{"title":"复方丹参滴丸联合单硝酸异山梨酯治疗心绞痛：系统综述和 Meta 分析","authors":"Ru Wang, Jing Hu, Yuanyuan Li, Hong Yin","doi":"10.1016/j.chmed.2023.12.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of Compound Danshen Dripping Pills (CDDP) combined with isosorbide mononitrate (ISMN) versus ISMN alone for treating angina pectoris in patients.</div></div><div><h3>Methods</h3><div>The PubMed, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials (RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography (ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.</div></div><div><h3>Results</h3><div>Our study included 7 245 patients with angina (59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio (OR) = 4.824, 95% confidence interval (CI) = 3.636–6.401, <em>P</em> = 0.000], the efficacy of angina symptom (OR = 4.347, 95% CI = 3.635–5.198, <em>P</em> = 0.000), the efficacy of ECG (OR = 3.364, 95% CI = 2.767–4.089, <em>P</em> = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride (TG) [mean difference (MD) = −35.176, 95% CI = −37.439 to −32.912, <em>P</em> = 0.000], total cholesterol (TC) (MD = −24.296, 95% CI = −26.429 to −22.163, <em>P</em> = 0.000), the duration of angina attack (MD = −1.991, 95% CI = −2.349 to −1.633, <em>P</em> = 0.000), and the frequency of angina attack [standardized MD (SMD) = −2.840, 95% CI = −3.416 to −2.265, <em>P</em> = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone (OR = 0.513, 95% CI = 0.421–0.626, <em>P</em> = 0.000).</div></div><div><h3>Conclusion</h3><div>CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore, this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.</div></div>","PeriodicalId":9916,"journal":{"name":"Chinese Herbal Medicines","volume":"16 4","pages":"Pages 622-637"},"PeriodicalIF":4.7000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Compound Danshen Dripping Pills combined with isosorbide mononitrate for angina pectoris: A systematic review and a Meta-analysis\",\"authors\":\"Ru Wang, Jing Hu, Yuanyuan Li, Hong Yin\",\"doi\":\"10.1016/j.chmed.2023.12.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To evaluate the efficacy of Compound Danshen Dripping Pills (CDDP) combined with isosorbide mononitrate (ISMN) versus ISMN alone for treating angina pectoris in patients.</div></div><div><h3>Methods</h3><div>The PubMed, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials (RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography (ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.</div></div><div><h3>Results</h3><div>Our study included 7 245 patients with angina (59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio (OR) = 4.824, 95% confidence interval (CI) = 3.636–6.401, <em>P</em> = 0.000], the efficacy of angina symptom (OR = 4.347, 95% CI = 3.635–5.198, <em>P</em> = 0.000), the efficacy of ECG (OR = 3.364, 95% CI = 2.767–4.089, <em>P</em> = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride (TG) [mean difference (MD) = −35.176, 95% CI = −37.439 to −32.912, <em>P</em> = 0.000], total cholesterol (TC) (MD = −24.296, 95% CI = −26.429 to −22.163, <em>P</em> = 0.000), the duration of angina attack (MD = −1.991, 95% CI = −2.349 to −1.633, <em>P</em> = 0.000), and the frequency of angina attack [standardized MD (SMD) = −2.840, 95% CI = −3.416 to −2.265, <em>P</em> = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone (OR = 0.513, 95% CI = 0.421–0.626, <em>P</em> = 0.000).</div></div><div><h3>Conclusion</h3><div>CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore, this combination could be used as an alternative treatment. 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引用次数: 0
摘要
目的 评价复方丹参滴丸（CDDP）联合单硝酸异山梨酯（ISMN）与单用单硝酸异山梨酯（ISMN）治疗心绞痛患者的疗效。方法 检索从开始到 2022 年 11 月的 PubMed、Web of Science、Cochrane Library、Embase 中国国家知识基础设施、中国生物医学文献服务系统、中华医学杂志数据库和万方 MED 数据库。研究纳入了随机对照试验（RCT）和队列研究。主要结果为心绞痛症状和心电图疗效、心绞痛症状疗效和心电图疗效。结果我们的研究纳入了 7 245 名心绞痛患者（59 项 RCT，11 项队列研究）。当 ISMN 与 CDDP 联用时，心绞痛症状和心电图的疗效[几率比（OR）= 4.824，95% 置信区间（CI）= 3.636-6.401，P = 0.000]，心绞痛症状的疗效（OR = 4.347, 95% CI = 3.635-5.198, P = 0.000）、心电图疗效（OR = 3.364, 95% CI = 2.767-4.089, P = 0.000）均优于单用ISMN治疗的患者。CDDP 联合 ISMN 在降低甘油三酯（TG）[平均差（MD）= -35.176，95% CI = -37.439 至 -32.912，P = 0.000]、总胆固醇（TC）（MD = -24.296，95% CI = -26.429 至 -22.163, P = 0.000）、心绞痛发作持续时间（MD = -1.991, 95% CI = -2.349 to -1.633, P = 0.000）和心绞痛发作频率[标准化 MD (SMD) = -2.840, 95% CI = -3.416 to -2.265, P = 0.000]。CDDP联合ISMN与单独使用ISMN相比，不良反应没有增加（OR = 0.513，95% CI = 0.421-0.626，P = 0.000）。因此，这种联合疗法可作为一种替代疗法。结论 CDDP 联合 ISMN 可提高疗效，且耐受性良好。
Compound Danshen Dripping Pills combined with isosorbide mononitrate for angina pectoris: A systematic review and a Meta-analysis
Objective
To evaluate the efficacy of Compound Danshen Dripping Pills (CDDP) combined with isosorbide mononitrate (ISMN) versus ISMN alone for treating angina pectoris in patients.
Methods
The PubMed, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials (RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography (ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.
Results
Our study included 7 245 patients with angina (59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio (OR) = 4.824, 95% confidence interval (CI) = 3.636–6.401, P = 0.000], the efficacy of angina symptom (OR = 4.347, 95% CI = 3.635–5.198, P = 0.000), the efficacy of ECG (OR = 3.364, 95% CI = 2.767–4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride (TG) [mean difference (MD) = −35.176, 95% CI = −37.439 to −32.912, P = 0.000], total cholesterol (TC) (MD = −24.296, 95% CI = −26.429 to −22.163, P = 0.000), the duration of angina attack (MD = −1.991, 95% CI = −2.349 to −1.633, P = 0.000), and the frequency of angina attack [standardized MD (SMD) = −2.840, 95% CI = −3.416 to −2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone (OR = 0.513, 95% CI = 0.421–0.626, P = 0.000).
Conclusion
CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore, this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.
期刊介绍：
Chinese Herbal Medicines is intended to disseminate the latest developments and research progress in traditional and herbal medical sciences to researchers, practitioners, academics and administrators worldwide in the field of traditional and herbal medicines. The journal's international coverage ensures that research and progress from all regions of the world are widely included.
CHM is a core journal of Chinese science and technology. The journal entered into the ESCI database in 2017, and then was included in PMC, Scopus and other important international search systems. In 2019, CHM was successfully selected for the “China Science and Technology Journal Excellence Action Plan” project, which has markedly improved its international influence and industry popularity. CHM obtained the first impact factor of 3.8 in Journal Citation Reports (JCR) in 2023.
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