5种常用口服中成药联合常规西药治疗稳定型心绞痛疗效的网状Meta分析

Net Meta-analysis of the Efficacy of 5 Commonly Used Oral Proprietary Chinese Medicines Combined with Conventional Western Medicines in the Treatment of Stable Angina Pectoris

目的通过网状Meta分析比较临床常用的5种口服中成药联合常规西药治疗冠心病稳定型心绞痛(CSA)的临床疗效。方法检索中国知网(CNKI)、万方(WanFang Database)、维普(Vip)数据库、Pubmed、the Cochrane Library、EMbase、Web of Science。检索时间为建库至2023年10月20日,并用NoteExpress文献管理软件自动查重,提取数据并用Cochrane协作网研发的偏倚风险评估工具进行文献质量评价,采用Stata17.0软件进行统计分析及作图。结果共纳入61项研究,涉及6620例患者。根据网状Meta分析结果显示,不同口服中成药联合西药常规治疗在临床疗效方面的排序为:通心络胶囊+麝香保心丸+常规治疗>芪参益气滴丸+通心络胶囊+常规治疗>通心络胶囊+常规治疗>养心氏片+常规治疗>麝香保心丸+常规治疗>芪参益气滴丸+常规治疗>参松养心胶囊+常规治疗>常规治疗;在心电图改善率方面的排序为通心络胶囊+麝香保心丸+常规治疗>芪参益气滴丸+通心络胶囊+常规治疗>养心氏片+常规治疗>参松养心胶囊+常规治疗>通心络胶囊+常规治疗>麝香保心丸+常规治疗>芪参益气滴丸+常规治疗>常规治疗。结论对于稳定型心绞痛的患者,口服中成药联合常规治疗可进一步改善症状,降低炎性反应,提升左室舒张功能等,且不良反应较少,但由于本研究纳入文献的数量有限,所以目前的结论现需要更多的研究进一步考证。

Objective To compare the clinical efficacy of five oral proprietary Chinese medicines commonly used in clinical practice combined with conventional western medicines in the treatment of stable angina pectoris(CSA)in coronary heart disease(CHD)by reticulated Meta-analysis.Method Searched China Knowledge Network(CNKI),WanFang Database,Vip database,Pubmed,the Cochrane Library,EMbase,and Web of Science.the search time was from the establishment of the database to 20 October 2023,and the data were automatically checked by NoteExpress literature management software.The data were extracted and evaluated for quality using the risk of bias assessment tool developed by the Cochrane Collaboration,and statistical analyses and graphs were performed using Stata 17.0 software.Results A total of 61 studies involving 6620 patients were included.According to the results of reticulated Meta-analysis,the rankings of different oral proprietary Chinese medicines combined with conventional treatment with western medicines in terms of clinical efficacy were as follows:Tongxinluo capsule+Musk Cardioprotective Pill+conventional treatment>Qishen Yiqi Drop Pill+Tongxinluo capsule+conventional treatment>Tongxinluo capsule+conventional treatment>Nourishing Heart's Tablets+conventional treatment>Musk Cardioprotective Pill+conventional treatment>Qishen Yiqi Drop Pill+conventional treatment>Ginseng Pine Nourishing Heart's Capsules+conventional treatment>conventional treatment.In terms of ECG improvement rate,the ranking was Tongxinluo capsule+Musk Cardioprotective Pill+conventional treatment>Qishen Yiqi Drop Pill+Tongxinluo capsule+conventional treatment>Nourishing Heart's Tablets+conventional treatment>Ginseng Pine Nourishing Heart capsule+conventional treatment>Tongxinluo capsule+conventional treatment>Musk Cardioprotective Pill+conventional treatment>Qishen Yiqi Drop Pill+conventional treatment>conventional treatment.Conclusion For patients with stable angina pectoris,oral pCms combined with conventional treatment can further improve symptoms,reduce inflammatory response,enhance left ventricular diastolic function,etc.,and have fewer adverse effects,but due to the limited number of literature included in this study,the current conclusions now require more studies for further examination.