补肾活血中药复方治疗冠心病心绞痛的系统评价

目的:采用循证医学的方法来评价补肾活血中药复方治疗冠心病心绞痛的疗效。方法:计算机检索Cochrane图书馆临床对照试验数据库(CCTR)、美国医学文摘数据库(Medline)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、清华同方全文数据库(CNKI)以及万方医学数据库,并进行手工补充检索。收集补肾活血中药复方治疗冠心病心绞痛的随机对照试验,使用Revman 4.2软件对纳入的研究进行系统分析。结果:共纳入13个随机对照试验,均为中文,方法学质量评价均为C级。Meta分析显示:补肾活血中药复方在改善心绞痛症状方面,优于常规西药或(和)地奥心血康胶囊[RR=1.28,95%CI(1.21,1.36),P0.01],差异有统计学意义。改善心电图方面,优于常规西药或(和)地奥心血康胶囊,[RR=1.49,95%CI(1.35,1.66),P0.01],差异有统计学意义。在中医证候疗效方面,优于常规西药或(和)地奥心血康胶囊[RR=1.21,95%CI(1.05,1.39),P=0.007]。降低甘油三酯、胆固醇方面,优于常规西药或(和)地奥心血康胶囊;降低全血黏度、血浆黏度方面,优于常规西药或(和)地奥心血康胶囊。结论:现有研究表明补肾活血中药复方治疗冠心病心绞痛与常规西药或(和)地奥心血康胶囊治疗的结果相比具有优势,可缓解心绞痛症状,改善心电图,降低甘油三酯、胆固醇,改善血液流变学指标。但受纳入文献的质量限制,其疗效有待高质量的随机对照试验来评价。

System Evaluation of Herbal Compound for Reinforcing Kidney and Activating Blood in the Treatment of Coronary Heart Disease Angina Pectoris

Objective: To evaluate the effect of herbal compound for reinforcing kidney and activating blood in the treatment of coronary heart disease angina pectoris by evidence-based medicine method. Methods: Cochrane Clinical Controlled Trials Database (CCTR), American Medical Abstracts Database (Medline), VIP Chinese PSTP (VIP), Chinese Biomedical Database (CBM), Periodical Full-Text Databases of CNKI (CNKI) and Wan Fang Medical Database were searched and manual supplementary retrieval was performed. Randomized controlled trials of herbal compound for reinforcing kidney and activating blood in the treatment of coronary heart disease angina pectoris were collected. Revman 4.2 was adopted for systemic analyzing the included studies. Results: Total 13 randomized controlled trials were included, and all of them were in Chinese. All the methodology quality evaluation were level C. Meta-analysis indicated that in the aspect of improving the symptoms of angina pectoris, herbal compound for reinforcing kidney and activating blood was better than conventional western medicine or (and) Di'ao capsule [RR=1.28, 95%CI (1.21, 1.36), P<0.01], the differences were statistically significant (P<0.05). In the aspect of improving electrocardiogram, it was better than conventional western medicine or (and) Di'ao capsule [RR=1.49, 95%CI (1.35, 1.66), P<0.01], the differences were statistically significant (P<0.05). In the aspect of curative effects of TCM syndrome, it was better than conventional western medicine or (and) Di'ao capsule [RR=1.21, 95%CI (1.05, 1.39), P=0.007]. In the aspect of lowering triglyceride and cholesterol, it was better than conventional western medicine or (and) Di'ao capsule; in the aspect of decreasing whole blood viscosity and plasma viscosity, it was better than conventional western medicine or(and) Di'ao capsule. Conclusion: The existing researches indicate that compared with conventional western medicine or(and) Di'ao capsule, Herbal Compound for Reinforcing Kidney and Activating Blood has advantages in the treatment of coronary heart disease angina pectoris. It can relieve angina pectoris symptoms, improve electrocardiogram, decrease triglyceride and cholesterol, and improve hemorrheological parameters. But with the quality limitations of the included literature, high quality randomized controlled trials were needed for evaluating its curative effects.