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四逆汤作为心绞痛辅助治疗的随机对照试验系统评价

Sini decoction as an adjuvant therapy for angina pectoris: a systematic review of randomized controlled trials.

作者信息

Wu Jin, Yuan Dongchao, Yang Mingqian, Xia Wei, Zhang Zhe, Zhang Huiyong, Fei Yutong, Yang Guanlin

出版信息

J Tradit Chin Med. 2017 Feb;37(1):12-22. doi: 10.1016/s0254-6272(17)30021-3.

Abstract

OBJECTIVE

To systematically assess the effects and safety of Sini decoction as an adjuvant therapy for patients with angina pectoris.

METHODS

We searched PubMed, Excerpt Medica Database, the Cochrane library, Wanfang Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database from the date of its inception until August 1, in 2014. Available literatures were selected according to the inclusion criteria. Two reviewers finished data extraction, checked the data and assessed the methodological quality of studies, independently. The Review Manage Software 5.1.0 was used for data analysis.

RESULTS

Six trials involving 453 participants were eligible. None of the trials reported the mortality due to angina pectoris. The secondary outcomes showed that Sini decoction, together with nitroglycerin when necessary, may have some effects on reducing the number of angina attacks and the amount of nitroglycerin. But in terms of reducing the duration of angina and improvement of electrocardiogram, there were no statistical differences between Sini decoction group and isosorbide dinitrate group. Only one reported that no adverse events were found.

CONCLUSION

Based on this systematic review, Sini decoction can reduce the dosage of nitroglycerin, when compared with isosorbide dinitrate group. And there were no enough evidence in the papers to draw any conclusions for the safety of Sini decoction.

摘要

目的

系统评价四逆汤作为辅助治疗对心绞痛患者的疗效及安全性。

方法

检索PubMed、医学文摘数据库、Cochrane图书馆、万方数据库、中国知网数据库、中国科技期刊数据库,检索时间从建库至2014年8月1日。根据纳入标准筛选可用文献。两名评价员独立完成数据提取、核对数据并评估研究的方法学质量。采用RevMan 5.1.0软件进行数据分析。

结果

6项试验共纳入453例患者。所有试验均未报告心绞痛导致的死亡情况。次要结局显示,四逆汤联合必要时使用的硝酸甘油,可能对减少心绞痛发作次数及硝酸甘油用量有一定作用。但在缩短心绞痛持续时间及改善心电图方面,四逆汤组与硝酸异山梨酯组之间无统计学差异。仅1项试验报告未发现不良事件。

结论

基于本系统评价,与硝酸异山梨酯组相比,四逆汤可减少硝酸甘油用量。且文献中没有足够证据就四逆汤的安全性得出任何结论。

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