摘要
目的：对中药治疗急性心肌梗死（AMI）的有效性作出较客观的评估。方法：①以（中文标题：心肌梗塞or心肌梗死）and（全部检索条目：中医or中药or中西医结合）的检索式检索中国生物医学文献光盘数据库（1978年1月～2004年11月）；②进行二次筛选并进行Jadad评分，筛选和评价过程由2位研究者独立进行，意见不同者通过讨论解决；③Meta分析，采用Cochrane协作网提供的Rev man 4．2软件进行统计分析。结果：8篇文献进入Meta分析，总病例数为738例。Meta分析显示与常规西药相比，加用中药干预对AMI患者病死率的影响没有统计学差异（P=0．24，RR为0．78[0．52，1．18]），临床总有效率（P=0．17）和心律失常发生率（P=0．07）也没有差异，RR分别为1．27[0．90，1．81]和0．78[0．60，1．02]，但中药干预组再梗率、心力衰竭发生率明显低于对照组（P分别为0．007和0．01），RR分别为0．41[0．21，0．78]和0．55[0．34，0．87]，治疗后左室EF射血分数明显高于对照组（P〈0．0001），VC2VID为4．85[2．63，7．08]。结论：与单纯西药相比，加用中药对减少再梗和心力衰竭、提高左室EF射血分数有益，而病死率、心律失常发生率和临床总有效率两组的差异没有统计学意义。但仅以本项Meta分析为基础，对于中药治疗AMI的疗效目前尚不能得出最终的结论。
Objective： To make an impersonal evaluation on the validity of Chinese materia medica for acute myocardial infarction. Methods： ①Searched the CBM database （1978.1 - 2004.11 ） with the search formula of （Chinese Title： myocardial infarction） AND （All research items： traditional Chinese medicine OR Chinese materia medica OR integrated traditional and western medicine）.②Literature bolting and scoring were performed by 2 researchers independently according to the Jadad Score, different opinions should be solved through discussion. ③Rev man 4.2 offered by Cochrane was used to do the meta-analysis. Results： Only 8 hteratures came into meta analysis （758 cases）, the result of analysis showed that compared with basic Western Medicine, additional Chinese materia medica could not reduce the mortality of AMI patients （P=0.24, RR0.78[0.52, 1.18]） or arrhythmia incidence rate （P =0.07, RR0.78[0.60, 1.02]）, and could not raise total clinical effective rate （P = 0.17, RR1.27[0.90, 1.81]）, but the intervention of Chinese materia medica could reduce re-infarction （P=0.007, RR0.41[0.21, 0.78]） and heart failure （P =0.01, RR0.55[0.34, 0.87]） compared with the control group, and improve the left ventricular ejection fraction （ P 〈 0. 0001, WMD 4.85 [ 2.63, 7.08 ] ）. Conclusion： Meta analysis shows that Chinese materia medica has some benefits in reducing re- infarction and heart failure, raising left ventricular ejection fraction, but we can not make a final conclusion of the effectiveness of Chinese materia medica for AMI base only on this Meta analysis.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2006年第9期528-531,共4页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家973计划资助课题(No.2003CB517103)
北京中医药大学资助课题(No.Y2001-10)
