Shi Zhaofeng, Zhao Chen, Hu Jiayuan, Dai Qianqian, Guan Manke, Zhong Changming, Tian Guihua, Shang Hongcai
Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing 100700, China.
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
Evid Based Complement Alternat Med. 2020 May 18;2020:3834128. doi: 10.1155/2020/3834128. eCollection 2020.
TCMI with the effect of and has been applied as complementary therapies during the perioperative period of PCI for patients with ACS, while the recommended time points and plans of TCMI are still short of the support of evidence-based medicine.
A systematic review and meta-analysis was conducted to evaluate the clinical efficacy and safety of TCMI on patients with ACS during the perioperative period of PCI. RCTs were searched based on standardized searching rules in seven medical databases from the inception up to August 2019. Two reviewers conducted the study selection, data extraction, and quality analysis independently. Data were analysed with the support of software and .
A total of 68 articles with 6,043 patients were enrolled. The result of meta-analysis showed that the TCMI combined with western medicine was superior to the western medicine alone on clinical efficiency (before the PCI, before and after the PCI, or overall, < 0.05), the occurrence of MACE (myocardial infarction and stenocardia: before the PCI, before and after the PCI, or overall, < 0.05; arrhythmia: before and after the PCI, < 0.05), and the level of inflammatory factors (hs-CRP: before the PCI, before and after the PCI, or overall, < 0.05; IL-6: after the PCI, < 0.05). The TCMI with the effect of obtained more support compared with based on the result of meta-analysis.
TCMI with the effect of or combined with western medicine generally showed the potential advantage on the treatment of ACS during the perioperative period of PCI. However, the optimal time point of intervention and recommended plan based on the effect still needs more clinical evidence. We consider that the research of precise and standardized application of TCMI will be a promising direction for TCM in the future.
具有[具体功效1]和[具体功效2]作用的中药注射剂已被用作急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）围手术期的辅助治疗方法，而中药注射剂的推荐使用时间点和方案仍缺乏循证医学的支持。
进行一项系统综述和荟萃分析，以评估中药注射剂在PCI围手术期对ACS患者的临床疗效和安全性。根据标准化检索规则，在7个医学数据库中检索自建库至2019年8月的随机对照试验（RCT）。两名研究者独立进行研究筛选、数据提取和质量分析。数据在[软件1]和[软件2]的支持下进行分析。
共纳入68篇文章，涉及6043例患者。荟萃分析结果显示，中药注射剂联合西药在临床疗效方面（PCI术前、PCI术前及术后或总体，P<0.05）、主要不良心血管事件（MACE，心肌梗死和心绞痛：PCI术前、PCI术前及术后或总体，P<0.05；心律失常：PCI术后，P<0.05）以及炎症因子水平方面（高敏C反应蛋白：PCI术前、PCI术前及术后或总体，P<0.05；白细胞介素-6：PCI术后，P<0.05）均优于单纯西药。基于荟萃分析结果，具有[具体功效1]作用的中药注射剂比具有[具体功效2]作用的中药注射剂获得了更多支持。
具有[具体功效1]或[具体功效2]作用的中药注射剂联合西药在PCI围手术期治疗ACS方面总体显示出潜在优势。然而，基于疗效的最佳干预时间点和推荐方案仍需要更多临床证据。我们认为，中药注射剂精准规范应用的研究将是未来中医药发展的一个有前景的方向。
