疏血通注射液联合低分子肝素佐治不稳定型心绞痛疗效与安全性的Meta分析
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摘要
目的:系统评价疏血通注射液联合低分子肝素佐治不稳定型心绞痛的临床疗效与安全性。方法:利用计算机检索Medline,PubMed,Nature、中国知网(CNKI)、万方、维普数据库(VIP)(检索时间设为2000年1月1日-2018年4月1日)等数据库,手工检索百度及相关杂志。利用Coehrane网提供的方法,对纳入文献进行质量评价,并运用Rev Man 5.3软件进行统计学分析。结果:纳入15项研究,治疗组纳入589例患者,对照组纳入572例患者,总计1 161例患者。Meta分析结果显示:在常规治疗的基础上,使用疏血通注射液联合低分子肝素治疗不稳型心绞痛的疗效明显优于常规治疗或常规治疗加用低分子肝素[RD=0.18,95%CI(0.14,0.22)],差异有统计学意义(P<0.05)。15项研究中,仅有1项研究在进行的过程中有1例患者出现轻微上消化道出血,余未提及明显不良反应。结论:疏血通注射液联合低分子肝素佐治不稳定型心绞痛能提高临床疗效,且安全性较好。
Objective:To systematically evaluate the clinical efficacy and safety of Shuxuetong Injection combined with Low Molecular Weight Heparin in the treatment of unstable angina pectoris.Method:Used computers to search databases such as Medline,PubMed,Nature,China Knowledge Network(CNKI),Wanfang,VIP Database(retrieving time:2000-01-01 to 2018-04-01),Baidu and related magazines were manually searched.Used the methods provided by Coehrane Network,the quality of the included literature was evaluated and RevMan 5.3 software was used for statistical analysis.Result:Of the 15 studies included,589 were in the treatment group and 572 in the control group,a total of 1 161 patients.The Meta-analysis showed that on the basis of conventional treatment,the use of Shuxuetong Injection in combination with Low Molecular Weight Heparin for the treatment of unstable angina was significantly better than conventional therapy or conventional treatment with Low Molecular Weight Heparin[RD=0.18,95%CI(0.14,0.22)],the difference was statistically significant(P<0.05).Among the 15 studies,only 1 case had a mild upper gastrointestinal bleeding during the course in one of the study,and no significant adverse reactions were mentioned.Conclusion:Shuxuetong Injection combined with Low Molecular Weight Heparin in the treatment of unstable angina can improve clinical efficacy and safety.
Objective:To systematically evaluate the clinical efficacy and safety of Shuxuetong Injection combined with Low Molecular Weight Heparin in the treatment of unstable angina pectoris.Method:Used computers to search databases such as Medline,PubMed,Nature,China Knowledge Network(CNKI),Wanfang,VIP Database(retrieving time:2000-01-01 to 2018-04-01),Baidu and related magazines were manually searched.Used the methods provided by Coehrane Network,the quality of the included literature was evaluated and RevMan 5.3 software was used for statistical analysis.Result:Of the 15 studies included,589 were in the treatment group and 572 in the control group,a total of 1 161 patients.The Meta-analysis showed that on the basis of conventional treatment,the use of Shuxuetong Injection in combination with Low Molecular Weight Heparin for the treatment of unstable angina was significantly better than conventional therapy or conventional treatment with Low Molecular Weight Heparin[RD=0.18,95%CI(0.14,0.22)],the difference was statistically significant(P<0.05).Among the 15 studies,only 1 case had a mild upper gastrointestinal bleeding during the course in one of the study,and no significant adverse reactions were mentioned.Conclusion:Shuxuetong Injection combined with Low Molecular Weight Heparin in the treatment of unstable angina can improve clinical efficacy and safety.
引文
[1]陈建辉.中西医结合治疗不稳定性心绞痛的研究进展与临床观察小结[D].成都:成都中医药大学,2007.
[2]Braunwald E,Autman E M,Beasley J W,et al.Guideline update for patients with unstable angina and non ST segment elevation myocardial infarction[J].Circulation,2002,106:1893-1900.
[3]詹莉,林红.尼可地尔治疗不稳定型心绞痛患者的临床疗效观察[J].中国热带医学,2014,14(11):1404-1406.
[4]黄雄峰,汪建民,陈乔,等.复方丹参注射液佐治新生儿缺氧缺血性脑病疗效的Meta分析[J].中国中药杂志,2015,40(1):141-148.
[5]赵博元.低分子肝素联合疏血通治疗不稳定性心绞痛69例临床观察[J].中国厂矿医学,2009,22(5):545.
[6]康银玲.关于疏血通治疗不稳定性心绞痛的研究[J].中医临床研究,2014,6(18):36-38.
[7]余细宝.疏血通联合低分子肝素钙治疗不稳定性心绞痛疗效分析[J].中国中医药咨讯,2011,3(23):216.
[8]吐逊姑丽·木沙.疏血通及低分子肝素注射液治疗冠心病不稳定性心绞痛疗效观察[J].中国实用医药,2011,6(20):112-113.
[9]陶登保,况佩君,程文林.疏血通联合低分子肝素钠治疗不稳定性心绞痛的临床观察[J].中国医药导报,2007,28(28):46-47.
[10]李大鹏,孙庆芳,翁志远,等.疏血通联用低分子肝素治疗不稳定性心绞痛临床观察[J].职业与健康,2009,25(2):217-218.
[11]冯文学,张忠锋,谷保琴,等.疏血通与低分子肝素钙联合治疗不稳定性心绞痛临床观察[J].医药论坛杂志,2007,28(18):49-50.
[12]杨琼芬,解仕良,毕德飞,等.疏血通注射液和低分子肝素治疗不稳定性心绞痛疗效及预后分析[J].中国实用医药,2014,9(12):143-144.
[13]方云.低分子肝素钙联合疏血通治疗不稳定型心绞痛52例疗效观察[J].齐齐哈尔医学院学报,2004,21(10):1134.
[14]刘庆利,于慧春.低分子肝素联合疏血通治疗不稳定型心绞痛的疗效及安全性[J].实用心脑肺血管病杂志,2009,17(11):955-956.
[15]张学梅,侯晓珍,吴亚男.低分子肝素钠联合舒血通治疗不稳定心绞痛124例[J].内蒙古中医药,2009,28(17):24-25.
[16]池祥波.低分子肝素钠联合疏血通治疗不稳定型心绞痛43例临床观察[J].现代医药卫生,2010,26(14):2089-2090.
[17]余碧菁,郑伯仁.低分子肝素钠联合疏血通注射液治疗不稳定型心绞痛的疗效观察[J].中国老年保健医学,2012,10(4):7-8.
[18]梅思军.低分子肝素联合疏血通注射液治疗不稳定型心绞痛[J].中西医结合心脑血管病杂志,2007,5(9):906-907.
[19]高艳红,李春生,袁俊强,等.低分子肝素钙联合疏血通治疗不稳定型心绞痛临床观察[J].中国医疗前沿,2009,4(11):12-13.
[20]杨萌萌,李锦,汪汉,等.红花黄色素治疗不稳定性心绞痛有效性和安全性的系统评价[J].中国循证医学杂志,2013,13(8):971-977.
[21]马礼坤.美国心脏病学院和美国心脏学会新的不稳定性心绞痛/非ST段抬高性心肌梗死的诊断和治疗指南解读[J].临床内科杂志,2007,24(12):808-810.
[22]Moher D,Pham B,Jones A,et al.Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses[J].Lancet,1998,352(9128):609.
[23]杨洪雁,杜智恒,白秀娟.水蛭药理作用的研究进展[J].东北农业大学学报,2012,43(3):128-133.
[24]郭征兵.中药地龙的药理作用及活性成分分析[J].当代医学,2017,23(19):199-200.
[2]Braunwald E,Autman E M,Beasley J W,et al.Guideline update for patients with unstable angina and non ST segment elevation myocardial infarction[J].Circulation,2002,106:1893-1900.
[3]詹莉,林红.尼可地尔治疗不稳定型心绞痛患者的临床疗效观察[J].中国热带医学,2014,14(11):1404-1406.
[4]黄雄峰,汪建民,陈乔,等.复方丹参注射液佐治新生儿缺氧缺血性脑病疗效的Meta分析[J].中国中药杂志,2015,40(1):141-148.
[5]赵博元.低分子肝素联合疏血通治疗不稳定性心绞痛69例临床观察[J].中国厂矿医学,2009,22(5):545.
[6]康银玲.关于疏血通治疗不稳定性心绞痛的研究[J].中医临床研究,2014,6(18):36-38.
[7]余细宝.疏血通联合低分子肝素钙治疗不稳定性心绞痛疗效分析[J].中国中医药咨讯,2011,3(23):216.
[8]吐逊姑丽·木沙.疏血通及低分子肝素注射液治疗冠心病不稳定性心绞痛疗效观察[J].中国实用医药,2011,6(20):112-113.
[9]陶登保,况佩君,程文林.疏血通联合低分子肝素钠治疗不稳定性心绞痛的临床观察[J].中国医药导报,2007,28(28):46-47.
[10]李大鹏,孙庆芳,翁志远,等.疏血通联用低分子肝素治疗不稳定性心绞痛临床观察[J].职业与健康,2009,25(2):217-218.
[11]冯文学,张忠锋,谷保琴,等.疏血通与低分子肝素钙联合治疗不稳定性心绞痛临床观察[J].医药论坛杂志,2007,28(18):49-50.
[12]杨琼芬,解仕良,毕德飞,等.疏血通注射液和低分子肝素治疗不稳定性心绞痛疗效及预后分析[J].中国实用医药,2014,9(12):143-144.
[13]方云.低分子肝素钙联合疏血通治疗不稳定型心绞痛52例疗效观察[J].齐齐哈尔医学院学报,2004,21(10):1134.
[14]刘庆利,于慧春.低分子肝素联合疏血通治疗不稳定型心绞痛的疗效及安全性[J].实用心脑肺血管病杂志,2009,17(11):955-956.
[15]张学梅,侯晓珍,吴亚男.低分子肝素钠联合舒血通治疗不稳定心绞痛124例[J].内蒙古中医药,2009,28(17):24-25.
[16]池祥波.低分子肝素钠联合疏血通治疗不稳定型心绞痛43例临床观察[J].现代医药卫生,2010,26(14):2089-2090.
[17]余碧菁,郑伯仁.低分子肝素钠联合疏血通注射液治疗不稳定型心绞痛的疗效观察[J].中国老年保健医学,2012,10(4):7-8.
[18]梅思军.低分子肝素联合疏血通注射液治疗不稳定型心绞痛[J].中西医结合心脑血管病杂志,2007,5(9):906-907.
[19]高艳红,李春生,袁俊强,等.低分子肝素钙联合疏血通治疗不稳定型心绞痛临床观察[J].中国医疗前沿,2009,4(11):12-13.
[20]杨萌萌,李锦,汪汉,等.红花黄色素治疗不稳定性心绞痛有效性和安全性的系统评价[J].中国循证医学杂志,2013,13(8):971-977.
[21]马礼坤.美国心脏病学院和美国心脏学会新的不稳定性心绞痛/非ST段抬高性心肌梗死的诊断和治疗指南解读[J].临床内科杂志,2007,24(12):808-810.
[22]Moher D,Pham B,Jones A,et al.Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses[J].Lancet,1998,352(9128):609.
[23]杨洪雁,杜智恒,白秀娟.水蛭药理作用的研究进展[J].东北农业大学学报,2012,43(3):128-133.
[24]郭征兵.中药地龙的药理作用及活性成分分析[J].当代医学,2017,23(19):199-200.