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灯盏细辛注射液辅助治疗心绞痛:一项随机对照试验的系统评价与Meta分析

[Dengzhan Xixin injection as an adjuvant treatment for angina pectoris: a systematic review and Meta-analysis of randomized controlled trials].

作者信息

Wang Feng-jiao, Xie Yan-ming, Liao Xing, Jia Min

出版信息

Zhongguo Zhong Yao Za Zhi. 2015 Aug;40(16):3298-307.

Abstract

The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P < 0.000 010 and electrocardiogram curative effect (OR = 2.21; 95% CI; [1.83, 2.68]; P < 0.000 010. Funnel figure seemed that there was publication bias. The current limited evidence showed that when compared with the control group, treatment group was superior in improving patients with angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.

摘要

本文旨在系统评价灯盏细辛注射液(DZXXI)辅助治疗心绞痛患者的有效性和安全性。检索了Cochrane图书馆、Medline、EMbase、CBM、CNKI、VIP和万方数据库。纳入了灯盏细辛注射液联合西药常规治疗与单纯西药常规治疗心绞痛患者的随机对照试验(RCT)。所有试验均按照Cochrane干预系统评价手册5.1进行评估,并使用RevMan 5.2软件进行Meta分析。共纳入30项RCT(3086例患者,其中治疗组1572例,对照组1514例)。治疗组与对照组的Meta分析显示,在减少心血管事件方面效果更佳(OR = 0.33;95%CI:[0.16, 0.67],P = 0.002),提高灯盏细辛注射液辅助治疗心绞痛患者的有效率(OR = 3.97;95%CI:[3.15, 5.02];P < 0.000 01)以及心电图疗效(OR = 2.21;95%CI:[1.83, 2.68];P < 0.000 01)。漏斗图显示可能存在发表偏倚。目前有限的证据表明,与对照组相比,治疗组在改善心绞痛患者方面更具优势。但基于研究的局限性,有必要进行设计严谨、随访时间长的临床试验以获取进一步证据。

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