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经皮冠状动脉介入治疗后冠心病的中医药疗法:一项随机、双盲、安慰剂对照试验的荟萃分析。

A traditional Chinese medicine therapy for coronary heart disease after percutaneous coronary intervention: a meta-analysis of randomized, double-blind, placebo-controlled trials.

机构信息

Department of Traditional Chinese Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510260, China.

School of Chinese Medicine, Jinan University, Guangzhou, Guangdong 510632, China.

出版信息

Biosci Rep. 2018 Oct 17;38(5). doi: 10.1042/BSR20180973. Print 2018 Oct 31.

Abstract

Huoxue Huayu therapy (HXHY) has been widely used to treat cardiovascular diseases in traditional Chinese medicine (TCM) such as hypertension and coronary heart disease (CHD). The present study describes a meta-analysis of a series of prospective randomized, double-blind, placebo-controlled trials conducted to evaluate the effect of HXHY on patients with CHD after percutaneous coronary intervention (PCI). The Cochrane Library, PubMed, EMBASE, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature database, and the Wanfang database were searched up until June 2018. A series of randomized controlled clinical trials were included and the subjects were patients with CHD who had undergone PCI. The experimental group was treated with HXHY therapy, and the control group was treated with placebo; meanwhile, all the patients accepted conventional Western medicine. Review Manager 5.3 software was used for the statistical analysis. Ten trials were included in the final study. The overall risk of bias assessment was low. HXHY had a greater beneficial effect on reducing the in-stent restenosis (ISR) rate (RR = 0.57, 95% confidence interval [CI] [0.40-0.80], =0.001) and the degree of restenosis (MD = -8.89, 95% CI [-10.62 to -7.17], <0.00001) compared with Placebo. Moreover, HXHY was determined to be more effective in improving Seattle Angina Questionnaires (SAQ) and the revascularization rate (RR = 0.54, 95% CI [0.32-0.90], =0.02) compared with Placebo, whereas the rate of death and MI of patients treated with HXHY were no different from those treated with the placebo (>0.05). Therefore, HXHY is an effective and safe therapy for CHD patients after PCI.

摘要

活血化瘀疗法(HXHY)已广泛用于治疗高血压和冠心病(CHD)等心血管疾病。本研究描述了一项荟萃分析,纳入了一系列旨在评估 HXHY 对经皮冠状动脉介入治疗(PCI)后 CHD 患者影响的前瞻性随机、双盲、安慰剂对照试验。检索了 Cochrane 图书馆、PubMed、EMBASE、中国国家知识基础设施(CNKI)、中国生物医学文献数据库和万方数据库,检索截至 2018 年 6 月。纳入了一系列随机对照临床试验,研究对象为接受 PCI 的 CHD 患者。实验组采用 HXHY 治疗,对照组采用安慰剂治疗;同时,所有患者均接受常规西药治疗。采用 Review Manager 5.3 软件进行统计分析。最终研究纳入 10 项试验。整体偏倚风险评估为低。与安慰剂相比,HXHY 降低支架内再狭窄(ISR)率(RR = 0.57,95%置信区间 [CI] [0.40-0.80],=0.001)和再狭窄程度(MD = -8.89,95% CI [-10.62 至 -7.17],<0.00001)的效果更好。此外,与安慰剂相比,HXHY 更能有效改善西雅图心绞痛问卷(SAQ)和再血管化率(RR = 0.54,95% CI [0.32-0.90],=0.02),而 HXHY 治疗组患者的死亡率和心肌梗死发生率与安慰剂治疗组无差异(>0.05)。因此,HXHY 是 PCI 后 CHD 患者的一种有效且安全的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2324/6435456/8ece675b41ad/bsr-38-bsr20180973-g1.jpg

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