疏肝法治疗高脂血症疗效的Meta分析

Shugan Therapy in the Treatment of Hyperlipidemia:a Meta-analysis

目的应用Meta分析系统评价疏肝法治疗高脂血症的有效性和安全性。方法检索中国知网(CNKI)、万方(WanFang Data)、维普(VIP)、PubMed、EMbase、Cochrane数据库自建库至2018年8月,应用疏肝法治疗高脂血症的临床随机对照试验(RCT)。由两位研究者独立筛选、提取文献数据及评价RCT偏倚风险后,采用RevMan5.3软件进行分析[临床疗效、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]。结果共纳入10项RCT,合计1 222例病人。Meta分析结果显示:试验组在临床疗效[优势比(OR)=2.79,95%CI(1.59,4.89),P=0.000 3]和降低TC[均方差(MD)=-0.58,95%CI(-0.78,-0.37),P <0.000 01]、TG[MD=-0.26,95%CI(-0.44,-0.09),P=0.003]、LDL-C[MD=-0.48,95%CI(-0.75,-0.21),P=0.000 5]方面均优于对照组,升高HDL-C[MD=0.18,95%CI(0.06,0.30),P=0.003]方面优于对照组。试验组699例病人中有13例报道发生不良反应,均为胃肠道反应,不良反应发生率低。结论应用疏肝法治疗高脂血症有效且安全性较好。

Objective To systematically review the efficacy and safety of Shugan therapy in the treatment of hyperlipidemia.Methods We searched databases including China National Knowledge Infrastructure(CNKI),WanFang data,VIP data,PubMed,EMbase and Cochrane,from inception till August 2018,and collected randomized controlled trials(RCTs)about Shugan therapy in the treatment of hyperlipidemia.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of included studies.Then using RevMan 5.3 software conducted the meta-analysis and analysized the clinical efficacy and biochemical indicators of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).Results Ten RCTs were enrolled,involving 1 222 patients.The results of meta-analysis showed that Shugan therapy for hyperlipidemia was superior to the control group in clinical efficacy[OR=2.79,95%CI(1.59,4.89),P=0.000 3]and lowering levels of TC[MD=-0.58,95%CI(-0.78,-0.37),P<0.000 01],TG[MD=-0.26,95%CI(-0.44,-0.09),P=0.003],LDL-C[MD=-0.48,95%CI(-0.75,-0.21),P=0.000 5],but increasing lever of HDL-C[MD=0.18,95%CI(0.06,0.30),P=0.003].As for the safety,13 cases in the treatment group which had699 cases occurred adverse reaction of gastrointestinal reaction.Conclusion The application of Shugan therapy in the treatment of hyperlipidemia is effective and safe.