| Objective:Meta-analysis was used to review the efficacy and safety of Shexiang Baoxin pill combined with western medicine in the treatment of unstable angina pectoris,so as to provide evidence-based medical for clinical application.Methods:To search the literatures collected from authoritative databases in China and abroad in recent ten years about Shexiang Baoxin pill combined with western medicine in the treatment of unstable angina pectoris.According to the inclusion criteria and exclusion criteria formulated by the Cochrane reviewers’manual and relevant professional opinions,randomized controlled trial literatures meeting the requirements were screened out,and data extraction were conducted on the final included literature.The quality assessment was accomplished according to the Cochrane risk of bias tool.Review Manager 5.3 software was used for Meta analysis of the data in the literature.Results:1.In this meta-analysis,a total of 22 literatures that met the standards were included,all of which were in Chinese.A total of 2732 patients were included,including 1377 in the experimental group and 1355 in the control group.2.The results of systematic evaluation showed that compared with the control group,the experimental group was:(1)In the difference of effective rate:RR=1.21,95%CI[1.16,1.25],P<0.00001;(2)In the change of clinical electrocardiogram:RR=1.27,95%CI[1.18,1.35],P<0.00001;the results were statistically significant.(3)In terms of the frequency of angina pectoris:I~2=97%,SMD=-1.72,95%CI[-2.26,-0.81],Z=3.73,P=0.0002;heterogeneity was high but the results were statistically significant.(4)In terms of the duration of angina pectoris,I~2=99%,MD=-0.96,95%CI[-1.16,-0.75],Z=9.23,P<0.00001,heterogeneity was high but the results were statistically significant.(5)In terms of increasing the stopping rate of nitroglycerin,MD=-0.46,95%CI[-0.54,-0.38],Z=11.32,P<0.00001,the difference was statistically significant.(6)In the test group,the changes of serum lipid TG(I~2=22%,MD=-0.29,P<0.00001)and TC(I~2=0%,MD=-1.17,P<0.00001)were significant and the heterogeneity was lower.The results of analysis of LDL-C(I~2=94%,MD=-0.40,P<0.0001)showed higher heterogeneity,but the differences all were statistically significant.(7)Hs-crp analysis results:SMD=-0.40,95%CI[-0.67,-0.13],Z=2.94,P=0.003,the comparison was statistically significant;CRP analysis results:SMD=-1.34,95%CI[-2.63,-0.06],Z=2.04,P=0.04,the difference between the two groups was not very statistically significant.Safety evaluation:a total of 9 included literatures described adverse reactions,among which,the adverse reactions in the test group mainly included lip numbness,which could be tolerated,and the symptoms disappeared spontaneously after a few minutes.The second was gastrointestinal reaction,which was not treated with drugs,and the symptoms were relieved by changing the way of medication.Adverse reactions such as headache and dizziness occurred in both groups,with no statistical significance.Conclusion:1.The results of this meta-analysis showed that the treatment of unstable angina pectoris with Shexiang Baoxin pill combined with western medicine had certain curative effect in terms of clinical efficiency,ecg changes,nitroglycerin stopped reduction rate,blood lipid and Hs-CRP,which was better than the treatment with conventional western medicine alone.But for the frequency and duration of angina,CRP than the control group,there were no obvious differences.2.Considering the poor quality of the studies included in the evaluation of this system,and the lack of adverse reaction reports and follow-up reports of patients in most of the studies,it was impossible to make an absolute evaluation on the safety of the treatment of this disease with Shexiang Baoxin pill.3.Considering the limitations of this study,the research results need to be further improved. |
