脉血康胶囊联合常规西药治疗不稳定性心绞痛的Meta分析

目的系统评价脉血康胶囊联合常规西药治疗不稳定性心绞痛的疗效及安全性。方法检索PubMed、the Cochrane Library、中国知网、万方数据知识服务平台等数据库自建库至2020年4月收录的有关脉血康胶囊联合常规西药治疗不稳定性心绞痛的随机对照临床试验(RCT),由2名研究者独立进行文献筛选、资料提取、质量评价,用RevMan 5.2软件进行Meta分析。结果共纳入11项研究,合计945例患者。Meta分析显示,脉血康胶囊联合常规西药在提高心绞痛总有效率RR=1.35,95%CI(1.25,1.45),P<0.00001];改善心电图ST段压低MD=-0.79,95%CI(-0.98,-0.60),P<0.00001]、T波倒置MD=-0.97,95%CI(-1.14,-0.80),P<0.00001],提高心电图改善总有效率RR=1.31,95%CI(1.15,1.50),P<0.0001];降低全血低切黏度MD=-2.19,95%CI(-2.68,-1.70),P<0.00001]、全血高切黏度MD=-0.66,95%CI(-0.79,-0.52),P<0.00001]和血浆黏度MD=-0.16,95%CI(-0.24,-0.09),P<0.0001];降低总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)MDTC=-0.68,95%CI(-0.86,-0.5),P<0.00001;MDTG=-0.44,95%CI(-0.55,-0.32),P<0.00001;MDLDL-C=-0.75,95%CI(-0.91,-0.58),P<0.00001]等方面均优于单纯西药治疗,且未出现明显不良反应。结论脉血康胶囊联合常规西药治疗不稳定性心绞痛疗效优于常规西药,且安全性较高。但因所纳入研究的质量较低、样本量较小,应慎重对待此结论,需更多大样本、多中心、设计严密的研究加以验证。

Meta-analysis of Maixuekang Capsule Combined with Conventional Western Medicine in the Treatment of Unstable Angina Pectoris

Objective To systematically evaluate the efficacy and safety of Maixuekang capsule in the treatment of unstable angina pectoris(UAP).MethodsPubMed,the Cochrane Library,CNKI,Wanfang and other databases were searched from their inception to April 2020,to collect RCT of Maixuekang capsule treating UAP,then two investigators screened the literatures, extracted data and assessed literature quality independently, and eventually used the RevMan 5.2 software to carry out the Meta-analysis.ResultsA total of eleven RCTs involving 945 patients were enrolled. Meta-analysis indicated that,Maixuekang capsule combined with conventional western medicine was superior to western medicine in increasing total effective rate of angina pectoris RR=1.35,95% CI(1.25,1.45),P<0.000 01];ameliorating ST-segment depression MD=-0.79,95% CI(-0.98,-0.60),P<0.000 01],T-wave inversion MD=-0.97, 95% CI(-1.14,-0.80), P<0.000 01] and enhancing the total effective rate of ECG improvement RR=1.31,95% CI(1.15,1.50),P<0.000 1];decreasing whole blood low shearing viscosity MD=-2.19,95% CI(-2.68,-1.70),P<0.000 01],whole blood high shearing viscosity MD=-0.66,95% CI(-0.79,-0.52),P<0.000 01] and plasma viscosity MD =-0.16,95% CI(-0.24,-0.09),P<0.000 1];lowering total cholesterolMD=-0.68,95% CI(-0.86,-0.5),P<0.000 01],triglyceride MD=-0.44,95% CI(-0.55,-0.32),P<0.000 01]and low density lipoprotein cholesterol MD=-0.75,95% CI(-0.91,-0.58),P<0.000 01]. Furthermore,all the studies have not shown any untoward effect.ConclusionThe efficacy of Maixuekang capsule combined with conventional western medicine is better than that of simple western medicine in the treatment of UAP,furthermore,it also has high drug safety. Considering the low quality and small scale of enrolled studies,this conclusion should be treated with caution,and larger sample,multi-center and well-designed clinical researches should be conducted to verify this conclusion.