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System of tanshinone IIA sodium injection in the treatment of coronary heart disease evaluation

Author: HeJian
Tutor: MaXiaoChang
School: Beijing University of Traditional Chinese Medicine
Course: Chinese medicine
Keywords: angina myocardial infarction clinical trials randomizedcontrolled meta analysis
CLC: R541.4
Type: Master's thesis
Year: 2012
Downloads: 126
Quote: 0
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Abstract


Coronary artery heart disease is induced by a variety of factors of coronary atherosclerotic lesions which cause the lumen organic stenosis or obstruction.Coronary circulation changes make an imbalance between coronary blood flow and myocardial demand, resulting in the lack of myocardial ischemiaoxygen (angina) or myocardial necrosis (myocardial infarction).With the development of socio-economic levels, CHD has become the leading killer of people in developed countries, as well as in China, in addition to current treatment options of CHD including the regular intensive drug therapy, lifestyle intervention and surgical treatment, there are undergoing percutaneous coronary intervention treatment. Sodium tanshinone ⅱa sulfonate(STS),as a treatment for coronary heart disease, angina, myocardial infarction,is manufactured by the Shanghai first biochemical pharmaceutical limited industry,as a water-soluble substances separated from Salvia compound of diterpenoid tanshinone ⅱ a sulfonate.Studies have shown that, tanshinone ⅱcan expand coronary artery, increase coronary blood flow,slow heart rate, increase myocardial contractility, improve myocardial metabolic disorder caused by hypoxia and cardiac dysfunction,anti-atherosclerosis, reduce myocardial oxygen consumption, reduce myocardial infarction area and also has many cardiovascular pharmacological activities of anticoagulant, inhibiting thrombosis, promoting tissue repair and reducing blood lipid.This research follows the evidence-based medicine and uses systematic review methods and means to further evaluate the efficacy and safety of STS in the treatment of coronary heart disease, to provide a basis for its application by the Meta analysis and Systems evaluation of published related documents about the STS in the treatment of coronary heart disease in recent years.Objects:By System evaluating the efficacy and safety of STS in the treatment of coronary heart disease, to provide a basis for its application.Methods:①Rtrieval Strategy:To carry out electronic retrieval from CBM Database,CNKI database,Wanfang database and Pubmed database using subject words like Sodium tanshinone ii a sulfonate, angina, myocardial infarction, randomize..All search Date bake from January1,2006to December 31,2010.②Literature Evaluation:Tow researchers carried out literature screening indendently according to the inclusion and exclusion criteria.Different ideas hangdled by the third party,we acquired characteristic data from related literature studis,and evaluated the methodology and report quality of RCT in accord with inclusion criteria.Meta analysis was by Reman4.2.9software.Results:The total number of literatures searehed was1016,39literatures existed including3618cases after exclude duplicate reports removal of experimental design study literature, and non-randomized study,All tests Jadad score less than3,no Double-blind trial," Funnel Plot " shows asymmetry,which indicates publication bias. Total effective, Excellent aspect of improving the symptoms of angina pectoris,combine Western medicine combined with sodium tanshinone ⅱ a sulfonate injection therapy with simple Western medicine treatment, treatment effects significantly better than control groups,Total effective, Excellent and effective aspect of the ECG effects, treated by Western medicine combined with sodium tanshinone ⅱ a sulfonate injection therapy and simple Western medicine treatment, treatment effects significantly better than control groups. Revascularization in acute myocardial infarction, treated by Western medicine combined with sodium tanshinone ⅱ a sulfonate injection therapy and simple Western medicine treatment, treatment effects significantly better than control groups.And the tests found no serious adverse reactions.Conclusion:On the basis of Western medicine treatment combined with sodium tanshinone ⅱ a sulfonate injection can further improve the clinical symptoms and ischemic ECG changes of coronary artery heart disease, and better security,But because of the existence of publication bias and low quality literature, no reports of the hidden of random scheme and the use of the programme of treatment analysis of intentionality, no blinded, so we can not rule out the possibility of the existence of selective bias, implement bias and measurement bias.So we still need more strict multicenter,large sample,specification complete coverage measurement indicators of quality researches to provide evidence of evidence-based medicine.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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