丹参多酚酸盐辅助治疗不稳定型心绞痛有效性和安全性的系统评价

摘要

Objective To evaluate systematically the efficacy and the safety of Salvianolate for unstable angina pectoris, from which to provide scientific proofs for clinical decision making. Methods We retrieved and selected publications. We evaluated the quality of eligible studies. And then Meta-analyses were performed for homogeneous studies by RevMan 5.0 software. If clinical heterogeneity existed among the studies, descriptive analysis was conducted. The potential publication-bias were analyzed by funnel plot analysis. Results A total of 20 papers and 1547 cases were included in the study.The analysis indicated that compared supplementing by Salvianolate on the basis of common drug with only using common drug, both in the clinical efficacy and the improvement of electrocardiogram,RRs and 95%CI were 1.33(1.25,1.41) and 1.36(1.27,1.45)respectively, and P values were less than 0.001 which have statistical significance. Compared to other traditional Chinese medicine injections, there were no clear differences both in the clinical efficacy and the improvement of electrocardiogram.Adverse reactions of Salvianolate were mainly headache and dizzy, which could be basically endured. Conclusion The preliminary studies have shown the positive clinical effect of Salvianolate in treating unstable angina pectoris,and the adverse reactions were light and few.%　　目的系统评价丹参多酚酸盐治疗不稳定型心绞痛的有效性和安全性，为临床决策提供科学依据。方法全面检索文献，并进行筛选。对纳入文献进行质量评价之后，采用RevMan5.0软件对同质研究进行Meta分析，对具临床异质性研究进行定性评价，潜在的发表偏倚采用“倒漏斗”图示分析。结果共纳入20个研究，1547个病例。分析结果显示：在常规西医药治疗基础上辅以丹参多酚酸盐，与只采用西医药治疗相比，在临床有效性和心电图改善方面RR及95%CI分别为1.33（1.25，1.41）、1.36（1.27,1.45），P值均＜0.001，有统计学意义；而与其他中药注射剂相比，临床有效性和心电图改善均不确切。使用丹参多酚酸盐的主要不良反应为头痛、头晕，但基本能耐受。结论丹参多酚酸盐对不稳定型心绞痛有一定的辅助治疗效果，且不良反应较少、较轻。