血府逐瘀汤制剂治疗不稳定型心绞痛的系统评价和Meta分析

摘要

Objective:To systematically appraise the effect and the safety of Xuefuzhuyu Decoction on unstable angina pectoris. Methods: Randomized controlled trial reports about Xuefuzhuyu Decoction were searched and quality evaluated. And then,these literatures were used to Meta analysis. Results: 10 randomized controlled trials, which were poor quality with Jadad scores less than 3, were included in the systematic review. A Meta-analysis showed that the combination of Xuefuzhuyu Decoction and conventional treatment had better effectiveness on both overall clinical manifestations and ECG than the regular conventional treatment. The odds ratio (OR) and 95% confidence interval (95% CI) of the comparison of the improvement on overall clinical manifestations were 2.72 (1.74-4.26). The OR and 95% Cl of comparison of the improvement of ECG were 2.30(1.67-3.15). Conclusion: The combination of Xuefuzhuyu Decoction and conventional treatment may have better effectiveness and safety for unstable angina pectoris than the regular conventional treatment had. Nevertheless,because of the unclear methodological quality of the included studies, the results of our Meta-analysis may possibly be of much bias. Further well-designed clinical studies are required for the evaluation of Xuefuzhuyu Decoction for the treatment of unstable angina pectoris.%目的 从循证医学的角度系统评价血府逐瘀汤制剂治疗不稳定型心绞痛的疗效和安全性。方法 通过全面检索与血府逐瘀汤制剂相关的随机对照研究文献，进行质量评价，纳入合格文献进行Meta分析。结果 10个随机对照实验纳入系统评价，均为Jadad评分小于3分的低质量研究。Meta分析结果显示血府逐瘀汤制剂联合常规治疗在整体临床症状和心电图的改善方面均优于单纯使用常规治疗。整体临床疗效比较OR值为2.72,95％可信区间为1.74～4.26;心电图改善情况比较OR值为230，95％可信区间为1.67～3.15。结论 血府逐瘀汤制剂联合常规治疗用于冠心病不稳定型心绞痛可能取得较单一常规治疗更好的效果，且安全性良好，但由于纳入的研究方法学质量低，存在发生偏倚的可能性高，尚需更多设计合理的高质量临床试验加以验证。