Pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Chengyu , ZHANG Xiaoyu , TANG Xiaoyi , LI Min , YANG Xinyu ,  SHANG Hongcai

Kay Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, P.R.China;

Corresponding author：

SHANG Hongcai, Email: shanghongcai@126.com

Keywords：

Pericarpium trichosanthis injection; Angina pectoris; ECG; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201703032

Video：

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ObjectiveTo systematically review the efficacy and safety of pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris.MethodsDatabases including CBM, CNKI, WanFang Data, VIP, PubMed, The Cochrane Library and Web of Science were searched from inception to February 20^th 2017 to collect randomized controlled trials (RCTs) about pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs involving 1 004 patients were included. The results of meta-analysis showed that: the effective rate of angina symptoms (RR=1.24, 95%CI 1.15 to 1.33, P<0.000 01) and resting ECG (RR=1.30, 95%CI 1.15 to 1.45, P<0.000 1) in pericarpium trichosanthis injection combined with conventional western medicine group were superior to the conventional western medicine group. And the adverse reaction was rare and could be more tolerated in pericarpium trichosanthis injection combined with conventional western medicine group.ConclusionPericarpium trichosanthis injection combined with conventional western medicine can improve the symptoms of angina pectoris and objective indicator of ECG. However, due to the low quality of included studies and lack of evidence, the above results are needed to be validated by further well-designed multicenter, large scale, double blind RCTs.

Citation： LI Chengyu, ZHANG Xiaoyu, TANG Xiaoyi, LI Min, YANG Xinyu, SHANG Hongcai. Pericarpium trichosanthis injection combined with conventional western medicine for angina pectoris: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(9): 1072-1078. doi: 10.7507/1672-2531.201703032 Copy

1.	陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告 2015》概要. 中国循环杂志, 2016, 31(6): 521-528.
2.	Roger VL, Go AS, Lloydjones DM, et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation, 2013, 127(1): 29-322.
3.	任胜男, 许龙, 张冬梅, 等. 老年人群心绞痛患病率: 医生诊断与 Rose 问卷诊断之比较. 中国老年学, 2015, 35(24): 7070-7072.
4.	Mancini GBJ, Gosselin G, Chow B, et al. Canadian cardiovascular society guidelines for the diagnosis and management of stable ischemic heart disease. Can J Cardiol, 2014, 30(8): 837-849.
5.	Krasopoulos G, Brister SJ, Beattie WS, et al. Aspirin " resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis. BMJ, 2008, 336(7637): 195-198.
6.	Liu L, Gao YH, Cao J, et al. High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome. J Geriatr Cardiol, 2016, 13(6): 531-536.
7.	Xiong XJ, Wang Z, Wang J. Innovative strategy in treating angina pectoris with Chinese patent medicines by promoting blood circulation and removing blood stasis: experience from combination therapy in Chinese medicine. Curr Vasc Pharmacol, 2005, 13(4): 540-553.
8.	张勇. 中药注射剂治疗冠心病心绞痛近况. 北京: 北京中医药大学, 2007: 1-27.
9.	Xiong XJ, Borrelli F, de Sá Ferreira A, et al. Herbal medicines for cardiovascular diseases. Evid Based Complement Alternat Med, 2014, 2014: 809741.
10.	王姗姗. 瓜蒌皮的药理作用及其临床应用. 山西医药杂志, 2009, 38(1): 67-68.
11.	吴嘉瑞. 基于文献数据库和传统药物警戒思想的中药注射剂安全性研究. 北京: 北京中医药大学, 2007: 1-172.
12.	[No authors listed]. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation, 1979, 59(3): 607-609.
13.	Anderson JL, Adams CD, Antman EM, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-st-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 2011, 123(18): e426-579.
14.	Fraker TD Jr, Fihn SD, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines writing group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. Circulation, 2007, 116(23): 2762-2772.
15.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 慢性稳定型心绞痛诊断与治疗指南. 中华心血管病杂志, 2007, 35(3): 195-206.
16.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 不稳定型心绞痛和非 ST 段抬高心肌梗死诊断与治疗指南. 中华心血管病杂志, 2007, 35(3): 295-304.
17.	郑筱萸. 中药新药临床研究指导原则. 北京: 中国医药科技出版社, 2002: 68-73.
18.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: http://handbook. cochrane.org.
19.	刘莉, 牛新萍. 瓜蒌皮注射液对稳定型心绞痛痰瘀互结证血管内皮功能的影响. 中西医结合心脑血管病杂志, 2014, 12(1): 3-5.
20.	刘颁, 石振东. 瓜蒌皮注射液联合阿司匹林治疗高龄不稳定型心绞痛的临床效果及对血小板聚集率的影响. 中国疗养医学, 2016, 25(2): 188-190.
21.	史永堂. 新通注射液联合低分子肝素治疗不稳定型心绞痛及对血脂的疗效观察. 中华中医药杂志, 2007, 22(11): 804-805.
22.	姜丹. 瓜蒌皮注射液联合西药治疗不稳定型心绞痛 (痰浊血瘀证) 随机平行对照研究. 实用中医内科杂志, 2013, 27(6): 65-67.
23.	张卫三, 刘入源, 洪秀芳. 瓜蒌皮注射液对冠心病稳定型心绞痛的治疗. 中华现代内科学杂志, 2006, 3(8): 893-894.
24.	杨丽君. 瓜蒌皮注射液联合西药治疗痰瘀互结冠心病心绞痛随机平行对照研究. 实用中医内科杂志, 2016, 30(12): 61-63.
25.	梅发光, 王忠良, 张义勤, 等. 瓜蒌皮注射液对不稳定型心绞痛患者斑块稳定性的影响. 河南中医, 2016, 36(11): 1913-1915.
26.	王群群, 张忠辉. 瓜蒌皮注射液治疗冠心病的临床观察. 心血管病防治知识 (学术版), 2016, 6(5): 60-62.
27.	赵海燕, 张秉戟. 瓜蒌皮注射液联用阿司匹林对不稳定性心绞痛患者血小板聚集功能的影响. 中国社区医师 (医学专业), 2010, 27(12): 140-141.
28.	黄绪兵. 瓜蒌皮注射液治疗冠心病心绞痛 50 例. 医药前沿, 2014, 22(8): 165.
29.	赵先, 宁泽琼, 王婧雯, 等. 瓜蒌皮注射液治疗心绞痛安全性和有效性的 Meta 分析. 西北药学杂志, 2016, 31(1): 86-91.
30.	Xiong XJ. Integrating traditional Chinese medicine into western cardiovascular medicine: an evidence-based approach. Nat Rev Cardiol, 2015, 12(6): e374.

1. 陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告 2015》概要. 中国循环杂志, 2016, 31(6): 521-528.
2. Roger VL, Go AS, Lloydjones DM, et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation, 2013, 127(1): 29-322.
3. 任胜男, 许龙, 张冬梅, 等. 老年人群心绞痛患病率: 医生诊断与 Rose 问卷诊断之比较. 中国老年学, 2015, 35(24): 7070-7072.
4. Mancini GBJ, Gosselin G, Chow B, et al. Canadian cardiovascular society guidelines for the diagnosis and management of stable ischemic heart disease. Can J Cardiol, 2014, 30(8): 837-849.
5. Krasopoulos G, Brister SJ, Beattie WS, et al. Aspirin " resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis. BMJ, 2008, 336(7637): 195-198.
6. Liu L, Gao YH, Cao J, et al. High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome. J Geriatr Cardiol, 2016, 13(6): 531-536.
7. Xiong XJ, Wang Z, Wang J. Innovative strategy in treating angina pectoris with Chinese patent medicines by promoting blood circulation and removing blood stasis: experience from combination therapy in Chinese medicine. Curr Vasc Pharmacol, 2005, 13(4): 540-553.
8. 张勇. 中药注射剂治疗冠心病心绞痛近况. 北京: 北京中医药大学, 2007: 1-27.
9. Xiong XJ, Borrelli F, de Sá Ferreira A, et al. Herbal medicines for cardiovascular diseases. Evid Based Complement Alternat Med, 2014, 2014: 809741.
10. 王姗姗. 瓜蒌皮的药理作用及其临床应用. 山西医药杂志, 2009, 38(1): 67-68.
11. 吴嘉瑞. 基于文献数据库和传统药物警戒思想的中药注射剂安全性研究. 北京: 北京中医药大学, 2007: 1-172.
12. [No authors listed]. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation, 1979, 59(3): 607-609.
13. Anderson JL, Adams CD, Antman EM, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-st-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 2011, 123(18): e426-579.
14. Fraker TD Jr, Fihn SD, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines writing group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. Circulation, 2007, 116(23): 2762-2772.
15. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 慢性稳定型心绞痛诊断与治疗指南. 中华心血管病杂志, 2007, 35(3): 195-206.
16. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 不稳定型心绞痛和非 ST 段抬高心肌梗死诊断与治疗指南. 中华心血管病杂志, 2007, 35(3): 295-304.
17. 郑筱萸. 中药新药临床研究指导原则. 北京: 中国医药科技出版社, 2002: 68-73.
18. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: http://handbook. cochrane.org.
19. 刘莉, 牛新萍. 瓜蒌皮注射液对稳定型心绞痛痰瘀互结证血管内皮功能的影响. 中西医结合心脑血管病杂志, 2014, 12(1): 3-5.
20. 刘颁, 石振东. 瓜蒌皮注射液联合阿司匹林治疗高龄不稳定型心绞痛的临床效果及对血小板聚集率的影响. 中国疗养医学, 2016, 25(2): 188-190.
21. 史永堂. 新通注射液联合低分子肝素治疗不稳定型心绞痛及对血脂的疗效观察. 中华中医药杂志, 2007, 22(11): 804-805.
22. 姜丹. 瓜蒌皮注射液联合西药治疗不稳定型心绞痛 (痰浊血瘀证) 随机平行对照研究. 实用中医内科杂志, 2013, 27(6): 65-67.
23. 张卫三, 刘入源, 洪秀芳. 瓜蒌皮注射液对冠心病稳定型心绞痛的治疗. 中华现代内科学杂志, 2006, 3(8): 893-894.
24. 杨丽君. 瓜蒌皮注射液联合西药治疗痰瘀互结冠心病心绞痛随机平行对照研究. 实用中医内科杂志, 2016, 30(12): 61-63.
25. 梅发光, 王忠良, 张义勤, 等. 瓜蒌皮注射液对不稳定型心绞痛患者斑块稳定性的影响. 河南中医, 2016, 36(11): 1913-1915.
26. 王群群, 张忠辉. 瓜蒌皮注射液治疗冠心病的临床观察. 心血管病防治知识 (学术版), 2016, 6(5): 60-62.
27. 赵海燕, 张秉戟. 瓜蒌皮注射液联用阿司匹林对不稳定性心绞痛患者血小板聚集功能的影响. 中国社区医师 (医学专业), 2010, 27(12): 140-141.
28. 黄绪兵. 瓜蒌皮注射液治疗冠心病心绞痛 50 例. 医药前沿, 2014, 22(8): 165.
29. 赵先, 宁泽琼, 王婧雯, 等. 瓜蒌皮注射液治疗心绞痛安全性和有效性的 Meta 分析. 西北药学杂志, 2016, 31(1): 86-91.
30. Xiong XJ. Integrating traditional Chinese medicine into western cardiovascular medicine: an evidence-based approach. Nat Rev Cardiol, 2015, 12(6): e374.

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