中医药干预急性心肌梗死的系统综述及Meta分析文献质量评价
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摘要
目的:评价中医药干预急性心肌梗死的系统综述和Meta分析文献的方法学质量和报告质量。方法:计算机检索万方期刊论文数据库、中国知网(CNKI)、维普期刊网(VIP)、中国生物医学文献数据库(CBM)以及Pub Med数据库,检索时间自各数据库建库至2017年3月,对符合纳入标准的文献,按照AMSTAR量表及PRISMA声明的评定条目提取相关信息,采用SPSS 21.0软件进行统计分析。结果:最终纳入文献20篇,包括中文文献17篇,英文文献3篇。其中2013年相关文献发表数量最多,为6篇。施加因素排前两位的分别为参麦针(共5篇,占25%)和生脉针(共3篇,占15%)。纳入分析的文献AMSTAR评分为(6.85±2.18)分,得分在9分以上较高质量的文献仅3篇。PRISMA评分为(18.90±5.45)分,得分在21分以上的文献有8篇。结论:因存在Meta分析所纳入临床研究异质性较大及方法学不规范等问题,对于中医药干预AMI的疗效尚不能得出可靠的结论,有待针对目前研究较多的干预药物如参麦、生脉及参附注射液开展大样本前瞻性的临床注册研究进一步证实。
Objective: To assess systematic review of TCM intervention for acute myocardial infarction(AMI),methodological quality and report quality for meta analysis of literature. Methods: The computer was used to search WanFang, CNKI, VIP, CBM and PubMed data bases, the retrieval time was from the time of building the database to March, 2017, the related information were abstracted from the paper which met the inclusion criteria according to the evaluation entries in AMSTAR scale and PRISMA state, and analyzed statistically using SPSS21.0 software.Results: Consequently, 20 articles were included, including 17 articles of Chinese literature, three articles of SCI literature. Among them, the publication number of the related literature at the year of 2013 was the most, six articles.The top two application factors were ShenMai injection(five papers altogether, holding 25%) and ShengMai injection(three papers altogether, 15%). AMSTAR scores of the included literature were(6.85±2.18) points, there were only three papers in higher quality scored more than nine points. PRISMA scores were(18.90 ±5.45) points, and there were eight papers scored more than 21 points. Conclusion: Due to the heterogeneity of clinical study and irregular methodology included in meta analysis, no reliable conclusions could be obtained on clinical effects of TCM intervention for AMI, large sample prospective clinical registration studies for intervention medicine such as ShenMai,ShengMai and ShenFu injection should be launched and need to be further confirmed.
Objective: To assess systematic review of TCM intervention for acute myocardial infarction(AMI),methodological quality and report quality for meta analysis of literature. Methods: The computer was used to search WanFang, CNKI, VIP, CBM and PubMed data bases, the retrieval time was from the time of building the database to March, 2017, the related information were abstracted from the paper which met the inclusion criteria according to the evaluation entries in AMSTAR scale and PRISMA state, and analyzed statistically using SPSS21.0 software.Results: Consequently, 20 articles were included, including 17 articles of Chinese literature, three articles of SCI literature. Among them, the publication number of the related literature at the year of 2013 was the most, six articles.The top two application factors were ShenMai injection(five papers altogether, holding 25%) and ShengMai injection(three papers altogether, 15%). AMSTAR scores of the included literature were(6.85±2.18) points, there were only three papers in higher quality scored more than nine points. PRISMA scores were(18.90 ±5.45) points, and there were eight papers scored more than 21 points. Conclusion: Due to the heterogeneity of clinical study and irregular methodology included in meta analysis, no reliable conclusions could be obtained on clinical effects of TCM intervention for AMI, large sample prospective clinical registration studies for intervention medicine such as ShenMai,ShengMai and ShenFu injection should be launched and need to be further confirmed.
引文
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[2]余锋,陈镜合.中西医结合防治冠心病策略初探[J].辽宁中医杂志,2008,35(7):995-996.
[3] Gao ZY,Xu H,Shi DZ,et al.Analysis on outcome of5284 patients with coronary artery disease:the role of integrative medicine[J].J Ethnopharmacol,2012,141(2):578-583.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,43(5):380-393.
[5]中国医师协会中西医结合医师分会,中国中西医结合学会心血管病专业委员会,中国中西医结合学会重症医学专业委员会,等.急性心肌梗死中西医结合诊疗专家共识[J].中国中西医结合杂志.2014,34(4):389-395.
[6] Shea BJ,Bouter LM,Peterson J,et al.External Validation of a measurement tool to assess systematic reviews(AMS TAR[J].Plos One,2007,2(12):1-5.
[7] Moher D,Shamsee L,Clarke M,et al.Preferred reporting items for systematic review and meta-analysis protocols(PRISMA-P)2015 statement[J].Systematic Reviews,2015(4):1-9.
[8]曾宪涛,冷卫东,郭毅,等.Meta分析系列之一:Meta分析的类型[J].中国循证心血管医学杂志,2012,4(1):3-5.
[9]袁金秋,刘雅莉,杨克虎,等.系统评价再评价纳入研究的质量评价方法调查[J].中国循证医学杂志,2012,12(2):238-242.
[10]尹森林,刘雪梅,何林,等.对系统评价/Meta分析报告规范的系统评价[J].中国循证医学杂志,2011,11(8):971-977.
[11] Bian Z,Liu B,Moher D,et al.Consolidated standards of reporting trails(CONSORT)for traditional Chinese medicine:current situation and future development[J].Front Med,2011,5(2):171-177.
[12]张质钢,王小虎,张秋宁.国内纳入标准对随机试验的界定差异有可能导致偏倚[J].中国循证医学杂志,2013,13(6):764-767.
[13] Higgins JPT,Green S.Cochrane handbook for systematic review of interventions version 5.1[EB/OL].The Cochrane collaboration,2011[2012-03-20].http://www.cochrane-handbook.org.
[14]李范,崔雷.谈Meta分析与综述类文献[J].中国实用眼科杂志,2012,30(1):31-35.
[15]康德英,洪旗,王家良.如何评价临床治疗性研究的Meta分析结果[J].中国预防医学杂志,2001,2(3):封3-封4.