目的 通过Meta分析评价大蒜素对老年冠心病(CHD)患者临床疗效的影响.方法 计算机检索PubMed、EMBase、Cochrane图书馆、Science Direct、Google Scholar、中国知网、维普网和万方数据知识服务平台,检索时间截至2017年10月,收集关于使用大蒜素治疗老年冠心病的临床随机对照试验(RCTs),对纳入文献进行质量评价和数据提取,采用Stata 11.0软件对心绞痛缓解情况、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(Apo-B)、血浆一氧化氮(NO)、血压(BP)进行分析.结果 共纳入9篇文献,574例患者.Meta分析结果显示,两组心绞痛缓解情况比较,差异无统计学意义〔RR=1.03,95%CI(0.94,1.13),P=0.559〕;大蒜素组TC水平低于对照组〔SMD=-1.16,95%CI(-2.23,-0.09),P=0.033〕;两组TG水平比较,差异无统计学意义〔SMD=0.70,95%CI(-0.74,2.15),P=0.34〕;大蒜素组LDL-C水平低于对照组〔SMD=-0.84,95%CI(-1.66,-0.02),P=0.04〕;大蒜素组Apo-B水平低于对照组〔SMD=-0.80,95%CI(-1.06,-0.54),P<0.001〕;大蒜素组血浆NO水平高于对照组〔SMD=0.71,95%CI(0,1.43),P=0.049〕;两组收缩压(SBP)水平比较,差异无统计学意义〔SMD=-1.04,95%CI(-2.64,0.55),P=0.20〕;两组舒张压(DBP)水平比较,差异无统计学意义〔SMD=-1.32, 95%CI(-2.81,0.16),P=0.08〕.结论 大蒜素能改善老年CHD患者血脂代谢紊乱情况及提高血浆NO浓度.
Objective To perform a meta analysis to evaluate the influence of allicin on the clinical effect for coronary heart disease (CHD) in elderly patients.Methods We searched the following databases:PubMed,EMBase,Cochrane Library,Science Direct,Google Scholar,CNKI,VIP network and the Wanfang Data Knowledge Service Platform.The search cutoff publication date was October 2017.Randomized controlled trials (RCTs) involving the use of allicin in treating elderly individuals with CHD were searched.The included studies underwent quality assessment and data extraction.Stata 11.0 was used for the meta analysis.The evaluated indices included angina remission,total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),apolipoprotein B (Apo-B),plasma nitric oxide (NO) and blood pressure (BP). Results A total of nine studies involving 574 patients were included.Meta analysis showed no significant difference in angina remission between the two groups〔RR=1.03,95%CI (0.94,1.13),P=0.559〕.The allicin group had a lower TC level than the control group〔SMD=-1.16,95%CI (-2.23,-0.09),P=0.033〕.There was no significant difference in TG level between the two groups〔SMD=0.70,95%CI (-0.74,2.15),P=0.34〕.The level of LDL-C in the allicin group was lower than that in the control group〔SMD=-0.84,95%CI (-1.66,-0.02),P=0.04〕.The level of Apo-B in the allicin group was lower than that in the control group〔SMD=-0.80,95%CI (-1.06,-0.54),P<0.001〕.The allicin group had a higher plasma NO level than did the control group〔SMD=0.71,95%CI (0,1.43),P=0.049〕.The SBP in both groups was not significantly different〔SMD=-1.04,95%CI (-2.64,0.55),P=0.20)〕,nor was the DBP〔SMD=-1.32,95%CI (-2.81,0.16), P=0.08〕.Conclusion Allicin improves dyslipidemia and increases plasma NO concentrations in elderly patients with CHD.