灯盏细辛注射液联用西药治疗不稳定心绞痛的Meta分析

Abstract

目的:评价灯盏细辛联合西药常规治疗不稳定型心绞痛临床疗效和安全性.方法:计算机检索Cochrane图书馆,Medline,EMbase,CBM,CNKI,VIP和万方数据库,由2位研究者独立筛选和提取资料,根据Cochrane Reviewer's Handbook 5.0评价标准和工具评价纳入文献质量,用RevMan 5.1软件进行数据分析.结果:共纳入17个随机对照试验,共计1644名患者.仅2个研究采用恰当的随机分配方法,1个研究提及采用单盲,其余所有研究均未提及随机方法、分配隐藏、盲法及失访.Meta分析结果显示:灯盏细辛注射液加用常规治疗组治疗不稳定心绞痛有效率(OR =3.54,95％CI[2.60～4.82])和心电图疗效( OR=2.36,95％CI[1.88～2.96])优于单用常规治疗组.本组纳入17篇研究报道的不良反应表现轻微,使用安全.研究可能存在发表偏倚.结论:目前证据证实灯盏细辛注射液联合常规疗法治疗不稳定性心绞痛比西医常规治疗更具有优势.但基于研究的局限,建议进行更多大样本、多中心,随访时间更长的随机对照研究加以证实.

To assess the efficacy and safety of Dengzhanxixin injection for unstable angina pectoris.All clinical studies of Dengzhanxixin injection for unstable angina pectoris (UAP) were searched from Cochrane library, Medline, EM-base, CBM, CNKI, Wanfang and VIP. Quality assessment and information extraction were done by two independent screening . The quality of the included documents was evaluated by the Cochrane Collaboration's tool for assessing risk of bias and allocation concealment. Revman 5.1.4 software was used for data analysis.A total of 17 randomized controlled trials were included (1 644 patients), in which, only 2 studies were true RCT, 1 study used single blind method, while other studies did not mention allocation concealment, blind and loss-up information. Meta-analysis showed that the Dengzhanxixin injection group was better than the conventional treatment group in efficiency (OR = 3.54, 95% CI [2.60-4.82]) and ECG (OR = 2.36, 95% CI[1.88-2.96]). Researches with ADR/AE information of Dengzhanxixin injection showed that the symptoms of ADR/AE were slight. This study may exist publication bias.Dengzhanxixin injection on the basis of conventional treatment can improve the efficacy of the treatment of unstable angina pectoris. However, due to the sample size of included studies were small and of lower quality, conclusions above still need high-qualitied randomized, double-blind, controlled trials be confirmed.