麝香保心丸治疗冠心病的Meta分析

摘要

Objective To review the curative effect and safety of Shexiang Baoxin Wan in treatment of coronary heart disease ( CHD ). Methods The literature of randomized and controlled trials ( RCT ) about treatment of CHD with Shexiang Baoxin Wan were retrieved from Cochrane Library, Pubmed, WANFANG, CNKI, CBM and VIP ( by June 30,2011 ),and then 2 reviewers independently chose RCT,extracted materials,checked crossly and gave methodological quality evaluaion. Meta analysis was conducted by using RevMan 5. 0 software. Results There were 16 RCT and 1698 patients brought into. The results of Meta analysis showed that in Shexiang Baoxin Wan group, the total curative effect (RR = 1.17,95% CI: 1. 12 ~ 1. 23 , P < 0. 01 ) and total ECG amelioration ( RR = 1. 24,95% CI: 1.16-1.33,P<0. 01 ) were higher than those in control group. The adverse reactions were more in Shexiang Baoxin Wan group than those in control group ( RR =7.08,95% CI: 3. 24 ~ 15.48,P <0. 01 ),which were mainly epigastric disten-tion,acid regurgitation,heartburn and dizziness. Conclusion The existing evidence shows that Shexiang Baoxin Wan is effective to CHD and can ameliorate ECG. The adverse reactions are mild and tolerable. As the limitation of the quality of enclosed literature, the review on the curative effect of CHD expects more randomized controlled double-blinded trials with high quality.%目的 评价麝香保心丸治疗冠心病的疗效及安全性.方法 计算机检索Cochrane Library、Pubmed、万方数据库(Wanfang)、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)至2011年6月30日,收集麝香保心丸治疗冠心病的随机对照试验(RCT),按纳入和排除标准由2名评价者独立选择试验、提取资料,交叉核对并进行方法学质量评估,使用RevMan 5.0软件进行Meta分析.结果 共纳入16项研究1698例患者.Meta分析结果:麝香保心丸组总临床疗效(RR=1.17,95%CI:1.12～1.23,P＜0.01)、总心电图改善(RR=1.24,95%CI:1.16～1.33,P＜0.01)优于对照组.但麝香保心丸组总不良反应高于对照组(RR=7.08,95%CI:3.24～15.48,P＜0.01),其中不良反应主要包括上腹胀满、返酸、烧心、头晕.结论 现有证据显示麝香保心丸治疗对冠心病临床疗效及心电图的改善明显,不良反应轻微可耐受.受纳入文献质量的限制,其治疗冠心病疗效的评价期待更多高质量的随机对照双盲研究,以做进一步的评价.