不同中药注射剂治疗不稳定型心绞痛的疗效与安全性：一项系统评价和贝叶斯网络Meta分析
Efficacy and safety of different traditional Chinese medicine injections in the treatment of unstable angina pectoris: a systematic review and Bayesian network meta-analysis.
作者信息
Chen Qiuhan, Wang He, Zhu Lin, Guo Ziyi, Cui Yingying, Ban Jifang, Chi Kuo, Shi Na, Wang Boyu, Liu Changxing, Zhou Yabin
机构信息
First Clinical Medical School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China.
Department of Cardiology, First Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China.
出版信息
Front Pharmacol. 2025 Mar 12;16:1550759. doi: 10.3389/fphar.2025.1550759. eCollection 2025.
OBJECTIVES
Several studies have explored the efficacy and safety of various traditional Chinese medicine (TCM) injections for unstable angina pectoris. However, comprehensive systematic evidence confirming the advantages of these injections is still lacking. This Bayesian network meta-analysis was carried out to evaluate and compare the efficacy of different TCM injections in treating unstable angina pectoris.
METHODS
A systematic search was implemented across PubMed, Cochrane Library, Embase, and Web of Science, with the date of search cutoff being February 2024. The Cochrane risk of bias tool was utilized to evaluate the bias risk in the included studies.
RESULTS
A total of 44 studies, encompassing 4,362 patients with unstable angina pectoris and 21 types of injections, were included. Compared with the standard treatment group, Danhong injection (SMD = -1.1, 95% CrI: -2.0, -0.15), Danshen Chuanxiongqin injection (SMD = -1.9, 95% CrI: -3.7, -0.12), Ginkgo Damole injection (SMD = -2.5, 95% CrI: -4.8, -0.29), Puerarin injection (SMD = -1.8, 95% CrI: -3.2, -0.37), and Shuxuetong injection (SMD = -7.8, 95% CrI: -13, -2.3) were found to significantly reduce the frequency of angina attacks. However, no significant improvement was observed in the duration of angina episodes with any of the included TCM injections compared with the standard treatment group. There was no significant difference in the incidence of adverse events from TCM injections.
CONCLUSION
Adjunctive treatment with TCM injections, in addition to conventional therapy, can remarkably reduce the frequency of angina attacks and demonstrates a favorable safety profile. However, it does not appear to significantly reduce the duration of angina episodes. Future studies should include more multicenter populations to validate our conclusions, as the population included in this study was predominantly Chinese.
SYSTEMATIC REVIEW REGISTRATION
identifier [CRD42024501984].
目的
多项研究探讨了各种中药注射剂治疗不稳定型心绞痛的疗效和安全性。然而，仍缺乏证实这些注射剂优势的全面系统证据。本贝叶斯网络荟萃分析旨在评估和比较不同中药注射剂治疗不稳定型心绞痛的疗效。
方法
在PubMed、Cochrane图书馆、Embase和Web of Science上进行系统检索，检索截止日期为2024年2月。采用Cochrane偏倚风险工具评估纳入研究中的偏倚风险。
结果
共纳入44项研究，涉及4362例不稳定型心绞痛患者和21种注射剂。与标准治疗组相比，丹红注射液（标准化均数差=-1.1，95%可信区间：-2.0，-0.15）、丹参川芎嗪注射液（标准化均数差=-1.9，95%可信区间：-3.7，-0.12）、银杏达莫注射液（标准化均数差=-2.5，95%可信区间：-4.8，-0.29）、葛根素注射液（标准化均数差=-1.8，95%可信区间：-3.2，-0.37）和舒血宁注射液（标准化均数差=-7.8，95%可信区间：-13，-2.3）可显著降低心绞痛发作频率。然而，与标准治疗组相比，纳入的任何一种中药注射剂在心绞痛发作持续时间方面均未观察到显著改善。中药注射剂不良事件的发生率无显著差异。
结论
除传统治疗外，加用中药注射剂可显著降低心绞痛发作频率，且安全性良好。然而，它似乎并不能显著缩短心绞痛发作的持续时间。由于本研究纳入的人群主要为中国人，未来的研究应纳入更多多中心人群以验证我们的结论。
系统评价注册
标识符[CRD42024501984]
Zotero 插件