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中药对冠心病合并脑缺血性卒中患者的治疗潜力:一项系统评价和荟萃分析

Therapeutic potential of Chinese herbal medicine for coronary heart disease patients with cerebral ischemic stroke: a systematic review and meta-analysis.

作者信息

Du Rui, Ao Yuhan, Wang Yang, Chen Zhihui, Liu Guanghui, Zhang Mingxue

机构信息

First Clinic College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.

Department of Senile Disease, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China.

出版信息

Front Pharmacol. 2025 Jul 16;16:1578783. doi: 10.3389/fphar.2025.1578783. eCollection 2025.

Abstract

OBJECTIVE

This research sought to demonstrate potential therapeutic strategies for coronary heart disease (CHD) patients with cerebral ischemic stroke (CIS) by rigorously evaluating the efficacy and safety of Chinese Herbal Medicine (CHM) through meta-analysis.

METHODS

A broad search approach was applied to obtain pertinent articles from both domestic and international databases, covering publications up to 31 December 2024. Using RevMan software (Version 5.4), a systematic review and meta-analysis were conducted to assess the efficacy and safety of CHM in treating CHD patients with CIS.

RESULTS

In the meta-analysis, 18 trails were analyzed, encompassing 2,202 patients in total. The aggregated findings indicated that the utilization of CHM improved the overall effective rate, ECG performance and TCM scores significantly. Furthermore, the CHM therapy demonstrated significant improvements in LVEF, MMSE, and NIHSS. Additionally, the CHMs therapy positively influenced lipid profiles, specifically TC, TG, LDL-C, and HDL-C. Notably, the application of CHM during the intervention was particularly effective in reducing blood viscosity, fibrinogen and platelet aggregation. Importantly, the CHM therapy was found to provide comparable safety profile to that of conventional western medicine treatment (WM) alone.

CONCLUSION

The CHM demonstrated superior efficacy in the management of CHD patients with CIS. Concurrently, the CHM showed potential for improving neurological damage, lipid profiles, and positively affecting hemorheological parameters, all while minimizing the risk of adverse effects. Even so, because of the limitations in study quality and the potential for reporting bias, it is crucial that these findings require to be further validated through rigorous, large-scale, and high-quality RCT in future research.

摘要

目的

本研究旨在通过荟萃分析严格评估中药治疗冠心病合并脑缺血性卒中(CIS)患者的疗效和安全性,以证明其潜在的治疗策略。

方法

采用广泛的检索方法,从国内外数据库中获取相关文章,涵盖截至2024年12月31日的出版物。使用RevMan软件(5.4版)进行系统评价和荟萃分析,以评估中药治疗冠心病合并CIS患者的疗效和安全性。

结果

在荟萃分析中,共分析了18项试验,总计2202例患者。汇总结果表明,使用中药显著提高了总有效率、心电图表现和中医证候积分。此外,中药治疗在左心室射血分数(LVEF)、简易精神状态检查表(MMSE)和美国国立卫生研究院卒中量表(NIHSS)方面也有显著改善。此外,中药治疗对血脂水平有积极影响,特别是总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)。值得注意的是,在干预期间应用中药在降低血液粘度、纤维蛋白原和血小板聚集方面特别有效。重要的是,发现中药治疗与单纯传统西医治疗(WM)具有相当的安全性。

结论

中药在冠心病合并CIS患者的管理中显示出卓越的疗效。同时,中药显示出改善神经损伤、血脂水平的潜力,并对血液流变学参数产生积极影响,同时将不良反应风险降至最低。即便如此,由于研究质量的局限性和报告偏倚的可能性,这些发现需要在未来的研究中通过严格、大规模和高质量的随机对照试验(RCT)进一步验证,这一点至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e4d/12307363/90d8e02bc008/fphar-16-1578783-g001.jpg

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