麝香保心丸联合曲美他嗪治疗老年缺血性心肌病心力衰竭疗效的Meta分析

摘要

Objective To investigate the clinical efficacy of Shexiang Baoxin Wan combining trimetazidine in treatment of ischemic cardiomyopathy and heart failure in elderly patients.Methods The databases of Cochrane Library, PubMed, NTIS, PEDro, EMbase, CNKI, WanFang Database and VIP Database were retrieved with computer before Mar. 31, 2016 for collecting clinical randomized controlled trials (RCT) about Shexiang Baoxin Wan combining trimetazidine in treatment of ischemic cardiomyopathy and heart failure in elderly patients. All RCT were selected by 2 reviewers independently according to inclusion and exclusion criteria, and data was extracted, checked crossly and given methodological quality evaluation. The extracted data was given a Meta-analysis by using RevMan 5.2 software.Results The results of the Meta-analysis on 12 clinical RCT showed that left ventricular ejection fraction (LVEF) increased significantly (SMD=1.55, 95%CI: 0.85~2.25), left ventricular end-diastolic inner diameter (LVEDd) decreased significantly (SMD=-1.57, 95%CI: -1.91~ -1.22), 6-minute walk test (6MWT) increased significantly (WMD=56.98, 95%CI: 42.76~71.19) and clinical efficacy was significantly improved (RR=1.30, 95%CI: 1.23~1.38) in treatment group compared with control group (allP<0.05).Conclusion The current evidence indicates that LVEF, LVEDd, 6MWT and clinical efficacy are significantly improved in elderly patients with ischemic cardiomyopathy and heart failure treated with Shexiang Baoxin Wan combining trimetazidine.%目的：探讨麝香保心丸联合曲美他嗪治疗老年缺血性心肌病心力衰竭的临床疗效。方法应用计算机在Cochrane Library、PubMed、National Technical Information Service（NTIS）、PEDro、Embase、中国期刊全文数据库（CNKI）、万方数据库和维普数据库（VIP）等电子数据库中检索2016年3月31日以前有关麝香保心丸联合曲美他嗪治疗老年缺血性心肌病心力衰竭的临床随机对照试验。由2名评价员按照纳入和排除标准独立选择文献并提取资料，交叉核对并进行方法学质量评估，应用RevMan5.2软件对所提取的数据进行Meta评价。结果对纳入的12个随机对照试验进行Meta分析，结果显示与对照组相比左室射血分数明显增加（SMD=1.55，95%CI：0.85～2.25）、左室舒张末期内径显著降低（SMD=-1.57，95%CI：-1.91～-1.22）、6 min步行距离明显增加（WMD=56.98，95%CI：42.76~71.19）、临床疗效显著改善（RR=1.30，95%CI：1.23~1.38），其差异均具有统计学意义（P均＜0.05）。结论现有证据表明麝香保心丸联合曲美他嗪治疗老年缺血性心肌病心力衰竭后患者左室射血分数、左室舒张末期内径、6 min步行距离、临床疗效得到显著改善。