首页|复方丹参滴丸联合常规西医治疗冠心病合并糖尿病有效性及安全性的Meta分析

复方丹参滴丸联合常规西医治疗冠心病合并糖尿病有效性及安全性的Meta分析

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目的 对复方丹参滴丸联合常规西医治疗冠心病合并糖尿病的有效性和安全性进行系统评价.方法 通过检索万方数据库(Wanfang)、中国知网(CNKI)、维普中文期刊(VIP)、中国生物医学文献数据库(SinoMed),以及Cochrane Library、PubMed、Embase和Web of Science等数据库,收集从建库至 2023 年 5 月复方丹参滴丸联合常规西医治疗冠心病合并糖尿病的随机对照试验(RCT),由 2 位研究人员独立完成文献筛选、数据整理和偏倚风险评价;应用RevMan 5.4 软件进行Meta分析.结果 纳入 24 项RCT,共 2 546 例患者.Meta分析结果显示,复方丹参滴丸联合常规西医治疗在提高冠心病合并糖尿病的总有效率[OR=4.93,95%CI(3.49,6.98),P<0.000 01]、血浆脂联素[MD=2.79,95%CI(2.30,3.27),P<0.000 01],降低空腹血糖[SMD=-1.06,95%CI(-1.24,-0.88),P<0.000 01]、餐后 2h血糖[MD=-1.53,95%CI(-1.71,-1.35),P<0.000 01]、糖化血红蛋白[MD=-1.56,95%CI(-2.01,-1.11),P<0.000 01]、同型半胱氨酸[MD=-8.47,95%CI(-8.89,-7.97),P<0.00001]、低密度脂蛋白[MD=-0.46,95%CI(-0.69,-0.24),P<0.0001]、总胆固醇[MD=-0.45,95%CI(-1.11,-0.20),P=0.005]、甘油三酯[MD=-0.42,95%CI(-0.50,-0.34),P<0.00001]、白细胞介素 6[SMD=-1.34,95%CI(-1.61,-1.07),P<0.000 01]、心血管不良事件[OR=0.35,95%CI(0.19,0.64),P=0.000 6]、不良反应发生率[OR=0.45,95%CI(0.24,0.86),P=0.01]方面均优于常规西医治疗.结论 复方丹参滴丸联合西医常规治疗冠心病合并糖尿病的疗效优于单纯西医治疗,而且安全性较好.但受纳入研究质量等因素的限制,上述结论仍需更多高质量的临床试验验证.
Efficacy and Safety of Compound Danshen Dripping Pills Combined with Conventional Western Medicine in the Treatment of Coronary Heart Disease Complicated with Diabetes Mellitus:A Meta-Analysis
Objective To systematically evaluate the efficacy and safety of Compound Danshen Dripping Pills combined with conventional western medicine in the treatment of coronary heart disease complicated with diabetes mellitus.Methods Wanfang database,CNKI,VIP,SinoMed,Cochrane Library,PubMed,Embase and Web of Science databases were searched to collect randomized controlled trials(RCTs)of Compound Danshen dripping pills combined with conventional western medicine in the treatment of coronary heart disease complicated with diabetes mellitus.The retrieval time is from the establishment of the database to May 2023.Two researchers independently completed literature screening,data collation and risk of bias evaluation.RevMan 5.4 software was used for Meta-analysis.Results Twenty-four RCTs with a total of 2 546 patients were included.Meta-analysis showed that the treatment of Compound Danshen Dripping Pills combined with conventional western medicine was better than that of conventional western medicine in improving the total effective rate of coronary heart disease complicated with diabetes mellitus[OR=4.93,95%CI(3.49,6.98),P<0.000 01],plasma adiponectin[MD= 2.79,95%CI(2.30,3.27),P<0.000 01],reducing fasting blood glucose[SMD=-1.06,95%CI(-1.24,-0.88),P<0.000 01],postprandial two-hour blood glucose[MD=-1.53,95%CI(-1.71,-1.35),P<0.000 01],glycosylated hemoglobin[MD=-1.56,95%CI(-2.01,-1.11),P<0.000 01],homocysteine[MD=-8.47,95%CI(-8.89,-7.97),P<0.000 01],low density lipoprotein[MD=-0.46,95%CI(-0.69,-0.24),P<0.000 01],total cholesterol[MD=-0.45,95%CI(-1.11,-0.20),P=0.005],triglycerides[MD=-0.42,95%CI(-0.50,-0.34),P<0.000 01],interleukin 6[SMD=-1.34,95%CI(-1.61,-1.07),P<0.000 01],cardiovascular adverse events[OR=0.35,95%CI(0.19,0.64),P=0.000 6],incidence of adverse reactions[OR=0.45,95%CI(0.24,0.86),P=0.01].Conclusion Compound Danshen Dripping Pills combined with conventional western medicine in the treatment of coronary heart disease with diabetes mellitus is more effective than conventional western medicine treatment,and with better safety.However,due to the limit of the quality of the included studies and other factors,the above conclusions still need to be verified by more high-quality clinical trials.

Compound Danshen Dripping Pillscoronary heart diseasediabetes mellitusMeta-analysisefficacysafety

徐柏榕、田晶、牛栋、邢作英、邱伯雍、王永霞

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河南中医药大学,河南 郑州 450000

河南中医药大学第一附属医院心脏中心,河南 郑州 450000

复方丹参滴丸 冠心病 糖尿病 Meta分析 有效性 安全性

第五批全国中医临床优秀人才研修项目河南省"双一流"心血管疾病中医药防治科技创新团队河南中医药大学"双一流"创建工程

国中医药人教函[2022]1号HSRP-DFCTCM-2023-3-03

2024

中药新药与临床药理
广州中医药大学

中药新药与临床药理

CSTPCD北大核心
影响因子:0.908
ISSN:1003-9783
年,卷(期):2024.35(2)
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