目的 系統(tǒng)評價曲美他嗪治療微血管心絞痛（CMVA）的臨床療效和安全性。方法 檢索中國學術期刊數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)庫（Wanfang）、中國生物醫(yī)學文獻服務系統(tǒng)（SinoMed）、維普中文期刊全文數(shù)據(jù)庫（VIP）、PubMed和Web of Science（WOS）數(shù)據(jù)庫從建庫至2022年5月有關曲美他嗪治療CMVA的臨床隨機對照試驗（RCT），采用ReviewManager 5.3軟件進行Meta分析。結果 共納入12項RCTs，包括1 195例患者，其中試驗組609例、對照組586例。Meta分析結果顯示，與對照組比較，試驗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］；平板運動試驗總運動時間延長［MD＝1.31，95% CI（1.02，1.60），P＜0.000 01］，平板運動試驗心電圖ST段壓低0.1 mV時間延長［MD＝1.28，95% CI（0.98，1.59），P＜0.000 01］，平板運動試驗心電圖ST段最大壓低幅度降低［SMD=-1.19，95% CI（-1.72，-0.65），P＜0.000 01］。結論 曲美他嗪可以改善CMVA患者心絞痛癥狀，延長CMVA患者平板運動時間和平板運動試驗中心電圖ST段壓低0.1 mV所需時間、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

國家自然科學基金資助項目（81573900）；北京中醫(yī)藥大學新奧獎勵基金（2019-XAJLJJ-019）；北京中醫(yī)藥大學 2019年度基本科研業(yè)務費項目（2019-JYB-JS-089）