摘要
目的系统评价脑心通胶囊联合常规西药治疗冠心病经皮冠状动脉介入术(PCI)后病人的抗栓疗效及安全性。方法计算机检索PubMed、The Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方、重庆维普数据库(VIP)等数据库,并进行手工检索,收集脑心通胶囊联合常规西药治疗冠心病PCI术后病人的临床随机对照试验(RCT),检索年限为建库至2022年3月23日。由2名研究人员独立筛选文献、提取资料、评价偏倚风险,采用RevMan 5.3软件进行Meta分析。结果最终纳入13项RCT,涉及1286例病人(其中试验组644例,对照组642例)。Meta分析结果显示,与常规西药治疗比较,脑心通胶囊联合常规西药治疗可降低冠心病PCI术后病人最大血小板聚集率、残余血小板聚集率、血小板聚集解聚率、血浆血管性血友病因子、血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)、纤维蛋白原及不良心血管事件的发生,提高病人最大血小板聚集抑制率及中医证候疗效,差异均有统计学意义(P<0.05)。共有7项研究报道了不良反应发生情况,主要表现为皮下出血、牙龋出血、消化道小出血、穿刺部位血肿等,两组不良反应发生率比较差异无统计学意义(P>0.05)。结论现有研究表明,脑心通胶囊联合常规西药能够抑制冠心病PCI术后病人血小板活化,改善机体凝血功能,提高抗栓疗效,但在临床应用安全性方面需要进一步研究证明其可靠性。
Objective To explore the antithrombotic effect and safety of Naoxintong Capsule combined with conventional western medicine on patients after percutaneous coronary intervention(PCI).Methods PubMed,the Cochrane library,Web of Science,CBM,CNKI,WanFang Data,VIP,and other databases were searched.The clinical randomized controlled trials(RCTs)of Naoxintong Capsule combined with conventional western medicine in the treatment of patients after PCI were collected.The retrieval time was from the establishment of the database to March 23,2022.Two researchers conducted literature screening and data extraction independently.Meta-analysis was performed by RevMan 5.3 software.Results Thirteen RCTs were included,involving 1286 patients(644 patients in experimental group and 642 patients in control group).The results of Meta-analysis showed that Naoxintong Capsule with conventional western medicine could decrease the maximum platelet aggregation rate,residual platelet aggregation rate,plasma von willebrand factor,GPⅡb/Ⅲa,fibrinogen,occurrence of adverse cardiovascular events,and increase the platelet aggregation and depolymerization rate,maximum platelet aggregation inhibition rate and curative effect of traditional Chinese medicine syndrome in patients after PCI(P<0.05).There were 7 studies reported the adverse reactions,such as subcutaneous hemorrhage,dental caries bleeding,gastrointestinal hemorrhage,hematoma at puncture site,and there was no statistical significance in the incidence of adverse reactions between two groups(P>0.05).Conclusion The current research showed that Naoxintong Capsule combined with conventional western medicine can inhibit platelet activation,improve coagulation function and antithrombotic effect in patients after PCI.However,further studies are needed to prove the reliability and safety.
作者
刘思娜
尚菊菊
仇盛蕾
刘鑫毅
杨悦文
王滋
LIU Sina;SHANG Juju;QIU Shenglei;LIU Xinyi;YANG Yuewen;WANG Zi(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)
出处
《中西医结合心脑血管病杂志》
2022年第13期2322-2328,共7页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
国家重点研发计划项目(No.2019YFC1708602)。
关键词
冠心病
经皮冠状动脉介入术
脑心通胶囊
抗栓疗效
安全性
META分析
coronary heart disease
percutaneous coronary intervention
Naoxintong Capsule
antithrombotic effect
safety
Meta-analysis
