中国中药杂志

2021, v.46(06) 1498-1510

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芪参益气滴丸联合西药治疗对经皮冠状动脉介入术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

代倩倩;石兆峰;胡嘉元;韩松洁;钟长鸣;关曼柯;田贵华;商洪才;
DAI Qian-qian;SHI Zhao-feng;HU Jia-yuan;HAN Song-jie;ZHONG Chang-ming;GUAN Man-ke;TIAN Gui-hua;SHANG Hong-cai;Dongzhimen Hospital,Beijing University of Chinese Medicine;

摘要(Abstract):

系统评价芪参益气滴丸联合西药治疗对经皮冠状动脉介入(PCI)术后不良心血管事件及生活质量的影响。计算机检索中国期刊全文数据库(CNKI)、万方数据库(Wanfang)、维普数据库(VIP)、中国医学文献数据库(SinoMed)、PubMed、Cochrane Library和Web of Science共7个中英文数据库,收集芪参益气滴丸联合常规西药治疗冠心病患者PCI术后的随机对照试验(RCT),检索时限从建库至2020年4月1日。2名研究人员独立进行文献筛选、资料提取与偏倚风险评价后,采用RevMan 5.3软件进行Meta分析。共纳入31项RCTs, 3 537例患者。Meta分析结果显示,在PCI术后主要不良心血管事件(MACE)方面,联用芪参益气滴丸可显著减少心绞痛复发、心律失常、心力衰竭以及再次血运重建事件的发生,优于常规西药治疗;而在改善非致死性心肌梗死、心源性死亡、支架内再狭窄、脑卒中等其他不良心血管事件方面,2组无明显差异。在改善左室射血分数(LVEF)、6 min步行试验(6MWT)、高敏C反应蛋白(hs-CRP)和西雅图心绞痛量表(SAQ)方面,联用芪参益气滴丸较常规西药治疗有明显优势,可升高LVEF,6MWT,SAQ,降低hs-CRP水平,差异均有统计学意义。2组患者发生不良反应较少,差异无统计学意义,主要表现为胃肠道反应、皮疹、牙龈等小出血,无严重不良反应,停药或对症处理后可消失。应用芪参益气滴丸联合西药治疗PCI术后患者可减少MACE的发生,提高临床疗效,改善生活质量和预后,且安全可靠。受纳入研究数量和质量的限制,仍需开展更多规范、严谨、高质量的临床研究进一步验证上述结论。
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.

关键词(KeyWords): 芪参益气滴丸;冠心病;经皮冠状动脉介入术;主要不良心血管事件;Meta分析
Qishen Yiqi Dropping Pills;coronary heart disease;percutaneous coronary intervention;major adverse cardiovascular events;Meta-analysis

Abstract:

Keywords:

基金项目(Foundation): 中共中央组织部第二批国家“万人计划”(2016)项目(W02020052)

作者(Author): 代倩倩;石兆峰;胡嘉元;韩松洁;钟长鸣;关曼柯;田贵华;商洪才;
DAI Qian-qian;SHI Zhao-feng;HU Jia-yuan;HAN Song-jie;ZHONG Chang-ming;GUAN Man-ke;TIAN Gui-hua;SHANG Hong-cai;Dongzhimen Hospital,Beijing University of Chinese Medicine;

Email:

DOI: 10.19540/j.cnki.cjcmm.20200618.501

参考文献(References):

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