丹参酮ⅡA磺酸钠治疗冠心病心绞痛疗效和安全性的Meta分析

Efficacy and Safety of Sodium Tanshinone ⅡA Sulfonate for the Treatment of Coronary Heart Disease Angina Pectoris:a Meta-analysis

目的:通过Meta分析评价丹参酮ⅡA磺酸钠治疗冠心病心绞痛的疗效和安全性。方法:计算机检索中国知网(CNKI)、维普(VIP)、万方、中国生物医学文献数据库(CMB)、PubMed、The Cochrane Library、EMbase等数据库,搜集关于丹参酮ⅡA磺酸钠与心绞痛的相关研究,检索时限截至2022年9月30日。由2名参与人员独立筛查文献、提取信息并评价纳入文献的偏倚风险,采用RevMan 5.3软件进行Meta分析。结果:共纳入20篇文献,涉及2975例病人。Meta分析结果显示,丹参酮ⅡA磺酸钠联合常规西药治疗冠心病心绞痛的临床总疗效[OR=3.32,95%CI(2.66,4.15),P<0.00001]、心绞痛发作次数[MD=-1.38,95%CI(-1.83,-0.92),P<0.00001]、心绞痛持续时间[MD=-6.27,95%CI(-8.06,-4.48),P<0.00001]、心电图疗效[OR=2.54,95%CI(1.92,3.36),P<0.00001]、总胆固醇[MD=-1.20,95%CI(-1.68,-0.71),P<0.00001]、三酰甘油[MD=-0.50,95%CI(-0.74,-0.26),P<0.00001]、高密度脂蛋白胆固醇[MD=0.17,95%CI(0.01,0.33),P<0.00001]、低密度脂蛋白胆固醇[MD=-0.54,95%CI(-0.84,-0.24),P<0.00001]均优于单纯使用常规西药。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:当前证据表明,丹参酮ⅡA磺酸钠联合常规西药治疗冠心病心绞痛的疗效优于常规治疗,但其安全性仍需要较多的研究提供更加可靠的证据。

Objective:To evaluate the efficacy and safety of sodium tanshinoneⅡA sulfonate for the treatment of coronary heart disease angina pectoris.Methods:CNKI,VIP,Wanfang Database,CBM,PubMed,the Cochrane Library,and EMbase databases were searched to collect the studies of the correlation between sodium tanshinoneⅡA sulfonate and angina,the deadline was September 30,2022.Two participants independently screened the literature,extracted information,and assessed the risk of bias of the included studies.RevMan 5.3 software was used for Meta-analysis.Results:Twenty studies involving 2975 patients were included.The results of Meta-analysis showed that the clinical efficacy of sodium tanshinoneⅡA sulfonate combined with conventional western medicine for coronary heart disease angina pectoris(OR=3.32,95%CI 2.66-4.15,P<0.00001),angina pectoris attack(MD=-1.38,95%CI-1.83--0.92,P<0.00001),duration of angina(MD=-6.27,95%CI-8.06--4.48,P<0.00001),electrocardiograph efficacy(OR=2.54,95%CI 1.92-3.36,P<0.00001),total cholesterol(MD=-1.20,95%CI-1.68--0.71,P<0.00001),triacylglycerol(MD=-0.50,95%CI-0.74--0.26,P<0.00001),high density lipoprotein cholesterol(MD=0.17,95%CI 0.01-0.33,P<0.00001),low density lipoprotein cholesterin(MD=-0.54,95%CI-0.84--0.24,P<0.00001)were better than those of conventional western medicine alone.Conclusion:The current limited evidence shows that sodium tanshinoneⅡA sulfonate combined with conventional western medicine for the treatment of angina pectoris is superior to conventional treatment.However,more studies are needed to provide more reliable evidence of its safety.