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尼可地尔片治疗冠状动脉慢血流的系统评价

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摘要:

目的 系统评价尼可地尔片治疗冠状动脉慢血流的有效性和安全性。方法 计算机检索
Cochrane Library、PubMed、EMbase、Web of Science、中国知识资源总库(CNKI)、中国科技期刊数
据库(VIP)、万方期刊数据库(WANFANG)、中国生物医学文献数据库(CBM)建库至2020年11月
的文献,结合补充检索,收集所有比较西药常规联合尼可地尔片与单纯西药常规疗法的随机对照试验
(RCTs),严格筛选文献并对纳入的文献进行资料提取,按照Cochrane Handbook方法评价纳入文献质
量,对纳入文献的偏倚风险进行评估,应用RevMan 5.3软件进行Meta分析。结果 共纳入15个研究,共
计1542例患者。Meta分析结果提示,相对于单纯西药常规治疗,尼可地尔片能显著提高冠状动脉慢血
流患者的临床有效率(RR=1.43,95%CI:1.17~1.75,P=0.0004);减少胸痛发作频率(MD=-1.36,
95%CI:-1.67~-1.05,P<0.00001),减少胸痛发作时间(MD=-1.31,95%CI:-1.61~-1.00,P
<0.00001);增加冠状动脉(冠脉)血流速度(MD=-8.85,95%CI:-13.50~-4.21,P=0.0002);改善
血清超敏C反应蛋白,降低炎症因子水平(MD=-0.92,95%CI:-1.35~-0.50,P<0.0001);改善血管
内皮功能(FMD水平:MD=2.78,95%CI:2.50~3.06,P<0.00001;基础血流水平:MD=2.76,95%CI:
0.05~5.46,P=0.05)。且未见明显不良反应。结论 尼可地尔片联合常规西药较单纯常规西药治疗冠脉慢
血流可进一步提高疗效,且安全性较好。

Abstract:

Objective To systematically review the efficacy and safety of nicordil tablets in the treatment of coronary slow flow (CSF). Methods The databases of Cochrane Library, PubMed, EMbase, Web of Science, CNKI, VIP, WanFang Data and CBM were retrieved from database establishment time to Nov. 2020 combined with supplement retrieving for collecting all randomized controlled trials (RCTs) about comparison between routine therapies of Western medicine combined with nicordil tablets and single routine therapies of Western medicine. The literature was strictly screened and data was extracted from included literature. The quality of included literature was reviewed according to Cochrane Handbook method. The risk of bias of included literatures was reviewed, and a Meta-analysis was conducted by using RevMan 5.3 software. Results There were totally 15 RCTs included involved 1542 patients. The results of Meta-analysis showed that nicordil tablets, compared with single routine therapies of Western medicine, improved significantly clinical effective rate in CSF patients (RR=1.43, 95%CI: 1.17~1.75, P=0.0004), reduced seizure frequency of chest pain (MD=-1.36, 95%CI: -1.67~-1.05, P<0.00001), shortened seizure time of chest pain (MD=-1.31, 95%CI: -1.61~-1.00, P<0.00001), improved coronary blood flow velocity (MD=-8.85, 95%CI: -13.50~-4.21, P=0.0002), improved high sensitivity C-reactive protein (hs-CRP), decreased inflammatory cytokines (MD=-0.92, 95%CI: -1.35~-0.50, P<0.0001), (MD=2.76, 95%CI: 0.05~5.46, P=0.05) and improved vascular endothelial function (FMD level: MD=2.78, 95%CI: 2.50~3.06, P<0.00001; basal blood flow level: MD=2.76, 95%CI: 0.05~5.46, P=0.05). There were no significant adverse reactions observed. Conclusion Nicordil tablets combined with routine therapies of Western medicine can further promote clinical efficacy with higher safety compared with single routine therapies of Western medicine.

基金项目:

山西省卫生健康委科研课题(2021090);山西省高等学
校科技创新项目(2020L0429);山西中医药大学科技创新能力培育计划
(2019PY-060);山西省科技攻关项目(20140313008-12)

参考文献:

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