions,RR=0.71,95%CI[0.40,1.24],P=0.26.Conclusion:Compared with the simple western medicine treatment,treating both qi and blood combined with treatment has a better effect on microvascular angina pectoris,without significant adverse reactions.