Zhang Xu-Ming, Zhao Xiao-Xiao, Liu Yi, Xie Yan-Ming
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China Tianjin University of Traditional Chinese Medicine Tianjin 301617, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2023 Sep;48(18):5078-5090. doi: 10.19540/j.cnki.cjcmm.20230601.502.
Bayesian network Meta-analysis was employed to compare the efficacy of different oral Chinese patent medicines in treating type 2 diabetes mellitus with angina pectoris of coronary heart disease. Randomized controlled trial(RCT) of oral Chinese patent medicines in treating type 2 diabetes mellitus complicated with angina pectoris of coronary heart disease were retrieved from 8 Chinese and English databases including CNKI, Wanfang, VIP, SinoMed, EMbase, PubMed, Cochrane Library, and Web of Science with the time interval from inception to November 2022. The BUGSnet package in R 4.2.1 was used to conduct Meta-analysis. A total of 45 RCTs were included, involving 4 727 patients and 7 oral Chinese patent medicines. Network Meta-analysis showed that the conventio-nal western medicine combined with Chinese patent medicines improved the outcome indicators. Shexiang Baoxin Pills + conventional western medicine had the best effect on reducing the incidence of adverse cardiovascular events, and Yixinshu Capsules + conventional western medicine on reducing the frequency and duration of angina pectoris. The conventional western medicine combined with oral Chinese patent medicines can reduce blood glucose indicators. Yindan Xinnaotong Soft Capsules + conventional western medicine had the best effect on reducing fasting blood glucose(FBG), 2 hours postprandial blood glucose(PBG), and glycosylated hemoglobin(HbA1c). The conventional western medicine combined with oral Chinese patent medicines can reduce blood lipid indicators. Yixinshu Capsules + conventional western medicine had the best effect on reducing total cholesterol(TC) and low density lipoprotein-cholesterol(LDL-C), and Yindan Xinnaotong Soft Capsules + conventional western medicine on reducing triglyceride(TG). Current evidence suggests that the patients with type 2 diabetes mellitus complicated with angina pectoris of coronary heart disease could reasonably choose oral Chinese patent medicines on the basis of routine antiplatelet, anticoagulant, hypoglycemic, and antihypertensive therapies, which could reduce the incidence of adverse cardiovascular events, alleviate the symptoms of angina pectoris, and reduce the glucose and lipid metabolism indicators. Shexiang Baoxin Pills + conventional treatment and Yixinshu Capsules + conventional western medicine have better effect on angina pectoris, Yindan Xinnaotong Soft Capsules + conventional western medicine on lowering blood glucose, and Yindan Xinnaotong Soft Capsules + conventional western medicine and Yixinshu Capsules + conventional western medicine on reducing blood lipid. Due to the lack of direct comparative results between Chinese patent medicines and other factors, high-quality studies remain to be carried out for further verification.
采用贝叶斯网络Meta分析比较不同口服中成药治疗2型糖尿病合并冠心病心绞痛的疗效。从中国知网、万方、维普、中国生物医学文献数据库、EMbase、PubMed、考克兰图书馆和Web of Science这8个中英文数据库中检索口服中成药治疗2型糖尿病合并冠心病心绞痛的随机对照试验，检索时间范围从建库至2022年11月。使用R 4.2.1中的BUGSnet软件包进行Meta分析。共纳入45项随机对照试验，涉及4727例患者和7种口服中成药。网络Meta分析表明，西药联合中成药可改善结局指标。麝香保心丸+西药在降低心血管不良事件发生率方面效果最佳，益心舒胶囊+西药在减少心绞痛发作频率和持续时间方面效果最佳。西药联合口服中成药可降低血糖指标。银丹心脑通软胶囊+西药在降低空腹血糖（FBG）、餐后2小时血糖（PBG）和糖化血红蛋白（HbA1c）方面效果最佳。西药联合口服中成药可降低血脂指标。益心舒胶囊+西药在降低总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）方面效果最佳，银丹心脑通软胶囊+西药在降低甘油三酯（TG）方面效果最佳。目前的证据表明，2型糖尿病合并冠心病心绞痛患者在常规抗血小板、抗凝、降糖和降压治疗的基础上，可合理选用口服中成药，这可降低心血管不良事件的发生率，缓解心绞痛症状，并降低糖脂代谢指标。麝香保心丸+常规治疗和益心舒胶囊+西药在治疗心绞痛方面效果较好，银丹心脑通软胶囊+西药在降低血糖方面效果较好，银丹心脑通软胶囊+西药和益心舒胶囊+西药在降低血脂方面效果较好。由于中成药与其他因素之间缺乏直接比较结果，仍需开展高质量研究进行进一步验证。
