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1.北京中医药大学 第三附属医院,北京 100029
2.北京中医药大学 东方医院,北京 100078
侯季秋,在读博士,从事中医心血管内科工作,E-mail:houjiqiu1992@126.com
赵海滨,博士,主任医师,从事中医心血管内科工作,E-mail:haibin999@126.com
收稿日期:2020-08-31,
网络出版日期:2021-02-02,
纸质出版日期:2021-07-05
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侯季秋,安莹,陈雅丽等.中药治疗对冠心病合并焦虑抑郁患者炎性因子影响的系统评价及Meta分析[J].中国实验方剂学杂志,2021,27(13):153-163.
HOU Ji-qiu,AN Ying,CHEN Ya-li,et al.Systematic Review and Meta-analysis of Traditional Chinese Medicine on Inflammatory Factors in Patients with Coronary Heart Disease Complicated with Anxiety and Depression[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):153-163.
侯季秋,安莹,陈雅丽等.中药治疗对冠心病合并焦虑抑郁患者炎性因子影响的系统评价及Meta分析[J].中国实验方剂学杂志,2021,27(13):153-163. DOI: 10.13422/j.cnki.syfjx.20210417.
HOU Ji-qiu,AN Ying,CHEN Ya-li,et al.Systematic Review and Meta-analysis of Traditional Chinese Medicine on Inflammatory Factors in Patients with Coronary Heart Disease Complicated with Anxiety and Depression[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):153-163. DOI: 10.13422/j.cnki.syfjx.20210417.
为系统评价中药治疗对冠心病合并焦虑抑郁患者外周血中炎性因子表达水平的影响及其抗焦虑抑郁的有效性和安全性,该研究通过检索中国知网、维普数据库、万方数据库及PubMed,Cochrane Library,收集中药治疗冠心病合并焦虑、抑郁的随机对照试验(RCT),由2名研究人员独立筛选文献、提取资料,对符合纳入标准的文献采用Cochrance偏倚风险评估工具进行质量评估后,使用Cochrane Revman 5.3进行系统评价及Meta分析
。
共纳入21篇研究文献,总样本量2 342例,试验组1 175例,对照组1 167例。Meta分析结果提示,试验组在即采用中药治疗组在降低患者外周血血清中超敏C反应蛋白(hs-CRP)[标准化均数差(SMD)=-1.61,95%置信空间(CI)(-2.14,-1.09),
P
<
0.01],白细胞介素(IL)-8[均数差(MD)=-5.03,95% CI(-8.37,-1.70),
P
=0.003],IL-17[MD=-33.27,95% CI(-40.15,-26.39),
P
<
0.01],肿瘤坏死因子(TNF)-
α
[SMD=-1.18,95% CI(-1.98,-0.38),
P
=0.004],同型半胱氨酸(Hcy)[MD=-3.45,95%CI(-4.85,-2.04),
P
<
0.01]表达水平方面优于对照组,在改善焦虑状态方面汉密顿焦虑量表(HAMA)[SMD=-1.97,95% CI(-2.48,-1.46),
P
<
0.01],改善抑郁状态方面汉密顿抑郁量表(HAMD)[SMD=-1.94,95% CI(-2.50,-1.38),
P
<
0.01],抑郁自评量表(SDS)[SMD=-0.72,95% CI(-0.90,-0.54),
P
<
0.01],试验组优于对照组,其差异具有统计学意义。4篇文献提及未发生明显不良反应,4篇提及试验组出现困倦、口干口苦、胃肠道反应等情况,但发生率明显低于对照组,其余13篇均未提及不良反应发生情况。
To systematically evaluate the effect of traditional Chinese medicine(TCM) on the expression of inflammatory factors in peripheral blood of patients with coronary heart disease complicated with anxiety and depression,and explore its efficacy and safety in treatment of anxiety and depression. In this study,CNKI,VIP database,WanFang database,PubMed and Cochrane Library were searched to collect randomized controlled trials(RCTs) of TCM in the treatment of coronary heart disease complicated with anxiety and depression,and 2 researchers independently screened the literatures and extracted the data. The quality of the included literatures was evaluated with Cochrance bias risk evaluation tool and Meta analysis was conducted by Cochrane Revman 5.3 software. A total of 21 research articles were included,with a total sample size of 2 342 cases,1 175 cases in the treatment group and 1 167 cases in the control group. Meta analysis results showed that the treatment group reduced the hypersensitive C-reactive protein(hs-CRP)[standard mean difference(SMD)=-1.61,95% confidence interval(CI)(-2.14,-1.09),
P
<
0.01],interleukin(IL)-8[mean difference(MD)=-5.03,95% CI(-8.37,-1.70),
P
=0.003],IL-17[MD=-33.27,95% CI(-40.15,-26.39),
P
<
0.01],tumor necrosis factor(TNF)-
α
[SMD=-1.18,95% CI(-1.98,-0.38),
P
<
0.01],and homocysteine(Hcy)[MD=-3.45,95% CI(-4.85,-2.04),
P<
0.01]. The treatment group was better than the control group in terms of relieving anxiety and depression,i.e. scores of Hamilton anxiety scale(HAMA) [SMD=-1.97,95% CI(-2.48,-1.46),
P
<
0.01],Hamilton depression scale(HAMD) [SMD=-1.94,95% CI(-2.50,-1.38),
P
<
0.01],and self-rating depression scale(SDS)[SMD=-0.72,95% CI(-0.90,-0.54),
P
<
0.01],so in terms of ,with statistically significant difference. 4 articles mentioned that no obvious adverse reactions occurred,4 articles mentioned that the treatment group had drowsiness,dry mouth and bitter mouth,gastrointestinal reactions,but the incidence rates were significantly lower than those of the control group. The other 13 articles did not mention the occurrence of adverse reactions.
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