目的 系統(tǒng)評(píng)價(jià)曲美他嗪治療微血管心絞痛（CMVA）的臨床療效和安全性。方法 檢索中國(guó)學(xué)術(shù)期刊數(shù)據(jù)庫(kù)（CNKI）、萬(wàn)方數(shù)據(jù)庫(kù)（Wanfang）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)服務(wù)系統(tǒng)（SinoMed）、維普中文期刊全文數(shù)據(jù)庫(kù)（VIP）、PubMed和Web of Science（WOS）數(shù)據(jù)庫(kù)從建庫(kù)至2022年5月有關(guān)曲美他嗪治療CMVA的臨床隨機(jī)對(duì)照試驗(yàn)（RCT），采用ReviewManager 5.3軟件進(jìn)行Meta分析。結(jié)果 共納入12項(xiàng)RCTs，包括1 195例患者，其中試驗(yàn)組609例、對(duì)照組586例。Meta分析結(jié)果顯示，與對(duì)照組比較，試驗(yàn)組的心絞痛癥狀臨床療效提高，心絞痛癥狀改善的總有效例數(shù)增加［OR＝4.63，95% CI（3.20，6.72），P＜0.000 01］、顯效例數(shù)增加［OR＝1.94，95% CI（1.40，2.68），P＜0.000 01］；平板運(yùn)動(dòng)試驗(yàn)總運(yùn)動(dòng)時(shí)間延長(zhǎng)［MD＝1.31，95% CI（1.02，1.60），P＜0.000 01］，平板運(yùn)動(dòng)試驗(yàn)心電圖ST段壓低0.1 mV時(shí)間延長(zhǎng)［MD＝1.28，95% CI（0.98，1.59），P＜0.000 01］，平板運(yùn)動(dòng)試驗(yàn)心電圖ST段最大壓低幅度降低［SMD=-1.19，95% CI（-1.72，-0.65），P＜0.000 01］。結(jié)論 曲美他嗪可以改善CMVA患者心絞痛癥狀，延長(zhǎng)CMVA患者平板運(yùn)動(dòng)時(shí)間和平板運(yùn)動(dòng)試驗(yàn)中心電圖ST段壓低0.1 mV所需時(shí)間、降低ST段壓低的最大幅度。

Objective To systematically evaluate the clinical efficacy and safety of trimetazidine (TMZ) in the treatment of coronary microvascular angina (CMVA). Methods Data were electronically searched from the CNKI, Wanfang Data, SinoMed, VIP, PubMed and Web of Science to collet randomized controlled trails (RCTs) on TMZ in the treatment of CMVA. The retrieval time was from database establishment to May 2022. Meta-analysis was performed using ReviewManager 5.3 software. Results A total of 12 RCTs were included, including 1 195 patients which 609 cases in experimental group and 586 cases in control group. Meta-analysis results showed that compared with the control group, the experimental group were increased the clinical efficacy of angina pectoris symptom, the total effective cases[OR=4.63, 95%CI (3.20, 6.72), P < 0.000 01], and the significant effective cases[OR=1.94, 95%CI (1.40, 2.68), P < 0.000 01], were prolonged the total exercise time of treadmill exercise test[MD=1.31, 95%CI (1.02, 1.60), P < 0.000 01] and the time of ST segment depression was prolonged by 0.1 mV in treadmill exercise test[MD=1.28, 95%CI (0.98, 1.59), P < 0.000 01], and decreased the maximal depression of ST segment in treadmill exercise test[SMD=-1.19, 95%CI (-1.72, -0.65), P < 0.000 01]. Conclusion TMZ can improve angina pectoris symptoms in CMVA patients, prolong treadmill exercise time and the time required for ST segment depression of 0.1 mV in treadmill exercise test, and reduce the maximum ST segment depression.

R972

國(guó)家自然科學(xué)基金資助項(xiàng)目（81573900）；北京中醫(yī)藥大學(xué)新奧獎(jiǎng)勵(lì)基金（2019-XAJLJJ-019）；北京中醫(yī)藥大學(xué) 2019年度基本科研業(yè)務(wù)費(fèi)項(xiàng)目（2019-JYB-JS-089）