摘要
目的系统评价活血化瘀中药对冠心病经皮冠状动脉介入治疗(PCI)术后出血事件及心血管不良事件的影响。方法计算机检索中国知网(CNKI)、维普(VIP)、万方(WanFang Data)、PubMed、the Cochrane Library和EMbase数据库,搜索关于活血化瘀中药对冠心病PCI术后出血事件影响的随机对照试验(RCT),检索时限从建库至2020年8月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.3软件进行Meta分析。结果Meta分析结果显示:两组出血事件发生率比较差异无统计学意义[RR=0.88,95%CI(0.68,1.13),P=0.31];试验组心血管不良事件发生率低于对照组[RR=0.48,95%CI(0.36,0.63),P<0.00001];试验组再狭窄率低于对照组[RR=0.35,95%CI(0.17,0.72),P=0.004];试验组心绞痛疗效优于对照组[RR=1.23,95%CI(1.05,1.43),P=0.010];试验组中医证候积分优于对照组[MD=-3.11,95%CI(-3.70,-2.51),P<0.00001]。结论现有证据表明,在西药常规治疗基础上应用活血化瘀中药未增加冠心病PCI术后出血风险,且能更有效减少心血管不良事件的发生。受纳入研究数量和质量的限制,上述结论尚待更高质量研究予以验证。
Objective To evaluate the effects of blood-activating and stasis-resolving traditional Chinese medicine on bleeding events and cardiovascular adverse events after percutaneous coronary intervention(PCI).Methods China National Knowledge Internet(CNKI),VIP,WanFang data,PubMed,the Cochrane Library,and EMbase databases were searched for randomized controlled trials(RCT)of promoting blood circulation and removing blood stasis on bleeding events after PCI.The retrieval time was from the establishment of the database to August 2020.Two researchers independently screened the literature,extracted data,and evaluated the risk of bias of the included study.RevMan 5.3 software were used for Meta-analysis.Results Meta-analysis results showed that there was no significant difference in the incidence of bleeding events after PCI between experimental group and control group[RR=0.88,95%CI(0.68,1.13),P=0.31].The incidence of cardiovascular adverse events in experimental group was lower than that in control group[RR=0.48,95%CI(0.36,0.63),P<0.00001].The restenosis rate of experimental group was better than that of control group[RR=0.35,95%CI(0.17,0.72),P=0.004].The therapeutic effect of angina pectoris in experimental group was better than that in control group[RR=1.23,95%CI(1.05,1.43),P=0.010].The score of traditional Chinese medicine syndrome in experimental group was better than that in control group[MD=-3.11,95%CI(-3.70,-2.51),P<0.00001]Conclusion The current evidence suggests that the existing evidence shows that the application of blood-activating and stasis-resolving traditional Chinese medicine on the basis of routine western medicine treatment does not increase the risk of bleeding after PCI,and can reduce the incidence of cardiovascular adverse events.Limited by the number and quality of the included studies,the above conclusions need to be verified by higher quality studies.
作者
吕丽娜
姜丽红
LYU Lina;JIANG Lihong(College of Traditional Chinese Medicine,Changchun University of Chinese Medicine,Changchun 130021,Jilin,China)
出处
《中西医结合心脑血管病杂志》
2022年第6期961-966,共6页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
国家自然科学基金面上项目(No.81673846)
吉林省科技厅发展计划项目(No.20200201320JC)。
关键词
冠心病
经皮冠状动脉介入治疗
活血化瘀
中药
出血事件
Meta分析
coronary heart disease
percutaneous transluminal coronary intervention
promoting blood circulation and removing blood stasis
traditional Chinese medicine
bleeding events
Meta-analysis
