| Background:Nicorandil is an adenosine triphosphate(ATP)potassium channel opener,which also has nitrate-like effects.Nicorandil was shown to dilate the epicardial coronary artery in the presence of significant luminal stenosis,it was also suggested that nicorandil may have direct dilator effects on coronary resistance vessels by its potassium channel opening effect.Theoretically,nicorandil may improve coronary microvascular dysfunction,by directly dilating coronary microvasculaturesin patients with angina and normal coronary angiograms.Objective:Application of evidence-based medicine generic system evaluation methods,systematic evaluation of clinical research at home and abroad on the clinical application of nicorandil,to clarify the question:evaluation of nicorandil whether or not combination with other anti-anginal drugs based on the clinical efficacy of microvascular angina.Found the problems of the present studies,pointed out the thought for further researches.Methods:In accordance with the principle of evidence-based medicine,the data about nicorandil for microvascular angina were searched in the Cochrane controlled trials register database,PubMed,Embase,Ovid,CNKI,Wanfang,Sinomed,VIPdatabase.The database to establish the initial to Mar.2017.Results:The study retrieved a total of 82 papers,according to the inclusion and exclusion criteria,the title,abstract,futher and full-text reading,finally included 3 studies with microvascular angina disease to do systematic review and Meta-analysis.Nicorandil group was on the basis of conventional treatment plus nicorandil,the control group was a control or placebo-contorlled or conventional treatment,the control group without application of nicorandil treatment intervention group.Quality of research evaluation,3 studies were randomized controlled studies,Class B.Meta-analysis results suggesting that:(1)use of nicorandil can significantly improve microvascular anginapatients with total exercise durations(MD= 0.70(0.26~1.13),P=0.002);(2)nicorandil has no significant influence on the occurrence of headache events in patients with microvascular angina(RR= 0.769,(0.372~1.590),P=0.48).Conclusion:According to the analysis,the application of nicorandil or on the basis of conventional treatment plus nicorandil can significantltly improve patients with total exercise durations,compared with other anti-drug angina,there is no difference between the risk of headache. |
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