Chen Hong, Zhou Cihang, Yu Mingwei, Feng Shuo, Ma Yunfei, Liu Zhengrong, Zhang Jiahui, Ding Tongjing, Li Bo, Wang Xiaomin
Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.
Beijing University of Traditional Chinese Medicine, Beijing 100029, China.
Evid Based Complement Alternat Med. 2019 Jun 26;2019:2609625. doi: 10.1155/2019/2609625. eCollection 2019.
A systematic review of randomized trials was performed to assess the effect of Ginkgo Biloba Dropping Pills (GBDP) on clinical hemorheology and blood lipid indicators.
The data of the Embase, Cochrane Library, PubMed, Clinical Trials, China National Knowledge Infrastructure, the Wanfang database, the VIP database, and the Sinomed were retrieved by computers from the establishment of the database to March 27, 2018, and screened and extracted by two researchers according to inclusion and exclusion criteria. Cochrane 5.0 recommended bias risk assessment tool was used to evaluate the methodological quality of the included literature, and Revman 5.3 software were used for meta-analysis.
10 literatures were finally selected in accordance with the standard. There were a total of 1201 cases, 608 cases in ginkgo biloba dropping pill group and 593 in routine treatment group. Compared with control group, GBDP significantly improved plasma viscosity [N=383, RR= - 0.45, 95%CI=(-0.86,-0.04), P=0.03], whole blood high shear [N=232, RR= - 0.92,95%CI=(-1.69, -0.16), P =0.02], whole blood low shear [N = 232, RR = - 2.22, 95% CI = (- 3.74, -0.7), P = 0.004], red blood cell specific volume [N =132, RR = - 4.55, 95% CI = (- 6.36, 2.73), P < 0.000 01], fibrinogen [N=243, RR=-0.60,95%CI=(-0.82,-0.39), P<0.00001], triglyceride [N=912, RR=-0.60,95%CI=(-1.12, -0.07), P =0.03], cholesterol [N=912, RR=-0.97,95%CI=(-1.41, -0.52), P <0.0001], low-density cholesterol [N=1100, RR=-0.72,95%CI=(-1.19, -0.25), P =0.003], and sensitivity analysis before and after of high-density cholesterol [N=1020, RR=0.08,95%CI=(-0.17,0.34), P =0.52] and [N=683, RR=0.27,95%CI=(0.13,0.42), P =0.0003]. And seven adverse reactions were reported.
GBDP can improve hemorheology indexes, which is to reduce the blood viscosity, to improve blood lipid status, and to prevent and treat cardiocerebral and renal vascular diseases to a certain extent, with slight clinical adverse reactions. But our results were based on small amount of clinical studies with poor quality and insufficient evidence, which may lead to low credibility of conclusions. Therefore, more large-sample, multiple-center, randomized controlled clinical trials and related mechanisms researches are needed to obtain better clinical trial evidence in order to verify the further effectiveness and safety of GBDP on hemorheology.
进行一项随机试验的系统评价,以评估银杏叶滴丸(GBDP)对临床血液流变学和血脂指标的影响。
通过计算机检索Embase、Cochrane图书馆、PubMed、临床试验、中国知网、万方数据库、维普数据库和中国生物医学文献数据库,检索时间从各数据库建库至2018年3月27日,由两名研究人员根据纳入和排除标准进行筛选和提取。采用Cochrane 5.0推荐的偏倚风险评估工具评估纳入文献的方法学质量,并用Revman 5.3软件进行荟萃分析。
最终按照标准筛选出10篇文献。共有1201例患者,银杏叶滴丸组608例,常规治疗组593例。与对照组相比,GBDP显著改善了血浆黏度[N = 383,RR = -0.45,95%CI =(-0.86,-0.04),P = 0.03]、全血高切变率[N = 232,RR = -0.92,95%CI =(-1.69,-0.16),P = 0.02]、全血低切变率[N = 232,RR = -2.22,95%CI =(-3.74,-0.7),P = 0.004]、红细胞比容[N = 132,RR = -4.55,95%CI =(-6.36,-2.73),P < 0.00001]、纤维蛋白原[N = 243,RR = -0.60,95%CI =(-0.82,-0.39),P < 0.00001]、甘油三酯[N = 912,RR = -0.60,95%CI =(-1.12,-0.07),P = 0.03]、胆固醇[N = 912,RR = -0.97,95%CI =(-1.41,-0.52),P < 0.0001]、低密度胆固醇[N = 1100,RR = -0.72,95%CI =(-1.19,-0.25),P = 0.003],以及高密度胆固醇前后的敏感性分析[N = 1020,RR = 0.08,95%CI =(-0.17,0.34),P = 0.52]和[N = 683,RR = 0.27,95%CI =(0.13,0.42),P = 0.0003]。共报告7例不良反应。
GBDP可改善血液流变学指标,即降低血液黏度,改善血脂状况,在一定程度上防治心脑血管和肾脏血管疾病,临床不良反应轻微。但我们的结果基于少量质量较差的临床研究,证据不足,可能导致结论的可信度较低。因此,需要更多大样本、多中心、随机对照临床试验及相关机制研究,以获得更好的临床试验证据,进一步验证GBDP在血液流变学方面的有效性和安全性。