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丹参酮ⅡA磺酸钠注射液辅助治疗不稳定型心绞痛:17项随机对照试验的荟萃分析

Sodium Tanshinone II A Sulfonate Injection as Adjuvant Treatment for Unstable Angina Pectoris: A Meta-Analysis of 17 Randomized Controlled Trials.

作者信息

Tan Di, Wu Jia-Rui, Zhang Xiao-Meng, Liu Shi, Zhang Bing

机构信息

Department of Clinical Pharmacology of Traditional Chinese Medicine, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 100102, China.

出版信息

Chin J Integr Med. 2018 Feb;24(2):156-160. doi: 10.1007/s11655-017-2424-x. Epub 2017 Nov 28.

Abstract

OBJECTIVE

To systematically evaluate the effectiveness and safety of Sodium Tanshinone II A Sulfonate Injection (STS) as one adjuvant therapy for treating unstable angina pectoris (UAP).

METHODS

Randomized controlled trials (RCTs) of UAP treated by STS were searched in the China National Knowledge Infrastructure Database (CNKI), VIP Database for Chinese Technical Periodicals (VIP), Wanfang Database, the Chinese Biomedical Literature Database (CBM), Web of Science, the Cochrane Library, Embase, and PubMed, which from inception to January, 2016. The Cochrane Risk Assessment Tool was used to evaluate the methodological quality of the RCTs. The Review Manager 5.3 software was used to conduct the metaanalysis.

RESULTS

The results showed that 17 RCTs involving 1,372 patients were included. The meta-analysis indicated that the combined use of STS and Western medicine (WM) in the treatment of UAP can obviously improve the total effective rate [risk ratio (RR)=1.31, 95% confidence interval (CI) (1.24,1.39), P<0.0001], and the total effective rate of electrocardiogram [RR=1.43, 95% CI (1.30,1.56), P<0.0001], decrease the level of CRP [mean difference (MD)=-3.06, 95%CI (-3.85,-2.27), P<0.00001], fibrinogen [MD=-1.03, 95% CI (-1.16,-0.89), P<0.00001], and whole blood high shear viscosity [MD=-0.70, 95% CI (-0.92,-0.49), P<0.00001]. Additionally, the occurrence of adverse drug reaction of the experimental group was significantly higher than that of the control group [RR=3.57, 95% CI (1.28, 9.94), P<0.05].

CONCLUSIONS

Compared with WM, the combined use of STS was more effective.

摘要

目的

系统评价丹参酮ⅡA磺酸钠注射液(STS)作为不稳定型心绞痛(UAP)辅助治疗药物的有效性和安全性。

方法

检索中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、Web of Science、Cochrane图书馆、Embase和PubMed中从建库至2016年1月发表的关于STS治疗UAP的随机对照试验(RCT)。采用Cochrane风险评估工具评价纳入RCT的方法学质量。使用RevMan 5.3软件进行荟萃分析。

结果

结果显示,共纳入17项RCT,涉及1372例患者。荟萃分析表明,STS联合西药治疗UAP可显著提高总有效率[风险比(RR)=1.31,95%置信区间(CI)(1.24,1.39),P<0.0001],以及心电图总有效率[RR=1.43,95%CI(1.30,1.56),P<0.0001],降低超敏C反应蛋白(CRP)水平[平均差(MD)=-3.06,95%CI(-3.85,-2.27),P<0.00001]、纤维蛋白原水平[MD=-1.03,95%CI(-1.16,-0.89),P<0.00001]和全血高切黏度[MD=-0.70,95%CI(-0.92,-0.49),P<0.00001]。此外,试验组药物不良反应发生率显著高于对照组[RR=3.57,95%CI(1.28,9.94),P<0.05]。

结论

与单纯西药治疗相比,STS联合西药治疗更有效。

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