论文部分内容阅读
目的评价中药汤剂治疗急性心肌梗死的疗效和安全性。方法检索Cochrane图书馆(2014年)、MEDLINE、中国学术期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)等数据库。检索不受发表语种限制,检索年限均为建库起至2015年12月20日。纳入中药汤剂干预急性心肌梗死的临床随机对照试验。按照数据提取表提取数据,采用Cochrane协作网推荐的评价标准对纳入试验进行质量评价,Rev Man 5.1软件进行资料分析,检验异质性,并根据异质性结果选择相应的效应模型。结果共纳入符合标准的21篇临床随机对照试验,共计1 819例患者。与常规治疗组比较,中药汤剂联合常规治疗可有效提高急性心肌梗死的冠脉血管再通率[RR=1.36,95%CI(1.16,1.59),P=0.0001],显著减少恶性心律失常[RR=0.52,95%CI(0.38,0.70),P<0.01]、心力衰竭[RR=0.48,95%CI(0.32,0.71),P=0.0003]及心源性休克[RR=0.53,95%CI(0.31,0.90),P=0.02]的发生。3项研究报道了不良反应。结论中药汤剂联合常规治疗能够有效提高急性心肌梗死的冠脉血管再通,具有显著减少恶性心律失常、心力衰竭及心源性休克等并发症发生的作用。
Objective To evaluate the efficacy and safety of Chinese herbal decoction in the treatment of acute myocardial infarction. Methods The Cochrane Library (2014), MEDLINE, CNKI, VIP, CBM and other databases were searched. Search is not subject to language restrictions, the search period are from the establishment of the library until December 20, 2015. A Randomized Controlled Trial of Traditional Chinese Medicine Decoction for Acute Myocardial Infarction. The data were extracted according to the data extraction table. The quality of the included trials was evaluated by using the evaluation criteria recommended by the Cochrane Collaboration. RevMan 5.1 software was used to analyze the data to test the heterogeneity and select the corresponding effect model according to the heterogeneity results. Results A total of 21 randomized controlled trials involving 2198 patients were included. Compared with the conventional treatment group, traditional Chinese medicine decoction combined with conventional treatment can effectively improve the rate of coronary recanalization in acute myocardial infarction [RR = 1.36,95% CI (1.16,1.59), P = 0.0001], significantly reduce the malignant arrhythmia [ RR = 0.52,95% CI 0.38,0.70, P <0.01], heart failure [RR = 0.48,95% CI 0.32,0.71, P = 0.0003] and cardiogenic shock [RR = 0.53,95% CI (0.31, 0.90), P = 0.02]. Three studies reported adverse reactions. Conclusion Traditional Chinese medicine decoction combined with conventional treatment can effectively improve coronary revascularization in acute myocardial infarction, and can significantly reduce the incidence of complications such as malignant arrhythmia, heart failure and cardiogenic shock.