摘要
目的综合评价美托洛尔联合麝香保心丸治疗不稳定型心绞痛的临床疗效和安全性。方法计算机检索Cochrane图书馆、PubMed、Embase、中国期刊全文数据库(CNKI)、中文期刊全文数据库(VIP)和万方数据知识服务平台(Wanfang),查找所有美托洛尔联合麝香保心丸治疗不稳定型心绞痛的随机对照试验(RCT),检索时限均为数据库建库至2018年9月。由2名研究人员独立按照纳入和排除标准选择文献并提取资料,交叉核对并进行方法学质量评估,应用RevMan 5.3软件对所提取的数据进行汇总分析。根据对照组是否使用美托洛尔进行亚组分析。结果共纳入31项研究,2845例患者。研究结果表明与对照组相比,美托洛尔联合麝香保心丸组患者的临床有效率显著升高(RR=1.27,95%CI:1.23~1.31);心绞痛发作频率显著降低(SMD=-7.71,95%CI:-8.59~-5.74);心绞痛持续时间显著降低(SMD=-3.88,95%CI:-4.65~-3.11);发作间期显著延长(MD=2.75 d,95%CI:2.63~2.87 d)。美托洛尔联合麝香保心丸组与对照组的不良反应发生率相似,亚组分析结果与整体结果类似。结论现有证据表明,美托洛尔联合麝香保心丸具有协同作用,能够明显提高临床疗效,临床应用价值高,是一种治疗不稳定型心绞痛的良好选择。
Objective To comprehensively evaluate the efficacy and safety of metoprolol combined with Shexiang Baoxin Pills(麝香保心丸) on unstable angina. Methods To collect randomized controlled trials(RCTs) which used metoprolol and Shexiang Baoxin Pills(麝香保心丸) in treating unstable angina, we electronically searched the databases of Cochrane Library, PubMed,Embase, CNKI, VIP, and Wan Fang from the inception of databases to September, 2018. Two researchers independently selected literature and extracted data based on inclusion and exclusion criteria, cross-checked and assessed the methodological quality.RevMan5.3 software was used to collect and analyze the extracted data. Subgroup analysis was made according to whether used metoprolol in the control group. Results There were 31 RCTs involving 2845 cases of unstable angina in our meta analysis. The results of meta-analysis showed that compared with the control group, metoprolol combined with Shexiang Baoxin Pills(麝香保心丸) has significantly increased patients' clinical effective rate(RR=1.27, 95% CI : 1.23-1.31), significantly decreased occurrence rate(SMD=-7.71, 95% CI :-8.59--5.74) and duration of angina(SMD=-3.88, 95% CI :-4.65--3.11). Interictal stage(MD=2.75 d, 95% CI :2.63-2.87 d) was significantly prolonged. The adverse reaction rate was similar between experimental group and control group, and the results of subgroup analysis were similar to overall results. Conclusion Based on present evidence, metoprolol and Shexiang Baoxin Pills(麝香保心丸) have synergistic effects. The therapy obviously improve the clinical effects and have high clinical application value, which is a good choice for the treatment of unstable angina.
引文
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