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目的系统评价瓜蒌皮注射液联合常规用药治疗心绞痛的有效性和安全性。方法计算机检索CBM、CNKI、Wan Fang Data、VIP、Pub Med、The Cochrane Library(2017年2期)和Web of Science数据库,搜集瓜蒌皮注射液联合常规用药治疗心绞痛的随机对照试验(RCT),检索时限均从建库至2017年2月20日。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行数据分析。结果共纳入10个RCT,涉及1 004名心绞痛患者。Meta分析结果显示:联合瓜蒌皮注射液在改善心绞痛症状[RR=1.24,95%CI(1.15,1.33),P<0.000 01]和静息心电图[RR=1.30,95%CI(1.15,1.45),P<0.000 1]方面优于对照组。与对照组相比,联合治疗组的不良反应发生更少,程度更轻。结论瓜蒌皮注射液联合常规治疗与常规治疗相比,可改善心绞痛症状及心电图指标。由于纳入文献质量普遍较低,证据强度不足,上述结论仍需要通过多中心、大样本、双盲随机对照试验研究提供高级别证据予以验证。
Objective To evaluate the efficacy and safety of guanpi skin injection combined with conventional medicine in the treatment of angina pectoris. Methods Randomized controlled trials (RCTs) of Cucurbita peeli injection combined with conventional treatment of angina pectoris were collected from CBM, CNKI, Wan Fang Data, VIP, Pub Med, The Cochrane Library (2017 issue 2) and Web of Science. Search time limit from the database to February 20, 2017. After two reviewers independently screened the literature, extracted data, and assessed the risk of being included in the study, Rev Man 5.3 software was used for data analysis. Results A total of 10 RCTs were included, involving 1,004 patients with angina pectoris. Meta-analysis showed that the combination of Guandi Pi injection in improving angina symptoms [RR = 1.24, 95% CI (1.15, 1.33), P <0.000 01] and rest electrocardiogram [RR = 1.30, 95% CI ), P <0.000 1] was superior to the control group. Adverse reactions occurred less frequently and to a lesser extent in the combination therapy group compared with the control group. Conclusion Gua Bipi injection combined with conventional treatment compared with conventional treatment, can improve the symptoms of angina and ECG indicators. Due to the generally lower quality of evidence included and the lack of evidence, the above conclusions still need to be verified by high-level evidence from multicenter, large-scale, double-blind, randomized controlled trials.