首页|丹蒌片联合西药治疗冠心病的疗效及安全性Meta分析

丹蒌片联合西药治疗冠心病的疗效及安全性Meta分析

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目的 系统评价单纯西药治疗冠心病与丹蒌片联合西药治疗的不同效果,为临床提供循证参考依据.方法 检索PubMed,Embase,Cochrane library,中国生物医学文献服务系统(Sinomed),中国知网(CNKI),维普(VIP),万方医学网(Wanfang)数据库,全面收集丹蒌片联合常规药物(治疗组)对比常规药物(对照组)治疗冠心病的随机对照临床试验(RCT),检索时间从2017年-2023年6月20 日.根据Cochrane风险偏倚评估工具对纳入的文献进行质量评价,采用RevMan 5.4软件进行分析.结果 共纳入14项随机对照试验,合计1292例患者,Meta分析结果显示,治疗组临床疗效[RR=1.24,95%CI(1.17,1.31),P<0.000 01 ];改善心电图ST段压低[MD=0.66,95%CI(0.53,0.80),P<0.000 01];T 波倒置[MD=0.25,95%CI(0.03,0.46),P=0.03];提高心电图改善有效率[RR=1.20,95%CI(1.02,1.41),P=0.03];提高硝酸甘油减停率[RR=1.34,95%CI(1.12,1.34),P=0.002];减少心绞痛发作次数[MD=1.43,95%CI(0.61,2.25),P=0.0007 ];降低心绞痛持续时间[MD=2.78,95%CI(1.79,3.76),P<0.000 01 ];降低不良反应发生率[RR=0.42,95%CI(0.24,0.76),P=0.004];中医证候积分[MD=4.47,95%CI(1.75,7.18),P<0.0001 ]等方面均优于对照组.结论 在常规治疗方案的基础上联合使用丹蒌片可提高大部分临床指标及症状的疗效,且具有一定安全性,但因所纳入研究的质量较低、样本量较小,今后仍需更多方案设计严密、实施科学的大样本、高质量的随机对照试验来进行进一步的评价和验证,以期提供更多可靠的循证证据,指导临床用药.
Efficacy and Safety of Danlou Tablets Combined with Western Medicine in the Treatment of Coronary Heart Disease:A Meta-analysis
Objective To systematically evaluate the efficacy of Danlou Tablets in combination with western med-icine versus single western medicine in the treatment of coronary artery disease,and to provide an evidence-based refer-ence for clinical practice.Methods PubMed,Embase,Cochrane Library,China Biomedical Literature Service System(Si-nomed),China National Knowledge Infrastructure(CNKI),China Scientific and Technological Journal Database(VIP),and Wanfang Data were searched to comprehensively collect randomized controlled trials(RCTs)comparing Danlou Tablets combined with conventional medicine(treatment group)to single conventional medicine(control group)in the treatment of coronary artery disease.The retrieval time was from 2017 to June 20,2023.The quality of the included studies was assessed using the Cochrane Risk of Bias Assessment Tool,and analysis was performed with RevMan 5.4.Results Fourteen RCTs involving a total of 1 292 patients were included.The meta-analysis revealed that the treatment group had significantly better outcomes in several aspects:clinical efficacy[RR=1.24,95%CI(1.17,1.31),P<0.000 01];improvement in ST-segment depression[MD=0.66,95%CI(0.53,0.80),P<0.000 01];T-wave inversion[MD=0.25,95%CI(0.03,0.46),P=0.03];ECG improvement[RR=1.20,95%CI(1.02,1.41),P=0.03];nitroglycerin reduction[RR=1.34,95%CI(1.12,1.34),P=0.002];angina attack frequency[MD=1.43,95%CI(0.61,2.25),P=0.000 7];duration of angina[MD=2.78,95%CI(1.79,3.76),P<0.000 01];incidence of adverse reactions[RR=0.42,95%CI(0.24,0.76),P=0.004];traditional Chinese medicine syndrome scores[MD=4.47,95%CI(1.75,7.18),P<0.000 1].Con-clusion Danlou Tablets combined with conventional treatment regimens can enhance the effectiveness of most clinical in-dices and symptoms with a degree of safety.However,due to the low quality and small sample sizes of the included studies,more rigorously designed,scientifically implemented,large-sample,high-quality RCTs are needed to further assess and validate the findings and to provide reliable evidence for guiding clinical pharmacotherapy.

Danlou TabletsCoronary heart diseaseIntegrated traditional Chinese and western medicineSafetyMeta-analysis

高诗雨、董悦、严晨涛、余天淏、张琳、曹红波

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天津中医药大学中医学院,天津 301617

丹蒌片 冠心病 中西医结合 安全性 Meta分析

国家自然科学基金资助项目

82274682

2024

世界中西医结合杂志
中华中医药学会

世界中西医结合杂志

CSTPCD
影响因子:1.053
ISSN:1673-6613
年,卷(期):2024.19(2)
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