丹参酮ⅡA磺酸钠治疗冠心病心绞痛随机对照试验的Meta分析(1)
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摘要：目的 根据现有临床研究评价丹参酮ⅡA磺酸钠治疗冠心病心绞痛的有效性及安全性。方法 通过PubMed、中国生物医学文献数据库、中国期刊全文数据库、万方数据库检索丹参酮ⅡA磺酸钠治疗冠心病心绞痛的随机对照临床试验文献，采用Cochrane协作网专用软件RevMan 4.2进行Meta分析。结果 共有29篇文献，2 712例患者符合纳入标准。所有试验根据Jadad评分均<3分，无双盲试验。“倒漏斗”图显示不对称，提示存在一定的发表偏倚。治疗组在改善心绞痛症状总有效率及显效率均显著优于对照组(P<0.01)，合并RR值分别为1.23(95%CI1.19～1.28)，1.37(95%CI1.27～1.47)；心电图疗效总有效率及显效率亦显著优于对照组(P<0.01)，合并RR值分别为1.33(95%CI1.23～1.43)，1.48(95%CI1.28～1.72)。试验未发现严重的副反应。结论 在西药常规治疗基础上合用丹参酮ⅡA磺酸钠可进一步改善冠心病心绞痛的临床症状及心电图缺血改变，但由于存在发表性偏倚及文献质量偏低，尚需更严格的循证医学证据。
关键词：丹参酮ⅡA磺酸钠；心绞痛；随机对照试验；Meta分析
中图分类号：R541.4 R289.5 文献标识码：B 文章编号：1672-1349(2011)06-0644-04Meta-analysis on Randomized Controlled Trials for Treatment of Angina Pectoris by Sodium TanshinoneⅡA Sulfonate
Wang Chenglong,Gu Feng,Wang Shaoli
Xiyuan Hospital,China Academy of Chinese Medical Sciences (Beijing 100091)
Abstract:Objective To review studies for the treatment of angina pectoris by sodium tanshinoneⅡA sulfonate and evaluate the safety and efficacy of the drug.Methods The randomized controlled trials (RCT) of sodium tanshinoneⅡA sulfonate for angina pectoris were searched from PubMed,China biology medicine disc (CBM),CNKI,and Wanfang DATA.RevMan4.2 was used for analysis.ResultsTwenty-nine RCTs including 2 712 patients were met the inclusion criteria.All the trials were not adequate in methodological quality.None of them was double-blinded trial.There was a significant funnel plot asymmetry,publication bias was found.Compared with the control group,the treatment group showed significant higher total effectiveness rate[P<0.01，RR1.23(95%CI：1.19 to 1.28)]and obvious efficiency[P<0.01，RR1.37(95%CI：1.27 to 1.47)] for improving angina symptom.The total effectiveness rate[P<0.01，RR1.33 (95%CI：1.23 to 1.43)]and obvious efficiency[P<0.01，RR1.48(95%CI：1.28 to 1.72)] in treatment group at ameliorating the electrocardiogram effect were also better than that in control group.There were no serious side-effects were found in the trials.Conclusion The present meta-analysis suggested that on the basis of conventional western medicine STS was helpful to improving symptom and alleviate the ischemia of electrocardiogram ......
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