不同中成药对痰瘀互结型冠心病患者血脂及微循环状态影响的 网状 Meta 分析.

Objective To evaluate the effectiveness and safety of different Chinese patent medicine in improving blood lipid and microcirculation in coronary heart disease patients with phlegm-blood stasis syndrome based on network meta-analysis. Methods The randomized controlled trials (RCTs) of different Chinese patent medicine in the treatment of blood lipid and microcirculation in coronary heart disease patients with phlegm-blood stasis syndrome were collected by searching CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of science databases from the establishment of the database to April 3, 2023. Literature quality evaluation and network meta-analysis were conducted using Review Manager 5.4 and Stata15.1 software. Results Thirty-seven RCTs were included, with a total sample size of 4 064 cases, involving 15 different Chinese patent medicines. The network meta-analysis showed that the efficacy of Chinese patent medicine combined with conventional Western medicine is often better than that of conventional Western medicine alone. There are no serious adverse reactions. The top three Chinese patent medicines with cumulative probability of total clinical efficacy were Guanmai Zaitong soft extract, Gualoupi Injection and Quyu Xiaoban Capsule. In terms of improving triglyceride (TG) and low-density lipoprotein (LDL-C), the top three Chinese patent medicines were Gualoupi Injection, Huxinkang Tablet and Guanxin Shutong Capsule. In terms of improving plasma viscosity and fibrinogen, the top three Chinese patent medicines were Ginkgo Damo Injection, Gualoupi Injection and Guanxin Shutong Capsule. In terms of improving endothelial function [nitric oxide (NO) and endothelin-1 (ET-1)], the top three Chinese patent medicines were Ginkgo Damo Injection, Danlou Tablet and Tongmai Yuxin Pill. In terms of reducing inflammation hypersensitivity C-reactive protein (hs-CRP), the top three Chinese patent medicines were Ginkgo Damo Injection, Huxinkang Tablet and Guanxin Shutong Capsule. Conclusion The current evidence shows that the combination of TCM, which is used for the treatment of phlegm-blood stasis syndrome, with conventional Western medicine in the treatment of coronary heart disease has advantages in improving clinical efficacy, blood lipids and microcirculation. TCM especially for the treatment of phlegm-blood stasis syndrome shows more obvious advantage, such as Guanmai Zaitong soft extract and Gualoupi injection, which can be taken into consideration as part of the clinical guidelines. However, due to the limited number and quality of the included literatures, the research results still need to be verified by more high-quality, multi-center, double-blind randomized trials. The purpose is to provide more reliable evidence-based medical reference. [ABSTRACT FROM AUTHOR]