复方丹参滴丸治疗冠心病心绞痛的系统评价再评价

Appraisal of Systematic Evaluations of Compound Danshen Dropping Pills in the Treatment of Coronary Heart Disease and Angina

目的 对复方丹参滴丸治疗冠心病心绞痛的系统评价进行再评价,以为决策者和研究者提供参考。方法 计算机检索中国知网(CNKI)、万方数据库(WanFang Data)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library等数据库,检索复方丹参滴丸治疗CAD的系统评价或Meta分析文献,检索时限均为建库起至2022年3月31日。采用AMSTAR量表评价纳入的CAD系统评价的方法学质量,基于GRADE系统对纳入的结局指标进行证据质量分级。结果 共纳入28项系统评价,AMSTAR量表结果显示:纳入文献方法学质量一般;GRADE证据质量分级结果显示:31项为中质量(32%),43项为低质量(44%),23项为极低质量(24%);导致降级最主要因素为偏倚风险(95项),其次为发表偏倚(56项)、不一致性(31项)。结论 目前复方丹参滴丸治疗冠心病心绞痛的系统评价/Meta方法学质量总体一般,结局指标证据等级普遍较低,临床决策应当谨慎参考。建议研究者今后进行系统评价或设计临床试验时更加科学、严谨,以获得高质量研究结果。

Objective To appraise the systematic evaluations of Compound Danshen Dropping Pills in the treatment of coronary heart disease and angina, to provide reference for decision makers and researchers.Methods CNKI,Wanfang Data, CBM,PubMed and the Cochrane library were searched to collect the literature on systematic evaluation or Meta-analysis of Compound Danshen Dropping Pills in the treatment of coronary heart disease and angina from the inception of the databases to March 31,2022.AMSTAR(a measurement tool for the assessment of multiple systematic reviews)was used to evaluate the methodological quality of the included system evaluations of coronary heart disease and angina, and the included outcome indicators were rated for quality of evidence based on Grading of Recommendations, Assessment, Development and Evaluations(GRADE)system.Results A total of 28 systematic evaluations were included.The results of AMSTAR showed that the methodological quality of the included literature was moderate.GRADE system revealed that 31 items(32%)were of moderate quality, 43 items(44%)of low quality, and 23 items(24%)of very low quality.The most important factor leading to degradation was the risk of bias(95 items),followed by publication bias(56 items)and inconsistency(31 items).Conclusion Generally, the quality of systematic evaluations/Meta-analyses of Compound Danshen Dropping Pills in the treatment of coronary heart disease and angina is moderate, and the evidence level of the outcome indicators is low.Thus we should be careful with the research findings in clinical decision-making.It is suggested that researchers should be more scientific and rigorous when conducting systematic evaluation or designing clinical trials in the future, to obtain high-quality research results.