益气活血方药治疗微血管性心绞痛的Meta分析

Meta-analysis of Yiqi Huoxue Formulas in the Treatment of Microvascular Angina

目的:系统评价益气活血类方药治疗微血管性心绞痛的有效性及安全性。方法:通过检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、Pub Med、Embase、Cochrane Library这6大数据库,搜集从建库至2020年10月1日关于益气活血类方药治疗微血管性心绞痛的文献,经过筛选、提取有效数据后,应用软件RevMan5.3对纳入文献的相关结局指标进行Meta分析。结果:本研究纳入随机对照试验(RCT)文献25篇,全部为中文文献,共纳入1 664例患者。Meta分析结果显示,与对照组比较,观察组在临床疗效(RR=1.23,95%CI为1.16~1.29,P<0.000 01)、心电图疗效(RR=1.31,95%CI为1.17~1.46,P<0.000 01)、心绞痛发作频率(SMD=-1.68,95%CI为-2.55~-0.81,P=0.000 2)、心绞痛发作持续时间(MD=-2.37,95%CI为-3.44~-1.31,P<0.000 1)、运动平板试验总运动时间(SMD=1.36,95%CI为0.55~2.18,P=0.001)、血管内皮素-1(ET-1)水平(SMD=-1.54,95%CI为-1.92~-1.16,P<0.000 01)、血浆一氧化氮(NO)水平(SMD=1.76,95%CI为1.08~2.44,P<0.000 01)、超敏C反应蛋白(hs-CRP)(SMD=-1.23,95%CI为-2.22~-0.24,P=0.01)等指标均优于对照组,差异均有统计学意义(均P<0.05)。结论:联用益气活血类方药治疗微血管性心绞痛优于常规西药治疗,且具有安全性。

Objective:To evaluate the efficacy and safety of Yiqi Huoxue Formulas systematically in the treatment of microvascular angina.Methods:CNKI,CSPD,CCD,PubMed, Embase, and Cochrane Library were searched to collect the research articles on the treatment of microvascular angina with Yiqi Huoxue Formulas from database inception to October 1,2020.After screening and extraction of effective data, RevMan5.3 software was used for Meta-analysis of the relevant indicators in the included articles.Results:Twenty-five randomized controlled trials(RCTs),all in Chinese, were enrolled, with 1 664 patients involved.The results of Meta-analysis showed that the experimental group was superior to the control group in terms of clinical efficacy(RR=1.23,95%CI 1.16 to 1.29,P<0.000 01),electrocardiogram efficacy(RR=1.31,95%CI 1.17 to 1.46,P<0.000 01),the occurrence of angina attack(SMD=-1.68,95%CI-2.55 to-0.81,P=0.000 2),duration of angina attack(MD=-2.37,95%CI-3.44 to-1.31,P<0.000 1),total exercise time(SMD=1.36,95%CI 0.55 to 2.18,P=0.001),ET-1(SMD=-1.54,95%CI-1.92 to-1.16,P<0.000 01),NO(SMD=1.76,95%CI 1.08 to 2.44,P<0.000 01),and hs-CRP(SMD=-1.23,95%CI-2.22 to-0.24,P=0.01).The differences between the two groups were statistically significant(P<0.05).Conclusion:The combination of Yiqi Huoxue Formulas is safe and superior to conventional western medicine in the treatment of microvascular angina.