Compound Danshen Dripping Pills combined with isosorbide mononitrate for angina pectoris: A systematic review and a Meta-analysis
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摘要:
目的：系统评价复方丹参滴丸 (CDDP) 联合单硝酸异山梨酯 (ISMN) 与单独使用ISMN治疗心绞痛的疗效。方法:通过计算机检索PubMed、Web of Science、Cochrane Library、Embase、CNKI、中国生物医学文献数据库、万方医学网等中关于CDDP联合ISMN治疗心绞痛的随机对照试验和队列研究，检索时间为建库至2022年11月。进一步筛选出符合的文献并提取数据进行Meta分析。数据采用Stata 14软件和Spss 26进行分析。结果:最终纳入59项随机对照试验和11项队列研究，共7081例心绞痛患者。Meta分析结果显示:CDDP联合ISMN治疗心绞痛的心绞痛症状联合心电图疗效(OR = 4.824, 95% CI = 3.636?6.401, P = 0.000)、心绞痛症状疗效(OR = 4.347, 95% CI = 3.635?5.198, P = 0.000)和心电图疗效(OR = 3.364, 95% CI = 2.767?4.089, P = 0.000)均优于单独使用ISMN；同时，联合用药在降低总胆固醇(MD = ?24.296, 95% CI = ?26.429 to ?22.163, P = 0.000)和甘油三酯 (MD = ?35.176, 95% CI = ?37.439 to ?32.912, P = 0.000)、缩短心绞痛发作时间(MD = ?1.991, 95% CI = ?2.349 to ?1.633, P = 0.000)，减少心绞痛发作频率(SMD = ?2.840, 95% CI = ?3.416 to ?2.265, P = 0.000)方面也优于单独使用ISMN；CDDP联合ISMN与单独使用ISMN组不良反应发生率无显著性差异(OR = 0.513, 95% CI = 0.421?0.626, P = 0.000)。结论：CDDP联合ISMN治疗心绞痛优于单用ISMN，患者耐受性良好。这种中西医结合的疗法可以作为患者的另一种治疗选择。但纳入文献普遍质量不高，且存在一定的发表偏倚，期待进一步的证据验证。
Abstract:
Objective: To evaluate the efficacy of Compound Danshen Dripping Pills (CDDP) combined with isosorbide mononitrate (ISMN) versus ISMN alone for treating angina pectoris in patients. Methods: The PubMed, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials (RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography (ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774. Results: Our study included 7 245 patients with angina (59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio (OR) = 4.824, 95% confidence interval (CI) = 3.636–6.401, P = 0.000], the efficacy of angina symptom (OR = 4.347, 95% CI = 3.635–5.198, P = 0.000), the efficacy of ECG (OR = 3.364, 95% CI = 2.767–4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride (TG) [mean difference (MD) =–35.176, 95% CI = –37.439 to–32.912, P = 0.000], total cholesterol (TC) (MD = –24.296, 95% CI =–26.429 to –22.163, P = 0.000), the duration of angina attack (MD =–1.991, 95% CI =–2.349 to–1.633, P = 0.000), and the frequency of angina attack [standardized MD (SMD) = –2.840, 95% CI =–3.416 to–2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone (OR = 0.513, 95% CI = 0.421–0.626, P = 0.000). Conclusion: CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore, this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.
Ru Wang, Jing Hu, Yuanyuan Li, Hong Yin *. Compound Danshen Dripping Pills combined with isosorbide mononitrate for angina pectoris: A systematic review and a Meta-analysis[J]. Chinese Herbal Medicines (CHM),2024,16(4):622-637
