| Objective:1.The purpose of this study is to systematically evaluate the efficacy and safety of Xuefu Zhuyu Decoction and its modification in the treatment of unstable angina pectoris,in order to provide evidence-based support for its application in clinical treatment in the future.2.By reviewing the clinical cases of unstable angina pectoris of coronary heart disease,comparing the efficacy of Xuefu Zhuyu Decoction combined with western medicine and conventional western medicine alone on TCM syndromes and discussing.Methods:1.Searching for Xuefu Zhuyu Decoction and its modified and subtracted treatment crowns published in English databases(Pubmed,Cochrane Library,Embase)and Chinese databases(CNKI,Wanfang,VIP)from the establishment of the database to October 31,2021.Randomized controlled trials in unstable angina pectoris all relevant articles.Two students independently searched the articles according to the retrieval method,used Note Express software to manage the retrieved articles,and used Rev Man5.4to perform meta-analysis on the finally accepted articles.2.A retrospective investigation method was used for the cases of the Third Department of Cardiology of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine during the period from October 1,2019 to October 1,2021,and the cases that met the research standards were selected.Whether they were treated with Xuefu Zhuyu Decoction,they were divided into a treatment group and a control group.The control group was treated with conventional western medicine,and the treatment group was treated with Xuefu Zhuyu Decoction on the basis of the control group.SPSS26.0 software is used to statistically analyze and evaluate the TCM syndromes scores,curative effect,half-year readmission rate and adverse reactions of the two groups of patients,so as to summarize the treatment effect of Xuefu Zhuyu Decoction on patients with unstable angina pectoris.Results:1.There are 25 articles in line with this study,and a total of 2346people are included in this study,all of which are RCTs.Meta-analysis was performed on the final included literature,and the following results were obtained:(1).Total clinical response rate:A total of 25 studies with a total of 2346people are included.After inspection,there is no heterogeneity.The results are as follows:effect size RR=1.20,95%CI[1.16,1.25],Z=10.51,P<0.00001,statistically significant;the total clinical effective rate of Xuefu Zhuyu Decoction combined with western medicine is obviously higher than that of western medicine;(2).ECG Efficacy:A total of 8 studies with a total of 610 people are included.After inspection,there is no heterogeneity.The results are as follows:effect size RR=1.32,95%CI[1.20,1.45],Z=5.67,P<0.00001,statistically significant;the effective rate of ECG after Xuefu Zhuyu Decoction combined with western medicine treatment is significantly higher than that of western medicine treatment;(3).Duration of angina pectoris:A total of 9 studies with a total of 938people are included.It is found that the heterogeneity is high.After subgroup analysis,it is found that there is no heterogeneity in the subgroup with a course of treatment of 4w<t≤8w(I~2=0%,P=0.48),and the study results show that MD=-2.25,95%CI[-2.44,-2.06],P<0.00001,statistically significant,indicating that Xuefu Zhuyu Decoction combined with western medicine can effectively shorten the duration of angina pectoris after 4-8 weeks of treatment,which is superior to conventional western medicine;other subgroups can only be descriptived analyze;(4).Blood lipids:HDL-C:A total of 5 studies with a total of 610 people are included.The heterogeneity is found to be high.Through sensitivity analysis,it is found that within-group heterogeneity can be reduced after removing 1 article.The results of the study show that MD=0.17,95%CI[0.12,0.22],P<0.00001,the difference is statistically significant,indicating that Xuefu Zhuyu Decoction combined with western medicine is significantly better than conventional western medicine in improving HDL-C level;LDL-C:A total of 4 studies with a total of 520 people are included.The heterogeneity is low upon inspection.The results of the study show:MD=-0.21,95%CI[-0.28,-0.13],P<0.00001,with statistical significance;it shows that Xuefu Zhuyu Decoction combined with western medicine is significantly higher than western medicine in improving LDL-C level;(5).The frequency of angina pectoris,blood lipids TC,TG and CRP indexes,although it is proved that Xuefu Zhuyu Decoction and modified and subtracted combined with western medicine treatment are superior to the western medicine group,with statistical significance,but due to the high heterogeneity of the combined results,followed by sensitivity and subgr oup analysis,the source of heterogeneity has still not been found,which may be due to differences in article quality,sample size,and baseline levels between groups.(6).Safety comparison:8 studies mentioned the adverse reactions of the drug,of which 4 studies have no adverse reactions during the trial,and 4studies have dizziness,headache,bradycardia,mild diarrhea and other adverse reactions during the trial.Overall,Xuefu Zhuyu Decoction combined with western medicine has good clinical safety in the treatment of unstable angina pectoris of coronary heart disease.2.A retrospective case study shows:after treatment,the total effective rate of TCM efficacy:the treatment group(94.44%)is significantly higher than the control group(84.38%).In terms of the sum of the total scores of TCM syndromes and the individual scores of each item(chest tightness,chest pain,tingling pain,palpitations,shortness of breath,insomnia,and forgetfulness),the scores in the treatment group are significantly lower than those in the control group,with P<0.05 in the two groups are academically meaningful;For the score of dark complexion,there is no significant difference between the two with P>0.05.In terms of the half-year rehospitalization rate of the two groups of patients,the treatment group is better than the control group(P<0.05),and there is no significant difference in the incidence of adverse reactions.Conclusion:1.This analysis shows that Xuefu Zhuyu Decoction and its modification combined with western medicine in the treatment of UAP patients have significant curative effects in improving clinical efficacy and electrocardiogram efficiency,reducing LDL level and increasing HDL level more effective.In terms of frequency of angina pectoris,duration of angina pectoris,TC,TG and CRP,although it has been proved that Xuefu Zhuyu Decoction and modified and subtracted combined with western medicine are superior to the western medicine group,due to the high heterogeneity of the combined results,after analysis,the source of heterogeneity has still not been found.2.A retrospective study discovers that Xuefu Zhuyu Decoction and Modified Combined with Western Medicine in the treatment of unstable angina pectoris of coronary heart disease improved the efficacy and score of TCM syndromes.In terms of the half-year rehospitalization rate of the two groups of patients,the treatment group is better than the control group(P<0.05),and there is no significant difference in the incidence of adverse reactions. |
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