摘要
目的:系统评价养心通脉方加减联合常规西药治疗冠状动脉粥样硬化性心脏病(简称冠心病)心绞痛的临床疗效。方法:检索中国知网、维普、万方、CBM、PubMed、Embase、the Cochrane Library数据库,时限从数据库建立至2021年2月。由2位研究员按要求独立筛选文献,统计资料及评价偏倚风险,采用Revman 5.3软件进行Meta分析,TSA 0.9软件进行试验序贯分析,Stata 15.0软件进行发表偏倚评估,GRADE 3.6进行证据质量评价。结果:共纳入10项研究,共计患者1201例。Meta分析显示,与常规西药比较,养心通脉方联用能有效提高治疗冠心病心绞痛的心绞痛总有效率[RR=1.21,95%CI=(1.10,1.33),P<0.0001]、证候总有效率[RR=1.18,95%CI=(1.10,1.26),P<0.00001]、心电图总有效率[RR=1.30,95%CI=(1.21,1.40),P<0.00001]。试验序贯分析显示心绞痛总有效率的获益具有结论性。Harbord检验显示不存在显著发表偏倚(P=0.51)。证据质量评价显示心绞痛总有效率和心电图总有效率的证据质量均为低,证候总有效率的证据质量为极低,推荐强度为弱推荐。结论:养心通脉方加减联合常规西药治疗冠心病心绞痛的疗效优于常规西药,具有在临床应用推广的价值。
Objective:To systematically evaluate the clinical efficacy of the Yangxin Tongmai decoction(养心通脉方)plus conventional Western medicine on coronary heart disease angina pectoris.Methods:The related literature was retrieved in CNKI,VIP,Wanfang,CBM,PubMed,Embase and the Cochrane Library database from the establishment of the database to February 2021.According to the requirements,two researchers independently screened the literature,collated relevant data and assessed the bias risk.RevMan 5.3 software was used for the Meta analysis,TSA 0.9 software was used for the trial sequential analysis,Stata 15.0 software was used for publication bias assessment,and GRADE 3.6 software was used for evidence quality assessment.Results:A total of 10 studies with 1201 cases were included.The Meta-analysis showed that compared with the conventional Western medicine,the Yangxin Tongmai decoction plus conventional Western medicine on coronary heart disease angina pectoris can effectively improve the total efficiency of angina pectoris[RR=1.21,95%CI=(1.10,1.33),P<0.0001],the total efficiency of TCM syndromes[RR=1.18,95%CI=(1.10,1.26),P<0.00001],and the total efficiency of ECG[RR=1.30,95%CI=(1.21,1.40),P<0.00001].The trial sequential analysis showed that the total efficiency of angina pectoris was conclusive.The Harbord test showed no significant publication bias(P=0.51).The evidence quality evaluation showed that the evidence quality of the total efficiency of angina pectoris and the total efficiency of ECG were both low,the evidence quality of the total efficiency of TCM syndromes was very low,and the recommendation intensity was weak.Conclusion:The Yangxin Tongmai decoction plus conventional Western medicine shows better efficacy on coronary heart disease angina pectoris than conventional Western medicine,and has the value of clinical application and promotion.
出处
《中医临床研究》
2021年第34期132-136,共5页
Clinical Journal Of Chinese Medicine
基金
国家自然科学基金项目(81973753)
关键词
养心通脉方
常规西药
冠状动脉粥样硬化性心脏病心绞痛
META分析
试验序贯分析
The Yangxin Tongmai decoction
Conventional Western medicine
Coronary heart disease angina pectoris
Metaanalysis
Trial sequential analysis
