黄芪桂枝五物汤加味治疗冠心病心绞痛的系统评价

摘要

目的 系统评价黄芪桂枝五物汤加味治疗冠心病心绞痛的有效性和安全性.方法 计算机检索中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方期刊数据库(WANFANG)、中国生物医学文献数据库(CBM)、美国国立医学图书馆(PubMed)、Cochrane图书馆建库至 2016年 12月的文献,搜集西药常规联合黄芪桂枝五物汤加味与单纯西药常规比较治疗冠心病心绞痛的临床随机对照试验,按照 Cochrane Handbook方法评价纳入文献质量,并采用 Revman5.3软件进行 Meta分析.结果 共纳入 6个研究,共计 742例病人,研究质量均为 C级.Meta分析结果显示,与单纯西药常规治疗比较,黄芪桂枝五物汤加味能显著提高冠心病心绞痛病人的临床总有效率[OR=4.25,95% CI (2.85,6.34),P＜0.000 01],改善心电图[OR=2.78,95% CI (1.98,3.90), P＜0.000 01],降低心绞痛发作频次[MD=-0.81,95% CI (-1.03,-0.59),P＜0.000 01],且未见明显不良反应.结论 黄芪桂枝五物汤加味联合西药常规较单纯西药常规治疗冠心病心绞痛可进一步提高临床疗效.%Objective To analyze the efficacy and safety of coronary heart disease(CHD) angina pectoris treating by Huangqi Guizhi Wuwu decoction (HGWD). Methods The China National Knowledge Infrastructure (CNKI),VIP database,Wanfang database,Chinese Biomedical Literature Database (CBM),PubMed,the Cochrane library were searched and the related journals were collected.The clini-cal randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) combined with HGWD and conventional western medi-cine were used to treat angina pectoris.The quality of the literature was evaluated according to the Cochrane Handbook method and Meta-analysis was performed using Revman 5.3 software. Results A total of 742 patients were enrolled in 6 studies.The quality of the study was grade C. Meta analysis showed that compared with conventional treatment of western medicine,HGWD improved the clinical effective rate[OR=4.25,95% CI (2.85,6.34), P＜0.000 01],improved the electrocardiogram[OR=2.78,95% CI (1.98,3.90), P＜0.000 01],reduced the frequency of angina pectoris [MD=-0.81,95% CI (-1.03,-0.59), P＜0.000 01].No adverse reactions was observed in HGWD group.Conclusion HGWD and western medicine can further improve the clinical efficacy in patients with angina pectoris.