盾叶冠心宁治疗稳定型心绞痛的系统评价

Systematic evaluation of Dunye Guanxinning in the treatment of stable angina pectoris

目的:系统评价盾叶冠心宁在治疗稳定型心绞痛中的临床疗效。方法:电子检索万方、维普、中国知网、PubMed、Web of Science、The Cochrane Library数据库,搜集建库至2020年12月已发表盾叶冠心宁治疗稳定型心绞痛的临床随机对照试验。由2名研究者独立对文献进行筛选、提取并依据Cochrane Handbook 5.2.3推荐评估工具评价纳入研究的偏倚风险;采用RevMan5.3软件进行Meta分析。结果:共纳入8篇文献,系统评价结果显示出在治疗稳定型心绞痛时,相比常规治疗,联合使用盾叶冠心宁可有效增加中医证候疗效,比值比(Odds Ratio,OR)=1.99,95%可信区间(Confidence Interval,CI)[1.28,3.09];心绞痛改善率,OR=2.44,95%CI[1.58,3.76];降低总胆固醇,均数差(Mean Difference,MD)=-0.31,95%CI[-0.49,-0.14];三酰甘油,MD=-0.17,95%CI[-0.32,-0.01]水平。结论:盾叶冠心宁组相比对照组,可明显降低稳定型心绞痛患者的总胆固醇、三酰甘油水平,同时又可以较好地改善患者临床症状。但受纳入文献质量和数量的限制,上述结论尚需更多临床高质量、多中心、随机双盲试验深入研究。

Objective:To systematically evaluate the clinical effect of Dunye Guanxinning(盾叶冠心宁)on stable angina pectoris.Methods:The databases of WanFang,VIP,CNKI,PubMed,Web of Science and The Cochrane Library databases were retrieved online to collect RCTs of Dunye Guanxinning on stable angina pectoris since the establishment to December 2020.Two researchers independently selected literatures,extracted datas and evaluated the risk bias in the included study.The risk assessment was conducted according to criteria recommended by Cochrane Handbook 5.3.Meta quantitative analysis was performed by RevMan 5.3 software then.Results:Eight RCTs were included in the study.The systematic evaluation results showed that compared with conventional treatment,the combination of Dunye Guanxinning can effectively enhance the clinical efficacy of TCM syndrome,OR=1.99,95%CI[1.28,3.09];the clinical efficacy of angina,OR=2.44,95%CI[1.58,3.76];and lower total cholesterol,MD=-0.31,95%CI[-0.49,-0.14];and triglyceride,MD=-0.17,95%CI[-0.32,-0.01].Conclusion:Dunye Guanxinning can further reduce the level of total cholesterol and triglyceride in patients with stable angina pectoris,and can effectively improve the clinical symptoms of patients.But restricted by quality and quantity in literature,this conclusion still needs more clinical quality,multicenter,randomized,double-blind trial.