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[芪参益气滴丸联合西药对经皮冠状动脉介入治疗后不良心血管事件及生活质量影响的Meta分析]

[Meta-analysis of effect of Qishen Yiqi Dripping Pills combined with Western medicine on adverse cardiovascular events and quality of life after percutaneous coronary intervention].

作者信息

Dai Qian-Qian, Shi Zhao-Feng, Hu Jia-Yuan, Han Song-Jie, Zhong Chang-Ming, Guan Man-Ke, Tian Gui-Hua, Shang Hong-Cai

机构信息

Dongzhimen Hospital,Beijing University of Chinese Medicine Beijing 100700,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2021 Mar;46(6):1498-1510. doi: 10.19540/j.cnki.cjcmm.20200618.501.

Abstract

To systemically evaluate the effect of Qishen Yiqi Dripping Pills combined with Western medicine on adverse cardiovascular events and quality of life after percutaneous coronary intervention(PCI). A total of 7 Chinese and English databases including CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library and Web of Science were searched by computer to collect the randomized controlled trials(RCTs) on Qishen Yiqi Dripping Pills combined with Western medicine in the treatment of patients with coronary heart disease after PCI with the retrieval time from the database establishment to April 1, 2020. Two researchers independently conducted li-terature screening, data extraction and bias risk assessment. Then, Meta-analysis was performed by using RevMan 5.3 software. A total of 31 RCTs were included, involving 3 537 patients. The results of Meta-analysis showed that in terms of major adverse cardiovascular events(MACE) after PCI, the combination of Qishen Yiqi Dripping Pills could significantly reduce the recurrence of angina pectoris, incidence of arrhythmia, heart failure and re-revascularization, and the effect was better than that of Western medicine treatment alone. However, there was no significant difference between the two groups in the improvement of non-fatal myocardial infarction, cardiac death, stent restenosis, stroke and other adverse cardiovascular events. In terms of improving left ventricular ejection fraction(LVEF), 6 min walking test(6 MWT), high-sensitivity C-reactive protein(hs-CRP) and Seattle angina pectoris scale(SAQ), the combination of Qishen Yiqi Dripping Pills and Western medicine treatment had obvious advantages over Western medicine treatment alone in increasing LVEF, 6 MWT and SAQ, and reducing the level of hs-CRP, with statistically significant differences. There were few adverse reactions in both groups, and there was no significant difference between the two groups. The main manifestations were gastrointestinal reactions, rash, gingiva and other small bleeding, and no serious adverse reactions occurred. The above reactions could disappear after drug withdrawal or symptomatic treatment. The application of Qishen Yiqi Dripping Pills combined with Western medicine in the treatment of patients after PCI could reduce the occurrence of MACE, improve the clinical efficacy, quality of life and prognosis in a safe and reliable manner. However, due to the quantity and quality limitations of included studies, more standardized, rigo-rous and high-quality clinical studies are still needed to further verify the above conclusions.

摘要

系统评价芪参益气滴丸联合西药对经皮冠状动脉介入治疗(PCI)后心血管不良事件及生活质量的影响。通过计算机检索中国知网(CNKI)、万方、维普、中国生物医学文献数据库(SinoMed)、PubMed、Cochrane图书馆和Web of Science这7个中英文数据库,收集芪参益气滴丸联合西药治疗PCI术后冠心病患者的随机对照试验(RCT),检索时间从各数据库建库至2020年4月1日。由两名研究人员独立进行文献筛选、数据提取及偏倚风险评估。然后,使用RevMan 5.3软件进行Meta分析。共纳入31项RCT,涉及3537例患者。Meta分析结果显示,在PCI术后主要心血管不良事件(MACE)方面,芪参益气滴丸联合用药可显著降低心绞痛复发率、心律失常发生率、心力衰竭及再次血管重建率,效果优于单纯西药治疗。然而,两组在非致死性心肌梗死、心源性死亡、支架再狭窄、卒中及其他心血管不良事件的改善方面差异无统计学意义。在改善左心室射血分数(LVEF)、6分钟步行试验(6MWT)、高敏C反应蛋白(hs-CRP)及西雅图心绞痛量表(SAQ)方面,芪参益气滴丸联合西药治疗在提高LVEF、6MWT及SAQ,降低hs-CRP水平方面明显优于单纯西药治疗,差异有统计学意义。两组不良反应较少,且两组间差异无统计学意义。主要表现为胃肠道反应、皮疹、牙龈等少量出血,未发生严重不良反应。上述反应停药或对症治疗后可消失。芪参益气滴丸联合西药应用于PCI术后患者治疗可安全可靠地降低MACE的发生,提高临床疗效、生活质量及预后。然而,由于纳入研究的数量和质量限制,仍需要更多规范、严谨、高质量的临床研究进一步验证上述结论。

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