复方丹参滴丸联合三种他汀类药物治疗冠心病心绞痛的系统评价
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摘要
[目的]评价复方丹参滴丸联合他汀类药物治疗冠心病心绞痛的临床疗效。[方法]检索中文全文期刊数据库(CNKI)、万方数据库(WanFang Data)、中国生物医学文献数据库(SinoMed)及PubMed,Cochrane Library、Embase数据库中使用复方丹参滴丸联合他汀类治疗冠心病心绞痛的临床随机对照试验研究,无语种限制。采用Cochrane Handbook 5.3推荐的偏倚风险评估工具评价纳入研究的质量。[结果]最终纳入符合标准的文献21篇,Meta分析结果显示:临床症状:异质性检验I2=44%,P=0.02,[RR=1.20,95%CI(1.16,1.25)];心电图(ECG):异质性检验I2=28%,P=0.19,[RR=1.36,95%CI(1.25,1.48)];血脂水平改善:胆固醇异质性检验I2=8%,P=0.36,[MD=-0.81,95%CI(-0.98,-0.63)],低密度脂蛋白(LDL)异质性检验I2=86%,P=0;血小板聚集率异质性检验I2=94%,P=0。[结论]复方丹参滴丸联合3种他汀类药物在改善临床症状、心电图缺血状态等方面有一定优势。
[Objective] To assess the clinical efficacy of danshen dropping pill combined with statin in the treatment of the heart of coronary heart disease.[Methods] To search the CNKI,WanFang Data,SinoMed PubMed,Cochrane Library,Embase database using compound danshen drop pill combined with statins in the clinical randomized controlled trial study of coronary heart disease angina pectoris,no language restriction. The quality of the study was analyzed by using the Cochrane Handbook 5.3 recommendation of bias risk assessment tool. [Results] 21 literatures were included in the standard,and the results of meta-analysis showed that clinical symptoms:heterogeneity test I2=44%,P =0.02),[RR =1.20,95% CI(1.16,1.25)]. ECG:heterogeneity test I2 =28%,P =0.19,(RR = 1.36,95% CI(1.25,1.48)]. Lipid levels improve:cholesterol heterogeneity test I2=8%,P=0.36,(MD=0.81,95%CI(0.98,0.63)],low density protein(LDL) heterogeneity test I2=86%,P=0;The heterogeneity test of platelet aggregation rate I2=94%,P =0. [Conclusion] Compound danshen dropping pill combined with three statins has obvious advantages in improving clinical symptoms and improving ecg ischemia.
[Objective] To assess the clinical efficacy of danshen dropping pill combined with statin in the treatment of the heart of coronary heart disease.[Methods] To search the CNKI,WanFang Data,SinoMed PubMed,Cochrane Library,Embase database using compound danshen drop pill combined with statins in the clinical randomized controlled trial study of coronary heart disease angina pectoris,no language restriction. The quality of the study was analyzed by using the Cochrane Handbook 5.3 recommendation of bias risk assessment tool. [Results] 21 literatures were included in the standard,and the results of meta-analysis showed that clinical symptoms:heterogeneity test I2=44%,P =0.02),[RR =1.20,95% CI(1.16,1.25)]. ECG:heterogeneity test I2 =28%,P =0.19,(RR = 1.36,95% CI(1.25,1.48)]. Lipid levels improve:cholesterol heterogeneity test I2=8%,P=0.36,(MD=0.81,95%CI(0.98,0.63)],low density protein(LDL) heterogeneity test I2=86%,P=0;The heterogeneity test of platelet aggregation rate I2=94%,P =0. [Conclusion] Compound danshen dropping pill combined with three statins has obvious advantages in improving clinical symptoms and improving ecg ischemia.
引文
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[14]李英杰,张爱清.复方丹参滴丸辅助治疗老年不稳定型心绞痛疗效观察[J].河北医药,2016,38(12):1842-1844.
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[17]徐连忠.复方丹参滴丸联合瑞舒伐他汀钙片治疗不稳定性心绞痛效果观察[J].中国乡村医药,2016,23(14):45,50.
[18]邓超蓝.复方丹参滴丸联合阿托代他汀治疗冠心病合并高脂血症临床疗效观察[J].现代诊断与治疗,2015,26(8):1754-1755.
[19]辛兆阳.复方丹参滴丸联合阿托伐他汀治疗不稳定型心绞痛的临床疗效[J].中国药物经济学,2014,9(12):234-235.
[20]殷秀霞,乔春友,王向玲,等.阿托伐他汀钙与复方丹参滴丸短期联合应用对冠心病患者血脂影响观察[J].临床荟萃,2011,26(18):1632-1633.
[21]刘学平,王云川.复方丹参滴丸联合辛伐他汀治疗冠心病疗效观察[J].中国社区医师,2011,27(9):16.
[22]黄芳,李迎,李科宇,等.复方丹参滴丸联合辛伐他汀治疗冠心病心绞痛疗效观察[J].医学临床研究,2017,34(2):373-375.
[23]张书军.尼可地尔联合用药对不稳定型心绞痛患者血清超敏C反应蛋白基质金属蛋白酶9淀粉样酶A及血脂水平的影响[J].临床心身疾病杂志,2017,23(5):14-17.
[24]肖铃.复方丹参滴丸药理作用及临床应用的研究进展[J].世界中医药,2015,10(7):1117-1119,1123.
[2]汤峰.复方丹参滴丸治疗冠心病的临床分析[J].中外医疗,2017,36(12):124-125,128.
[3]闫英华.单硝酸异山梨酯缓释片联合复方丹参滴丸治疗冠心病心绞痛37例疗效观察[J].中国现代医生,2016,54(35):97-99.
[4]黄春雨,周果,李刚,等.复方丹参滴丸联合耳穴埋豆及穴位按摩对稳定性心绞痛的干预[J].中国实验方剂学杂志,2017,23(2):175-180.
[5]冯艳.复方丹参滴丸与辛伐他汀治疗不稳定型心绞痛临床观察[J].中西医结合心脑血管病杂志,2014,12(1):22-23.
[6]叶春恒.复方丹参滴丸联合辛伐他汀治疗不稳定型心绞痛的疗效观察[J].实用心脑肺血管病杂志,2013,21(9):54-55.
[7]胡静.复方丹参滴丸联合阿托伐他汀治疗不稳定心绞痛疗效观察[J].河北医学,2013,19(5):693-695.
[8]刘清安.辛伐他汀(舒降之)联合复方丹参滴丸治疗冠心病合并高脂血症102例临床分析[J].医学理论与实践,2012,25(13):1583-1584.
[9]卢爱萍.复方丹参滴丸治疗心绞痛86例[J].陕西医学杂志,2012,41(7):886-887.
[10]阚准.使用复方丹参滴丸和阿托伐他汀钙治疗稳定性心绞痛80例的临床观察[J].求医问药:学术版,2011,9(10):214-214.
[11]钟小明.复方丹参滴丸治疗不稳定型心绞痛疗效观察[J].中西医结合心脑血管病杂志,2011,9(8):916-917.
[12]李灿林.复方丹参滴丸联合马来酸桂哌齐特治疗冠心病心绞痛疗效观察[J].现代诊断与治疗,2015,26(20):4598-4599.
[13]李静.复方丹参滴丸联合西药治疗对冠心病心绞痛随机平行对照研究[J].实用中医内科杂志,2015,29(5):140-141.
[14]李英杰,张爱清.复方丹参滴丸辅助治疗老年不稳定型心绞痛疗效观察[J].河北医药,2016,38(12):1842-1844.
[15]赵艳.复方丹参滴丸与辛伐他汀联合用药治疗冠心病的疗效观察[J].吉林医学,2010,31(30):5311-5312.
[16]任子美,刘保卫.复方丹参滴丸治疗冠心病心绞痛30例疗效观察[J].现代中医药,2008,28(4):10-11.
[17]徐连忠.复方丹参滴丸联合瑞舒伐他汀钙片治疗不稳定性心绞痛效果观察[J].中国乡村医药,2016,23(14):45,50.
[18]邓超蓝.复方丹参滴丸联合阿托代他汀治疗冠心病合并高脂血症临床疗效观察[J].现代诊断与治疗,2015,26(8):1754-1755.
[19]辛兆阳.复方丹参滴丸联合阿托伐他汀治疗不稳定型心绞痛的临床疗效[J].中国药物经济学,2014,9(12):234-235.
[20]殷秀霞,乔春友,王向玲,等.阿托伐他汀钙与复方丹参滴丸短期联合应用对冠心病患者血脂影响观察[J].临床荟萃,2011,26(18):1632-1633.
[21]刘学平,王云川.复方丹参滴丸联合辛伐他汀治疗冠心病疗效观察[J].中国社区医师,2011,27(9):16.
[22]黄芳,李迎,李科宇,等.复方丹参滴丸联合辛伐他汀治疗冠心病心绞痛疗效观察[J].医学临床研究,2017,34(2):373-375.
[23]张书军.尼可地尔联合用药对不稳定型心绞痛患者血清超敏C反应蛋白基质金属蛋白酶9淀粉样酶A及血脂水平的影响[J].临床心身疾病杂志,2017,23(5):14-17.
[24]肖铃.复方丹参滴丸药理作用及临床应用的研究进展[J].世界中医药,2015,10(7):1117-1119,1123.