芎芍胶囊治疗PCI术后再狭窄的临床疗效和安全性的Meta分析

Meta-analysis of the Clinical Efficacy and Safety of Xiongshao Capsule in the Treatment of In-stent Restenosis after PCI

目的系统评价芎芍胶囊治疗冠心病经皮冠状动脉介入治疗(PCI)术后再狭窄的有效性和安全性。方法计算机检索PubMed、Web of Science、EMbase、the Cochrane Library、中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)、万方数据资源系统(WanFang Data)等数据库,纳入芎芍胶囊联合常规西药对比单独使用常规西药干预冠心病PCI术后的随机对照试验(RCT)。由两位评价者独立筛选文献、提取资料、评价偏倚风险,应用RevMan 5.3软件进行Meta分析。结果共纳入RCT 7项,涉及938例病人,Meta分析结果显示,试验组在心绞痛复发率[RR=0.30,95%CI(0.23,0.40),P<0.00001]、再狭窄发生率[RR=0.56,95%CI(0.45,0.70),P<0.00001]、终点事件发生率[RR=0.47,95%CI(0.33,0.67),P<0.0001]、血瘀证积分[MD=-5.92,95%CI(-7.74,-4.10),P<0.00001]、最小管腔直径[MD=0.47,95%CI(0.35,0.59),P<0.00001]、狭窄程度[MD=-13.71,95%CI(-18.09,-9.33),P<0.00001]方面均优于对照组,而两组不良反应发生率差异无统计学意义(P>0.05)。结论现有证据表明,在西药常规基础上加用芎芍胶囊联合治疗冠心病PCI术后临床效果更好,且安全性较好。

Objective To evaluate the effectiveness and safety of Xiongshao Capsule in the treatment of in-stent restenosis after percutaneous coronary intervention(PCI).Methods Randomized controlled trial(RCT)of Xiongshao Capsule and conventional Western medicine compared with conventional Western medicine alone in the treatment of in-stent restenosis after PCI were searched from PubMed,Web of Science,EMbase,the Cochrane Library,CNKI,VIP,SinoMed,WanFang Data,and other databases.Two reviewers independently screened the literature,extracted data,and evaluated the risk of bias in the included studies.RevMan5.3 software was used for Meta analysis.Results A total of 7 RCTs were included,involving 938 patients.The results of the Meta analysis showed that in the experimental group the recurrence rate of angina[RR=0.30,95%CI(0.23,0.40),P<0.00001],the incidence of restenosis[RR=0.56,95%CI(0.45,0.70),P<0.00001],end-point event rate[RR=0.47,95%CI(0.33,0.67),P<0.0001],blood stasis syndrome score[MD=-5.92,95%CI(-7.74,-4.10),P<0.00001],minimum lumen diameter[MD=0.47,95%CI(0.35,0.59),P<0.00001],degree of stenosis[MD=-13.71,95%CI(-18.09,-9.33),P<0.00001]were better than that in the control group,but there was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Existing evidence shows that the combination of Xiongshao Capsules in the treatment of in-stent restenosis after PCI is effective and safe on the basis of conventional treatment.