2022 年10 期 第30 卷
医学循证增强型体外反搏对行经皮冠状动脉介入治疗的冠心病患者疗效影响的Meta 分析
Effect of Enhanced External Counterpulsation on the Efficacy of Coronary Disease Patients Undergoing PCI: a Metaanalysis
作者:祁祥1,卢健棋2,温志浩2,朱智德1,毛志华1
- 单位:
- 1.530200广西壮族自治区南宁市,广西中医药大学 2.530200广西壮族自治区南宁市,广西中医药大学第一附属医院心内科 国家中医心血管病临床医学研究中心分中心
- Units:
- 1.Guangxi University of Chinese Medicine, Nanning 530200, China2.Department of Cardiology, the First Affiliated Hospital to Guangxi University of Chinese Medicine/Branch Center ofNational Clinical Research Center of Traditional Chinese Medicine and Cardiovascular Disease, Nanning 530200, China
- 关键词:
- 冠心病;增强型体外反搏;经皮冠状动脉介入治疗;Meta分析
- Keywords:
- Coronary disease; Enhanced external counterpulsation; Percutaneous coronary intervention; Metaanalysis
- CLC:
- R 654.33
- DOI:
- 10.12114/j.issn.1008-5971.2022.00.210
- Funds:
- 国家自然科学基金资助项目(82160887);广西中医药适宜技术开发与推广项目(GZSY21-17)
摘要:
目的 系统评价增强型体外反搏(EECP)对行经皮冠状动脉介入治疗(PCI)的冠心病患者疗效的影响。方法 计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Web ofScience、Cochrane Library、Embase上公开发表的EECP对行PCI的冠心病患者疗效影响的RCT(试验组采用EECP联合常规治疗,对照组采用常规治疗)。检索时限从建库至2022年4月。提取纳入文献的资料,采用Cochrane手册中的偏倚风险评估工具对纳入文献进行方法学质量评价,采用RevMan 5.3软件进行Meta分析。结果 最终纳入22篇文献,共包含1 861例患者。Meta分析结果显示,试验组心绞痛改善率高于对照组〔OR =4.22,95%CI (2.68,6.65),P <0.000 01〕,中医证候改善率高于对照组〔OR =2.33,95%CI (1.46,3.71),P =0.000 4〕,一氧化氮(NO)高于对照组〔均数差(MD )=19.49,95%CI (6.89,32.08),P =0.002〕,内皮素1(ET-1)低于对照组〔MD =-27.17,95%CI (-39.49,-14.84),P <0.000 1〕,N端脑利钠肽前体(NT-proBNP)低于对照组〔MD =-401.36,95%CI (-639.68,-163.05),P =0.001〕,血管细胞黏附分子1(VCAM-1)低于对照组〔MD =-164.19,95%CI (-274.85,-53.52),P =0.004〕,6 min步行距离(6MWD)长于对照组〔MD =17.83,95%CI (12.18,23.47),P <0.000 01〕。结论 EECP是一种安全性较高的心脏康复手段,能有效改善行PCI的冠心病患者的心绞痛症状、中医证候、心功能、血管内皮功能及减轻其血管内炎症程度。
Abstract:
Objective To systematically evaluate the effect of enhanced external counterpulsation (EECP) on theefficacy of coronary disease patients undergoing percutaneous coronary intervention (PCI) . Methods CNKI, Wanfang Data, VIP,CBM, PubMed, Web of Science, Cochrane Library, Embase were searched on online for randomized controlled trial (RCT) reportingthe effect of EECP on the efficacy of coronary disease patients undergoing PCI (the test group was treated with EECP combined withconventional therapy, the control group was treated with conventional therapy) . The retrieval time was from the establishment of thedatabase to April 2022. The data of the included literature were extracted, the bias risk assessment tool in Cochrane manual wasused to evaluate the quality of the included literature, and RevMan 5.3 was used for meta-analysis. Results A total of 22 articleswere included, and involving 1 861 patients. The results of meta-analysis showed that, the improvement rate of angina pectoris inthe test group was higher than that in the control group [OR =4.22, 95%CI (2.68, 6.65) , P < 0.000 01] , the improvement rate of TCM syndrome in the test group was higher than that in the control group [OR =2.33, 95%CI (1.46, 3.71) , P =0.000 4] , nitric oxide(NO) in the test group was higher than that in the control group [mean difference (MD ) =19.49, 95%CI (6.89, 32.08) , P =0.002] ,endothelin-1 (ET-1) in the test group was lower than that in the control group [MD =-27.17, 95%CI (-39.49, -14.84) , P< 0.000 1] , N-terminal brain natriuretic peptide precursor (NT-proBNP) in the test group was lower than that in the control group[MD =-401.36, 95%CI (-639.68, -163.05) , P =0.001] , vascular cell adhesion molecule-1 (VCAM-1) in the test group was lowerthan that in the control group [MD =-164.19, 95%CI (-274.85, -53.52) , P =0.004] , 6 minute walking distance (6MWD) in thetest group was longer than that in the control group [MD =17.83, 95%CI (12.18, 23.47) , P <0.000 01] . Conclusion EECP is asafe means of cardiac rehabilitation, which can effectively improve angina symptoms, TCM syndromes, cardiac function, vascularendothelial function and reduce the degree of intravascular inflammation in coronary disease patients undergoing PCI.
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