世界中医药

作者	单位
周琦1，邢文龙2，刘红旭1，尚菊菊1，来晓磊1，李爱勇1，刘庆荣3	1 首都医科大学附属北京中医医院，北京，100010； 2 首都医科大学，北京，100069； 3 中国医学科学院阜外医院，北京，100037

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中文摘要:

目的：对养心氏片治疗经皮冠状动脉介入治疗术（PCI）后胸痛的有效性及安全性进行Meta分析，为其临床应用提供参考。方法：检索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、China Biology Medicine disc、PubMed、Embase、Web of science及Cochrane图书馆数据库，检索年限为建库至2021年8月。根据检索策略及纳入排除标准筛选养心氏片治疗经皮冠状动脉介入治疗术后胸痛的随机对照临床试验，结合“Cochrane偏倚风险评估”工具、改良Jadad量表对纳入的文献进行质量评价，Rev Man 5.3软件进行Meta分析。结果：纳入文献8篇，697例患者，养心氏片组349例，对照组348例。文献质量评价5篇4分，3篇3分。Meta分析显示，养心氏片组治疗PCI术后胸痛有效［6项研究，n=505；RR（95％CI）＝1.29（1.16～1.42），P<0.001］；具有改善PCI术后中医证候的趋势，但差异无统计学意义［2项研究，n=149；RR（95％CI）＝1.56（0.85～2.85），P=0.15］；改善PCI术后7 d心电图ST段压低幅度［2项研究，n=163；MD（95％CI）＝0.07（0.05～0.09），P<0.001］；降低PCI术后主要不良心血管事件发生率［2项研究，n=163，RR（95％CI）＝0.41（0.25～0.70），P<0.001］；增加PCI术后6 min步行距离［2项研究，n=150；MD（95％CI）＝80.30，（23.12～137.47），P<0.01］；不增加不良反应发生率［2项研究，n=198，RR（95％CI）＝1.35（0.77～2.37），P=0.29］。结论：在规范化西药治疗基础上联合应用养心氏片，对经皮冠状动脉介入治疗术后胸痛具有改善作用，且具有较好的安全性，期待未来更多高质量的研究开展，为养心氏片的临床应用提供更多证据。

English Summary:

To Meta-analyze the efficacy and safety of Yangxinshi Tablets in the treatment of chest pain after percutaneous coronary intervention(PCI) to provide a reference for its clinical application.Methods:CNKI,CSPD,CCD,China Biology Medicine disc,PubMed,Embase,Web of Science,and Cochrane Library were searched for randomized controlled trials(RCTs) on Yangxinshi Tablets in the treatment of chest pain after PCI according to the search strategy and inclusion and exclusion criteria from database inception to August 2021.Cochrane risk-of-bias tool and modified Jadad scale were used to evaluate the quality of included RCTs.Meta-analysis was carried out by RevMan 5.3.Results:Eight research articles were included,with 697 patients involved,including 349 patients in the Yangxinshi Tablets group,and 348 in the control group.Literature quality evaluation showed 4 points for five articles and 3 points for three articles.Meta-analysis showed that the Yangxinshi Tablets group was effective in the treatment of chest pain after PCI［6 RCTs,n=505; RR(95%CI)＝1.29(1.16 to 1.42)，P<0.001］,and had the trend of improving traditional Chinese medicine(TCM) syndrome after PCI［2 RCTs,n=149; RR(95%CI)＝1.56(0.85 to 2.85)，P=0.15］.Additionally,the Yangxinshi Tablets group could also improve the ST-segment depression amplitude of ECG 7 days after PCI［2 RCTs,n=163; MD(95%CI)＝0.07(0.05 to 0.09)，P<0.001］,reduce the incidence of major adverse cardiovascular events after PCI［2 RCTs,n=163,RR(95%CI)=0.41(0.25 to 0.70),P<0.001］,and increase the 6-min walking distance after PCI［2 RCTs,n=150; MD(95%CI)＝80.30,(23.12 to 137.47)，P<0.01］.There was no increase in the incidence of adverse events［2 RCTs,n=198,RR(95%CI)=1.35(0.77 to 2.37),P=0.29］.Conclusion:Yangxinshi Tablets combined with conventional western medicine can improve chest pain after PCI with good safety.More high-quality research is encouraged to provide evidence for the clinical application of Yangxinshi Tablets.

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