温胆汤调节血脂异常系统评价

摘要

Objective To systematically assess the clinical efficacy and security of Wendan Decoction in the treatment of dyslipidemia. Methods Retrieved from CNKI, CBM, VIP database, Wanfang Database, and PubMed, articles of RCTs about Wendan Decoction in the treatment of dyslipidemia were included. The searching range was from the establishment of the database to April, 2016. NoteExpress3.2.0 was used to establish database. Two researchers independently screened the articles and extracted the data. Cochrane Systematic Review Manual 5.1.0 was used for quality evaluation. Meta-analysis was performed with RevMan5.3 software. Results 12 articles involving 848 patients were included. Results of Meta-analysis showed that compared with the western medicine treatment, Wendan Decoction group was more capable of significantly improving clinical effective rate of dyslipidemia [OR=2.46, 95%CI (1.41, 4.30), P=0.001], lowering the level of TG [WMD=-0.31, 95%CI (-0.46, -0.15), P=0.0001] and LDL-C [WMD=-0.25, 95%CI (-0.30, -0.20), P=0.00001], but there was no statistical significance in regulating TC [WMD=-0.14, 95%CI (-0.35, -0.08), P=0.49] and HDL-C [WMD=0.04, 95%CI (-0.01, -0.1), P=0.13] between the two groups; compared with the western medicine group, Wendan Decoction combined with western medicine group was more capable in the clinical effective rate of dyslipidemia (P<0.05), regulating the level of TG [WMD=0.30, 95%CI (-0.37, -0.23), P=0.00001], TC [WMD=0.65, 95%CI (-0.80, -0.69), P=0.00001], LDL-C (P<0.05, P<0.01) between the two groups; Wendan Decoction combined with western medicine group had low rate of adverse reactions. Conclusion Wedan Decoction can effectively regulate dyslipidemia, with good safety. High quality RCTs in large-scale and multi-center are necessary for further evidence due to the poor methodological quality of included trials with few samples and other limitations.%目的 系统评价温胆汤调节血脂异常的临床疗效及安全性.方法 计算机检索中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(重庆维普)、中国学术期刊数据库(万方数据)、PubMed数据库中温胆汤调节血脂临床随机对照试验相关文献,检索范围均为建库至2016年4月.采用NoteExpress3.2.0建立数据库.2名研究者独立筛选文献、提取资料,根据Cochrane系统评价手册5.1.0进行质量评价后,采用RevMan5.3软件进行Meta分析.结果 共纳入12篇文献,共计受试者848例.Meta分析结果显示:温胆汤组在调节血脂临床有效率[OR=2.46,95%CI(1.41,4.30),P=0.001]、调节血清三酰甘油(TG)[WMD=-0.31,95%CI(-0.46,-0.15),P=0.0001]、低密度脂蛋白胆固醇(LDL-C)[WMD=-0.25,95%CI(-0.30,-0.20),P=0.00001]方面均明显优于西药组,而在调节血清总胆固醇(TC)[WMD=-0.14,95%CI(-0.35,-0.08),P=0.49]、高密度脂蛋白胆固醇(HDL-C)[WMD=0.04,95%CI(-0.01,-0.1),P=0.13]方面组间比较差异无统计学意义;温胆汤联合西药组在调节血脂临床有效率(P<0.05)、调节TG[WMD=0.30,95%CI(-0.37,-0.23),P=0.00001]、TC[WMD=0.65,95%CI(-0.80,-0.69),P=0.00001]、LDL-C(P<0.05,P<0.01)方面均明显优于西药组.温胆汤组及温胆汤联合西药组不良反应发生率低.结论 温胆汤能有效调节血脂,且安全性较好.但纳入研究质量普遍偏低,尚需更多大样本、多中心、高质量的临床随机对照试验进一步验证.