经皮冠状动脉介入治疗（PCI）患者的中医证型分布及预后危险因素：系统评价和meta分析

Distribution of traditional Chinese medicine pattern types and prognostic risk factors in patients undergoing percutaneous coronary intervention (PCI): a systematic review and meta-analysis

    摘要
  • 摘要:
    目的 探讨经皮冠状动脉介入治疗（PCI）中医证候分布及相关风险因素，并评估现有研究的报告质量，以期为未来的标准化研究提供指导。
    方法 分别在PubMed、Cochrane Library和Web of Science等英文数据库，以及中国知网（CNKI）、维普（VIP）和万方数据库等中文数据库中检索PCI相关论文。论文检索的时间跨度从数据库建立至2023年10月1日。使用Stata 12和Python（V 3.9）进行统计分析。采用观察性研究报告规范（STROBE）声明评估纳入研究的报告质量。
    结果 共筛选出1 356篇文章，纳入40项横断面研究，涉及10 270名参与者。PCI前最常见的中医证候为气滞血瘀证（n = 261，36.45%），PCI后1 – 2周最常见的中医证候为痰瘀互结证（n = 109, 27.18%）, PCI后6个月至1年最常见的中医证候为气虚血瘀证（n = 645，37.03%）。吸烟比值比（OR） = 1.15，95%置信区间（CI）（0.83 – 1.47），I2 = 24.7%，P = 0.257、寒凝气滞证OR = 4.62，95% CI（1.37 – 7.86），I2 = 61.6%，P = 0.074及低密度脂蛋白（LDL）升高 OR = 1.38，95% CI（0 .92 – 1 .85）， I2 = 12.2%，P = 0.286是再狭窄的风险因素。高血压 OR = 7.26, 95% CI（3.54 – 14.88），I2 = 91.6%，P = 0.001 和超重 即身体质量指数（BMI）> 23 OR = 1.20，95% CI（1.07 – 1.35），I2 = 85.3%，P = 0.009 是伴发焦虑的显著风险因素。
    结论 本系统评价和meta分析显示，不同中医证型患者PCI术后特点和危险因素不同，未来需要更多相对高质量的研究，以提供更多的支持性证据。

     

    Abstract:
    Objective To clarify the distribution of traditional Chinese medicine (TCM) pattern and its associated risk factors after percutaneous coronary intervention (PCI), and evaluate the reporting quality of existing studies to guide future research standardization.
    Methods English databases including PubMed, Cochrane Library, and Web of Science, as well as Chinese databases including China National Knowledge Infrastructure (CNKI), China Scientific Journal Database (VIP), and Wanfang Database were searched to retrieve papers about PCI. The time span for the paper retrieval was set from the foundation of the databases to October 1, 2023. Statistical analyses were performed using Stata 12 and Python (V 3.9). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was used to assess the reporting quality of included studies.
    Results Overall, 1 356 articles were selected, and 40 cross-sectional studies were included with 10 270 participants. The most common TCM patterns before, one to two weeks after, and six months to one year after PCI was Qi stagnation and blood stasis (n = 261, 36.45%), intertwined phlegm and blood stasis (n = 109, 27.18%), and Qi deficiency and blood stasis (n = 645, 37.03%), respectively. Smoking odds ratio (OR) = 1.15, 95% confidence interval (CI) (0.83 – 1.47), I2 = 24.7%, P = 0.257, pattern of congealing cold and Qi stagnation OR = 4.62, 95% CI (1.37 – 7.86), I2 = 61.6%, P = 0.074, and low-density lipoprotein (LDL) OR = 1.38, 95% CI (0.92 – 1.85), I2 = 12.2%, P = 0.286 were risk factors for restenosis. Hypertension OR = 7.26, 95% CI (3.54 – 14.88), I2 = 91.6%, P = 0.001, and overweight i.e., body mass index (BMI) > 23 OR = 1.20, 95% CI (1.07 – 1.35), I2 = 85.3%, P = 0.009 were significant risk factors of concomitant anxiety.
    Conclusion This systematic review and meta-analysis revealed that patients with different TCM pattern types have distinct characteristics and risk factors after PCI. More high-quality studies are warranted to provide supportive evidence for future research and clinical practice.

     

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