Liu Wei, Xiong Xingjiang, Yang Xiaochen, Chu Fuyong, Liu Hongxu
Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.
Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Evid Based Complement Alternat Med. 2016;2016:8565907. doi: 10.1155/2016/8565907. Epub 2016 Sep 29.
We systematically assess the current clinical evidence of Gualouxiebaibanxia (GLXBBX) decoction for the treatment of angina pectoris (AP). We included RCTs testing GLXBBX against conventional drugs and GLXBBX combined with conventional drugs versus conventional drugs. 19 RCTs involving 1730 patients were finally identified, and the methodological quality was evaluated as generally low. The results of the meta-analysis showed that GLXBBX alone had significant effect on improving angina symptoms (RR: 1.24, 95% CI 1.14 to 1.35; < 0.00001), ECG (RR: 1.28 [1.13,1.44]; < 0.0001), and HDL-C (MD: 0.56 [0.54,0.58]; < 0.00001) compared with anti-arrhythmic drugs. A significant improvement in angina symptoms (RR: 1.17 [1.12,1.22]; < 0.00001) and ECG (RR = 1.22; 95% CI = [1.14,1.30]; < 0.00001) was observed for GLXBBX plus conventional drugs when compared with conventional drugs. Eight trials reported adverse events without serious adverse effects. GLXBBX appears to have beneficial effects on improvement of ECG and reduction of angina symptoms in participants with AP. However, the evidence remains weak due to the poor methodological quality of the included studies. More rigorous trials are needed to confirm the results.
我们系统地评估了瓜蒌薤白半夏汤治疗心绞痛(AP)的当前临床证据。我们纳入了比较瓜蒌薤白半夏汤与传统药物以及瓜蒌薤白半夏汤联合传统药物与传统药物的随机对照试验(RCT)。最终确定了19项涉及1730例患者的RCT,方法学质量评估总体较低。荟萃分析结果显示,与抗心律失常药物相比,单独使用瓜蒌薤白半夏汤在改善心绞痛症状(RR:1.24,95%CI 1.14至1.35;P<0.00001)、心电图(RR:1.28[1.13,1.44];P<0.0001)和高密度脂蛋白胆固醇(HDL-C,MD:0.56[0.54,0.58];P<0.00001)方面有显著效果。与传统药物相比,瓜蒌薤白半夏汤加传统药物在心绞痛症状(RR:1.17[1.12,1.22];P<0.00001)和心电图(RR = 1.22;95%CI = [1.14,1.30];P<0.00001)方面有显著改善。八项试验报告了不良事件,但无严重不良反应。瓜蒌薤白半夏汤似乎对改善AP参与者的心电图和减轻心绞痛症状有有益作用。然而,由于纳入研究的方法学质量较差,证据仍然薄弱。需要更严格的试验来证实结果。