背景:中成药对预防冠状动脉再狭窄有疗效。然而,不同CPM之间的相对疗效尚未得到充分研究。方法:从包括PubMed在内的电子数据库中搜索随机临床试验,WebofScience,科克伦图书馆,Embase,CNKI,VIP,万方,SinoMed,中国临床试验注册中心,和ClinicalTrials.gov.进行贝叶斯网络荟萃分析,以分析CPMs在预防血管造影再狭窄方面的功效,复发性心绞痛,急性心肌梗死,经皮冠状动脉介入治疗后的靶病变血运重建。结果:这项网络荟萃分析包括47项试验,5,077名患者评估了11项干预措施。关于血管造影再狭窄,CPM(血脂康胶囊除外)联合标准治疗(Std)疗效优于单纯Std,冠心舒通胶囊加用Std可使血管造影再狭窄的风险降低76%(相对风险0.24,95%置信区间0.11-0.45,证据的确定性非常低至中等),最有可能是最好的干预措施。复方丹参滴丸联合性病在缓解心绞痛复发方面优于其他干预措施。与单独使用Std相比,可以将风险降低83%(RR0.17,95%CI0.04-0.51,非常低至中等的证据确定性)。在经皮冠状动脉介入治疗后的急性心肌梗死中,与Std单独相比,丹红注射液加Std具有显着效果(RR0.11,95%CI0.00-0.69,非常低至中等的证据确定性),可能是最佳治疗方法。与单独使用Std相比,川芎秦片加Std是最有效的治疗方法,可将靶病变血运重建减少90%(RR0.10,95%CI0.00-0.60,非常低至中等的证据确定性)。结论:CPM联合Std可降低经皮冠状动脉介入术后再狭窄的风险。然而,由于显著的数据限制,我们应谨慎解释结果.
Background: Chinese patent medicines (CMPs) have curative effectiveness in preventing coronary
restenosis. However, the relative efficacy between different CPMs has not been sufficiently investigated. Methods: Randomized clinical trials were searched from electronic databases including PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, WanFang, SinoMed, Chinese Clinical Trial Registry, and ClinicalTrials.gov. Bayesian network meta-analysis was performed to analyze CPMs\' efficacy in preventing angiographic
restenosis, recurrence angina, acute myocardial infarction, and target lesion revascularization after percutaneous coronary intervention. Results: This network meta-analysis included 47 trials with 5,077 patients evaluating 11 interventions. Regarding angiographic
restenosis, the efficacy of CPMs (except Xuezhikang capsule) combined with standard treatment (Std) was superior to Std alone, and Guanxin Shutong capsule plus Std reduced the risk of angiographic
restenosis by 76% (relative risk 0.24, 95% confidence interval 0.11-0.45, and very low to moderate certainty of evidence), most likely the best intervention. Fufang Danshen dripping pill combined with Std showed superiority over other interventions for relieving recurrence angina, which can reduce the risk by 83% (RR 0.17, 95% CI 0.04-0.51, very low to moderate certainty of evidence) compared to Std alone. In acute myocardial infarction after percutaneous coronary intervention, compared with Std alone, Danhong injection plus Std displayed a significant effect (RR 0.11, 95% CI 0.00-0.69, very low to moderate certainty of evidence) and was the best treatment probably. Chuanxiongqin tablet plus Std was the most effective treatment for reducing target lesion revascularization by 90% (RR 0.10, 95% CI 0.00-0.60, very low to moderate certainty of evidence) compared with Std alone. Conclusion: The results indicated that CPMs combined with Std reduced the risk of coronary
restenosis after percutaneous coronary intervention. However, the results should be interpreted cautiously due to significant data limitations.