文献类型：期刊文献

中文题名：9种活血化瘀类中成药治疗冠心病PCI术后心绞痛的网状Meta分析

英文题名：Network Meta-Analysis of Huoxuehuayu(活血化瘀)Chinese Patent Medicines in the Treatment of Angina Pectoris after PCI of Coronary Heart Diseases

作者：王薇[1];王玲云[1];吴汶燕[1];奚华清[1];柴辉[2];范晓涌[2];刘凯[1]

第一作者：王薇

机构：[1]甘肃中医药大学,兰州730000;[2]兰州市第一人民医院,兰州730000

第一机构：甘肃中医药大学

年份：2025

卷号：41

期号：6

起止页码：80

中文期刊名：中药药理与临床

外文期刊名：Pharmacology and Clinics of Chinese Materia Medica

收录：;北大核心:【北大核心2023】；

基金：国家自然科学基金项目(编号:82260869);兰州市人才创新创业项目(编号:2019-RC-71)。

语种：中文

中文关键词：冠心病PCI术后心绞痛;中成药;网状Meta分析;临床疗效

外文关键词：Angina Pectoris after PCI of Coronary Heart Disease;Chinese Patent Medicine;Network Meta-Analysis;Clinical Effect

摘要：目的:系统评价活血化瘀类中成药治疗冠心病PCI术后心绞痛的临床疗效及安全性。方法:计算机检索Pubmed、The Cochrane Library、Embase、Web of Science、中国知网、维普、万方、中国生物医学数据库,搜集中成药联合常规西药治疗冠心病PCI术后心绞痛的随机对照试验(RCT),检索时限设定为建库至2023年6月25日,制定纳入排除标准后,由2名研究者独立筛选文献、提取资料、评价纳入研究的偏倚风险后,采用Stata 15.1软件进行网状Meta分析。结果:共纳入35个RCTs,包括3448例患者、9种中成药(丹蒌片、地奥心血康软胶囊、复方丹参滴丸、冠心丹参滴丸、冠心舒通胶囊、麝香保心丸、通心络胶囊、养心氏片、银丹心脑通软胶囊)。网状Meta分析疗效排序结果显示:(1)在提高总有效率方面,SUCRA排序为:常规治疗联合通心络胶囊(SUCRA=96.8%)>联合丹蒌片(SUCRA=68.8%)>联合复方丹参滴丸(SUCRA=65.4%)>联合麝香保心丸(SUCRA=65.2%)>联合冠心丹参滴丸(SUCRA=50.0%)>联合地奥心血康软胶囊(SUCRA=40.0%)>联合冠心舒通胶囊(SUCRA=34.6%)>联合养心氏片(SUCRA=28.6%)。(2)在减少心绞痛每周发作频率方面,SUCRA排序为:常规治疗联合冠心舒通胶囊(SUCRA=77.7%)>联合麝香保心丸(SUCRA=69.3%)>联合银丹心脑通软胶囊(SUCRA=64.1%)>联合地奥心血康软胶囊(SUCRA=60.9%)>联合通心络胶囊(SUCRA=56.5%)>联合复方丹参滴丸(SUCRA=32.9%)>联合养心氏片(SUCRA=30.9%)。(3)在减少心绞痛每分钟持续时间方面,SUCRA排序为:常规治疗联合银丹心脑通软胶囊(SUCRA=88.0%)>联合麝香保心丸(SUCRA=78.9%)>联合冠心舒通胶囊(SUCRA=61.9%)>联合地奥心血康软胶囊(SUCRA=52.7%)>联合通心络胶囊(SUCRA=43.6%)>联合复方丹参滴丸(SUCRA=40.5%)>联合养心氏片(SUCRA=23.3%)。(4)降低hs-CRP方面,SUCRA排序为:常规治疗联合麝香保心丸(SUCRA=98.5%)>联合地奥心血康软胶囊(SUCRA=84.8%)>联合丹蒌片(SUCRA=66.0%)>联合复方丹参滴丸(SUCRA=50.0%)>联合通心络胶囊(SUCRA=27.9%)>联合冠心舒通胶囊(SUCRA=20.2%)。(5)降低ET-1方面,SUCRA排序为:常规治疗联合通心络胶囊(SUCRA=80.8%)>联合冠心丹参滴丸(SUCRA=75.8%)>联合地奥心血康软胶囊(SUCRA=50.6%)>联合复方丹参滴丸(SUCRA=48.0%)>联合冠心舒通胶囊(SUCRA=39.8%)。(6)在升高NO方面,SUCRA排序为:常规治疗联合冠心丹参滴丸(SUCRA=86.7%)>联合复方丹参滴丸(SUCRA=65.1%)>联合通心络胶囊(SUCRA=53.4%)>联合冠心舒通胶囊(SUCRA=49.6%)>联合地奥心血康软胶囊(SUCRA=37.8%)。结论:当前证据显示,在常规西药治疗的基础上联合活血化瘀类中成药可改善冠心病PCI术后的心绞痛症状,减轻血管内皮细胞受损,不良反应较少,且在不同的结局指标中各有优势和侧重。因纳入研究的数量和质量欠佳,上述研究结论待更多高质量研究予以验证。
To evaluate the clinical efficacy and safety of Huoxuehuayu(活血化瘀)Chinese patent medicine in the treatment of angina pectoris after PCI of coronary heart diseases.Methods:Retrieval of Pubmed,the Cochrane Library,Embase,Web of Science,CNKI,VIP,WangFang Data,and CBM database from their establishment to June 25th,2023 were performed by computer to collect the randomized controlled trials(RCTs)of Chinese patent medicine combined with conventional Western medicine in the treatment of angina pectoris after PCI of coronary heart diseases.After establishing inclusion and exclusion criteria,two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.Stata 15.1 software was used to perform a network meta-analysis.Results:A total of 35 RCTs were included,involving 3448 patients and nine kinds of Chinese patent medicine:Danlou(丹萎)Tablet,Diao Xinxuenkang(地奥心血康)Soft Capsule,Compound Danshen(丹参)Dripping Pill,Guanxin Danshen(冠心丹参)Dripping Pill,Guanxin Shutong(冠心舒通)Capsule,Shexiang Baoxin(麝香保心)Pill,Tongxinluo(通心络)Capsule,Yangxinshi(养心氏)Tablet,andYindanxinnaotong(银丹心脑通)Soft Capsule.The efficacy ranking results of network meta-analysis showed that①In terms of improving the total effective rate,SUCRA was ranked as follows:conventional treatment combined with Tongxinluo Capsule(SUCRA=96.8%)>conventional treatment combined with Danlou Tablet(SUCRA=68.8%)>conventional treatment combined with Compound Danshen Dripping Pill(SUCRA=65.4%)>conventional treatment combined with Shexiang Baoxin Pill(SUCRA=65.2%)>conventional treatment combined with Guanxin Danshen Dripping Pill(SUCRA=50.0%)>conventional treatment combined with Diao Xinxuenkang Soft Capsule(SUCRA=40.0%)>conventional treatment combined with Guanxinshutong Capsule(SUCRA=34.6%)>conventional treatment combined with Yangxinshi Tablet(SUCRA=28.6%).②In terms of reducing the weekly frequency of angina pectoris,SUCRA was ranked as follows:conventional treatment combined with Guanxinshutong Capsule(SUCRA=77.7%)>conventional treatment combined with Shexiang Baoxin Pill(SUCRA=69.3%)>conventional treatment combined with Yindanxinnaotong Soft Capsule(SUCRA=64.1%)>conventional treatment combined with Diao Xinxuekang Soft Capsule(SUCRA=60.9%)>conventional treatment combined with Tongxinluo Capsule(SUCRA=56.5%)>conventional treatment combined with Compound Danshen Dripping Pill(SUCRA=32.9%)>conventional treatment combined with Yangxinshi Tablet(SUCRA=30.9%).③In terms of reducing the duration of angina pectoris per minute,SUCRA was ranked as fllows:conventional treatment combined with Yindanxinnaotong Soft Capsule(SUCRA=88.0%)>conventional treatment combined with Shexiang Baoxin Pill(SUCRA=78.9%)>conventional treatment combined with Guanxinshutong Capsule(SUCRA=61.9%)>conventional treatment combined with Diao Xinxuekang Soft Capsule(SUCRA=52.7%)>conventional treatment combined with Tongxinluo Capsule(SUCRA=43.6%)>conventional treatment combined with Compound Danshen Dripping Pill(SUCRA=40.5%)>conventional treatment combined with Yangxinshi Tablet(SUCRA=23.3%).In terms of reducing hs-CRP,the order of SUCRA was as follows:conventional treatment combined with Shexiang Baoxin Pill(SUCRA=98.5%)>conventional treatment combined with Diao Xinxuekang Soft Capsule(SUCRA=84.8%)>conventional treatment combined with Danlou Tablet(SUCRA=66.0%)>conventional treatment combined with Compound Danshen Dripping Pill(SUCRA=50.0%)>conventional treatment combined with Tongxinluo Capsule(SUCRA=27.9%)>conventional treatment combined with Guanxinshutong Capsule(SUCRA=20.2%).In terms of reducing ET-1,SUCRA was ranked as follows:conventional treatment combined with Tongxinluo Capsule(SUCRA=80.8%)>conventional treatment combined with Guanxin Danshen Dripping Pill(SUCRA=75.8%)>conventional treatment combined with Diao Xinxuekang Soft Capsule(SUCRA=50.6%)>conventional treatment combined with Compound Danshen Dripping Pill(SUCRA=48.0%)>conventional treatment combined with Guanxinshutong Capsule(SUCRA=39.8%).@In terms of increasing NO,SUCRA was ranked as follows:conventional treatment combined with Guanxin Danshen Dripping Pill(SUCRA=86.7%)>conventional treatment combined with Compound Danshen Dripping Pill(SUCRA=65.1%)>conventional treatment combined with Tongxinluo Capsule(SUCRA=53.4%)>conventional treatment combined with Guanxinshutong Capsule(SUCRA=49.6%)>conventional treatment combined with Diao Xinxuekang Soft Capsule(SUCRA=37.8%).Conclusion:Conventional Western medicine treatment combined Huoxuehuayu Chinese patent medicine can improve the angina pectoris symptoms after PCI of coronary heart diseases and alleviate the injury of vascular endothelial cells,and it has less adverse reaction.In addition,in different outcome indicators,each treatment has its own advantages and emphasis.Due to the poor quantity and quality of included studies,the above conclusions need to be verified by more high-quality studies.