健脾化痰类方治疗高脂血症痰浊证疗效的Meta分析

Meta-analysis of curative effect of invigorating spleen to resolving phlegm on turbid phlegm syndrome of hyperlipidemia

关键词:  中医药  高脂血症  痰浊证  健脾化痰类方  Meta分析

Key words:  traditional Chinese medicine  hyperlipidemia  invigorating spleen to resolving phlegm  turbid phlegm syndrome  Meta-analysis

摘要:

[目的] 运用Meta分析对中医健脾化痰类方治疗高脂血症痰浊证的临床疗效进行评价。[方法] 检索中国知网（CNKI）、维普数据库（VIP）、万方数据库、Pubmed数据库近5年（2011年1月1日-2016年7月30日）公开发表的中药治疗高脂血症痰浊证的随机对照试验（RCT）相关文献，筛选符合条件的文献并用Cochrane协作网提供的RevMan5.3软件对文献进行评价分析。[结果] 共纳入研究8个，包括688名患者。Meta分析结果显示：采用健脾化痰类方治疗高脂血症痰浊证临床有效率优于西药治疗[OR=1.9，95% CI （1.23，2.94），Z=2.89，P=0.004]；对中医证候改善的疗效中药组明显优于西药组[OR=9.65，95% CI （5.56，16.73），Z=8.07，P<0.000 01]；在降低甘油三酯（TG）方面，中药组疗效优于西药组[SMD=-0.02，95% CI （-1.47，-0.16），Z=2.45，P=0.01]；而在调节胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）方面，中药组与西药组疗效相当（P>0.05）；在安全性方面，中医组与西药组相当（P>0.05）。[结论] 健脾化痰类方治疗高脂血症痰浊证有一定的综合疗效，健脾化痰或可作为高脂血症痰浊证的基本治疗原则广泛推广，临证加减。本次研究纳入文献质量较低，仍需大量高质量的RCT研究文献进行进一步的分析。

Abstract:

[Objective] To systematically review the curative effect of traditonal Chinese medicine (TCM) in patients with hyperlipidemia of turbid phlegm syndrome.[Methods] Databases such as Pubmed, VIP, Wanfang Data and CNKI were searched for the randomized controlled trails about traditional Chinese medicine as the interventions for hyperlipidemia of turbid phlegm syndrome from January 1st, 2011 to July 30th, 2016. Screening and extracting the eligible literature according to the inclusion and exclusion criteria and evaluating them by Jadad scale and Revman 5.3 software.[Results] A total of 8 studies involving 688 patients were included. The Meta-analysis showed that compared with western medicine, TCM can significantly improve the total curative effect[OR=1.9, 95%CI (1.23, 2.94), Z=2.89, P=0.004] and curative effect of TCM syndromes[OR=9.65, 95%CI(5.56, 16.73), Z=8.07, P<0.000 01] of hyperlipidemia patients of turbid phlegm syndrome, as well as decreasing the plasma level of TG[SMD=-0.02, 95%CI (-1.47, -0.16), Z=2.45, P=0.01]. But it did not show any difference on TC, LDL-C, HDL-C and adverse reactions between TCM and Western medicine (P>0.05).[Conclusion] TCM is superior than western medicine in terms of curative effect of laboratory tests,TCM syndromes and plasma level of TG, but it still needs more reliable studies to vertification.