黄芪注射液和黄芪总皂苷注射液治疗冠心病心绞痛临床疗效的系统评价
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作者单位:

1. 陕西省人民医院中心实验室,陕西 西安 710068;2. 陕西省中医医院急诊科,陕西 西安 710003;3. 西安交通大学医学部公共卫生学院,陕西 西安 710049

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R259

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* 基金项目: 国家自然科学基金面上项目(81573823)
收稿日期: 2016 - 12- 13
作者简介: 王海芳(1972-),女,山西阳泉人,博士,助理研究员,研究方向:中药抗动脉粥样硬化分子机制。
△通信作者:刘勤社,E-mail:lqsspph@126.com


Meta-analysis of Clinical Efficacy of Astragalus Injection and AstragalusTotal-saponinInjection in Patients with Angina Pectoris
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Affiliation:

1. Central Lab of Shaanxi Provincial People’s Hospital, The Third Affiliated Hospital of the Medical College of Xian Jiaotong University, Xian 710068, China; 2. Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xian 710003, China;3. School of Public Health, Xian Jiaotong University Health Science Center, Xian 710049, China

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    摘要:

    目的 系统评价黄芪注射液和黄芪总皂苷注射液辅助治疗冠心病心绞痛的临床疗效。方法 计算机检索相关数据库,包括PubMed、The Cochrane Library、EMbase、CBM、CNKI、VIP和WanFang Data,收集2015年12月之前的研究文献,由两位研究者根据纳入及排除标准独立筛选文献、提取信息及评价纳入文献的方法学质量,采用Rev Man 5.2软件进行Meta分析。结果 Meta分析结果显示,在改善心绞痛症状和改善心电图方面,黄芪注射液辅助西药治疗疗效优于单纯常规西药治疗,其统计结果分别为[OR=3.67,95% CI(2.42,5.56),P<0.001]和[OR=3.15,95% CI(2.26,4.41),P<0.001];黄芪总皂苷注射液与川芎嗪注射液的疗效无显著差异,其统计结果分别为[OR=1.12,95% CI(0.58,2.15),P=0.74]和[OR=1.15,95% CI(0.63,2.11),P=0.64]。以气虚血瘀证型冠心病心绞痛作为观察证型对相关研究进行分析,显示黄芪总皂苷注射液和川芎嗪注射液对中医症候的疗效相似(P=0.81)。结论 在治疗冠心病心绞痛方面,黄芪注射液和黄芪总皂苷注射液均具有显著疗效,不过,此结论仍需设计严谨的高质量临床试验进一步进行验证。

    Abstract:

    Objective To evaluate the clinical efficacy of Astragalus Injection and Astragalus Total-saponin Injection in Patients with angina pectoris. Methods Search the Cochrane Library, PubMed, CBM, CNKI, WanFang Data and VIP and collect information of randomized controlled trial(RCT) about the application of Astragalus Injection and Astragalus Total-saponin Sodium Chloride Injection in the treatment of Angina pectoris, building a database to retrieve the time to December, 2015. Two reviewers independently screened the literatures based on inclusion and exclusion criteria, and extracted information and evaluation methods including studies after methodology quality by use of software Rev Man 5.2.9 Meta-analysis. Results Meta-analysis showed that, compared with conventional western medicine treatment, Astragalus Injection associated with western medicine treatment could significantly improve the symptoms of angina[OR=3.67, 95% CI(2.42, 5.56), P<0.001]and the electrocardiogram[OR=3.15, 95% CI(2.26, 4.41), P<0.001]. The clinical efficacy of Astragalus Total-saponin Injection was comparative to that of Ligustrazine Sodium Chloride Injection([OR=1.12, 95% CI(0.58, 2.15), P=0.74] and [OR=1.15, 95% CI(0.63, 2.11), P=0.64], respectively). When angina patients of Qi and Blood Stasis type were analyzed separately, it was shown that Astragalus Total-saponin Injection had similar efficacy in the improvement of traditional Chinese medicine syndromes with Ligustrazine Sodium Chloride Injection(P=0.81). Conclusion Both Astragalus Injection and Astragalus Total-saponin Injection have significant effects in the treatment of angina pectoris. However, Due to the poor quality and the quantity limitation, he above conclusions still need to be verified through more large samples of high-quality RCT.

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