본문 바로가기
KERD
논문KCI 등재

변이형 협심증 환자에 대한 한약병용치료의 효과 : 체계적 문헌고찰과 메타분석

Effects of Combining Herbal Medicine with Western Medicine on Patients with Variant Angina Pectoris: Systemic Review and Meta-analysis (PRISMA Compliant)

권정남|전현영|권성은
대한한방내과학회 (The Society Of Korean Oriental Internal Medicine)|2024.12|대한한방내과학회지 (The Journal of Korean Oriental Internal Medicine)|제45권 제6호|pp. 1071-1099|DOI 10.22246/jikm.2024.45.6.1071

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

meta-analysisKorean medicineherbal medicinesystemic reviewvariant angina
주제분류한의학

초록

Objective: The aim was to compare the effectiveness of traditional Korean herbal medicine versus conventional management in patients with variant angina. Methods: We searched several databases, including five international databases and five domestic electronic databases, for relevant studies. A search was conducted using keywords such as “Korean medicine”, “Chinese medicine”, and “variant angina pectoris” on February 28, 2024. Two review authors independently extracted the data. We assessed the risk of systemic errors by evaluating risk domains using the Cochrane risk of bias tool. When appropriate, meta-analyses were performed. Results: Twenty-nine trials were included in the review. For these reports, a meta-analysis was performed using RevMan 5.3. The meta-analysis showed that the treatment group (herbal medicine combined with Western medicine) had a significantly higher clinical effective rate and ECG effective rate than the control group (Western medicine only) (OR 4.56 95% CI 3.43 to 6.07, P<0.00001, I2=0%) (OR 3.20 95% CI 2.07 to 4.93, P<0.00001, I2=0%). The treatment group also showed a significantly reduced frequency and duration of angina (MD -1.77 95% CI -2.08 to -1.46, P=0.006, I2=50%) (MD -1.51 95% CI -2.24 to -0.78, P<0.00001, I2=0%). Conclusion: This systematic review and meta-analysis suggests that the combined treatment of herbal medicine and Western medicine can be effective in treating variant angina. However, the results might be somewhat biased because of the unknown or high risk of bias in the included trials and the insufficiency of subgroup studies. Therefore, further studies should consider a large number of high-quality clinical studies.

Abstract

Objective: The aim was to compare the effectiveness of traditional Korean herbal medicine versus conventional management in patients with variant angina. Methods: We searched several databases, including five international databases and five domestic electronic databases, for relevant studies. A search was conducted using keywords such as “Korean medicine”, “Chinese medicine”, and “variant angina pectoris” on February 28, 2024. Two review authors independently extracted the data. We assessed the risk of systemic errors by evaluating risk domains using the Cochrane risk of bias tool. When appropriate, meta-analyses were performed. Results: Twenty-nine trials were included in the review. For these reports, a meta-analysis was performed using RevMan 5.3. The meta-analysis showed that the treatment group (herbal medicine combined with Western medicine) had a significantly higher clinical effective rate and ECG effective rate than the control group (Western medicine only) (OR 4.56 95% CI 3.43 to 6.07, P<0.00001, I2=0%) (OR 3.20 95% CI 2.07 to 4.93, P<0.00001, I2=0%). The treatment group also showed a significantly reduced frequency and duration of angina (MD -1.77 95% CI -2.08 to -1.46, P=0.006, I2=50%) (MD -1.51 95% CI -2.24 to -0.78, P<0.00001, I2=0%). Conclusion: This systematic review and meta-analysis suggests that the combined treatment of herbal medicine and Western medicine can be effective in treating variant angina. However, the results might be somewhat biased because of the unknown or high risk of bias in the included trials and the insufficiency of subgroup studies. Therefore, further studies should consider a large number of high-quality clinical studies.

참고문헌 (60)

  1. Mayer S, "Prinzmetal's variant angina", Clinical Cardiology, 21(4), pp.243~246 (1998)
  2. Cosby RS, "Variant angina : Case reports and critique", The American Journal of Medicine, 53(6), pp.739~742 (1972)
  3. Vyacheslavovna SM, "Current view on vasospastic prinzmetal angina", Chronos, 7(5), pp.15~18 (2022)
  4. Choi MJ, "Cardictive Factors for Long-term Clinical Outcomes in Patients Predictive Factors for Long-term Clinical Outcomes in Patients with Variant Angina", Korean J Med, 84(4), pp.522~530 (2013)
  5. MacAlpin RN, "Cardiac arrest and sudden unexpected death in variant angina : complications of coronary spasm that can occur in the absence of severe organic coronary stenosis", American heart journal, 125(4), pp.1011~1017 (1993)
  6. Kang JA, "Clinical characteristics of patients with variant angina", Korean J Med, 63(2), pp.195~202 (2002)
  7. Makani H, "Peripheral edema associated with calcium channel blockers : incidence and withdrawal rate-a meta-analysis of randomized trials", Journal of hypertension, 29(7), pp.1270~1280 (2011)
  8. Münzel T, "Nitrate therapy and nitrate tolerance in patients with coronary artery disease", Current opinion in pharmacology, 13(2), pp.251~259 (2013)
  9. Sosnowski C, "Coronary artery stent placement as a treatment of acute coronary syndrome in course of variant angina", International journal of cardiology, 108(2), pp.259~261 (2006)
  10. Pasternak RC, "Variant angina : Clinical spectrum and results of medical and surgical therapy", The Journal of Thoracic and Cardiovascular Surgery, 78(4), pp.614~622 (1979)
  11. Kundu A, "Variant angina and aborted sudden cardiac death", Current Cardiology Reports, 20, pp.1~6 (2018)
  12. Ladwig K, "Psychological comorbidity and quality of life in patients with an implantable cardioverter", defribrillator(ICD), 2010, pp.21, 129~136
  13. 苏晓燕, "通心络胶囊治疗变异型心绞痛96例临床观察", 中国中西医结合急救杂志, (02), pp.119~ (2000)
  14. 卢飞舟, "“平心痛口服液”治疗变异型心绞痛62例", 上海中医药杂志, (06), pp.11~12 (2002)
  15. 石增文, "舒心益脉胶囊治疗变异性心绞痛临床观察", 医学研究通讯, (02), pp.64~ (2003)
  16. 谢宏赞, "中西医结合治疗冠心病变异性心绞痛32例总结", 湖南中医杂志, (02), pp.15~16 (2005)
  17. 周大林, "自拟三七益心汤配合西药治疗变异型心绞痛32例临床观察", 淮海医药, 27(05), pp.427~428 (2009)
  18. 彭建新, "中西医结合治疗变异型心绞痛38例临床观察", 中医药导报, 15(03), pp.29~30 (2009)
  19. 高向军, "血府逐瘀汤加减治疗变异性心绞痛24例疗效观察", 山西中医学院学报, 12(02), pp.45~46 (2011)
  20. 林楠, "中西医结合治疗变异型心绞痛的临床观察", 中华中医药学刊, 29(03), pp.671~672 (2011)
  21. 卜彤, "通心络胶囊联合硫氮酮治疗变异型心绞痛临床研究", 中国医药科学, 2(16), pp.56~57 (2012)
  22. 范修云, "益心汤联合西药治疗变异性心绞痛60例疗效观察", 山西医药杂志, 41(08), pp.826~ (2012)
  23. 古思嘉, "麝香保心丸联合地尔硫卓治疗变异型心绞痛临床观察", 中国社区医师(医学专业), 14(22), pp.224~ (2012)
  24. 张传玲, "三七通络汤联合西药对变异型心绞痛患者动态心电图的影响", 中医学报, 27(04), pp.459~460 (2012)
  25. 朱登攀, "中西医结合治疗变异型心绞痛的疗效与安全性", 中医临床研究, 5(23), pp.67~68 (2013)
  26. 唐军, "从"内风"论治变异性心绞痛的临床观察", 中国中医急症, 22(07), pp.1210~1211 (2013)
  27. 陆毓庆, "复方丹参滴丸辅助治疗变异型心绞痛临床观察", 中国中医急症, 22(03), pp.415~ (2013)
  28. 刘志宁, "复方丹参滴丸对老年变异型心绞痛患者内皮功能的影响", 中国老年学杂志, 34(09), pp.2369~2370 (2014)
  29. 区育华, "复方丹参滴丸辅助治疗变异型心绞痛的临床疗效观察", 中国医药指南, 12(11), pp.272~273 (2014)
  30. 李海云, "三七通络汤辨治对变异型心绞痛患者动态心电图影响的临床研究", 中国生化药物杂志, 34(01), pp.90~92 (2014)
  31. 喻典平, "中西医结合治疗变异型心绞痛37例临床观察", 中国民族民间医药, 24(07), pp.90~ (2015)
  32. 刘毅, "地尔硫联合桃红四物汤治疗冠状动脉痉挛性心绞痛的临床观察", 社区医学杂志, 13(07), pp.29~30 (2015)
  33. 曹云和, "复方丹参滴丸治疗变异性心绞痛患者的临床疗效观察", 检验医学与临床, 13(02), pp.264~266 (2016)
  34. 谭明琴, "四逆汤联合单硝酸异山梨酯治疗变异性心绞痛的效果分析", 中国当代医药, 24(29), pp.121~123 (2017)
  35. 肖莹, "四逆汤结合地尔硫卓治疗变异性心绞痛的疗效分析", 临床医药文献电子杂志, 5(77), pp.172~ (2018)
  36. 徐静, "血府逐瘀汤加减联合西药治疗变异型心绞痛的效果观察", 中国民康医学, 31(13), pp.85~86 (2019)
  37. 陈占兴, "三七通络汤辨治影响变异型心绞痛患者动态心电图的临床效果", 青海医药杂志, 49(04), pp.71~72 (2019)
  38. 彭亮, "脉络通颗粒联合非洛地平治疗冠心病变异型心绞痛的疗效观察", 现代药物与临床, 36(07), pp.1392~1395 (2021)
  39. 谢李平, "四逆汤联合地尔硫卓治疗变异性心绞痛患者的临床效果", 临床合理用药杂志, 14(05), pp.50~52 (2021)
  40. 徐娟娟, "速效救心丸联合氨氯地平治疗变异型心绞痛的临床研究", 现代药物与临床, 38(12), pp.3021~3025 (2023)
  41. 李华政, "芪参益气滴丸联合地尔硫卓治疗变异型心绞痛的临床效果分析", 中国合理用药探索, 20(08), pp.78~83 (2023)
  42. Min SW, "Case Report of Korean Medical Treatment of Chest Pain After Percutaneous Coronary Intervention", J Int Korean Med, 42(2), pp.184~196 (2021)
  43. Kim K, "A Case of Chest Pain Patient Diagnosed as Angina Pectoris and Treated with Jagamcho-tang", J of Oriental Chr Dis, 6(1), pp.121~126 (2000)
  44. Wei PL, "Core prescription excavation of launched Chinese patent medicines for treating different syndromes of angina pectoris", Zhongguo Zhong Yao Za Zhi, 44(5), pp.1041~1047 (2019)
  45. Kim MJ, "A Case Report of Korean Medicine Treatment for A Patient with Variant Angina and Asthma Symptoms", J Int Korean Med, 43(5), pp.864~873 (2022)
  46. Wang R, "Compound Danshen Dripping Pills combined with isosorbide mononitrate for angina pectoris : A systematic review and a Meta-analysis", Chinese Herbal Medicines, 16(4), pp.622~637 (2024)
  47. Shin JY, "Bangyakhappyeon commentary", pp.62~64 (2000), Traditional Medicine Research Center
  48. Han GJ, "A Case Report of Chemotherapy-Induced Hand-Foot Syndrome Treated with Modified Dohongsamul-tang", J Int Korean Med, 39(2), pp.259~267 (2018)
  49. Park CH, "A Case Report of Korean Medicine Treatment on Clinical Symptoms in a Patient with Post-stroke Deep Vein Thrombosis", J Int Korean Med, 44(5), pp.999~1010 (2023)
  50. Kim NY, "Effect of Boyanghwanoh-tang extract on Blood Pressure and Regional Cerebral Blood Flow in Rats", Journal of Physiology &Pathology in Korean Medicine, 15(5), pp.682~686 (2001)
  51. Kim YY, "A Case Study of Patient with Jung Choong, Gyeong Gye that Improved by Hyeolbuchukyeo-tang", The Korean Society of Oriental Neuropsychiatry, 20(3), pp.249~259 (2009)
  52. Lee MH, "Case Study of a Deep-vein Thrombosis Patient Treated with Combinatorial Hyulbuchuko-tang", J Int Korean Med, 37(2), pp.315~321 (2016)
  53. Liu J, "Anti-Inflammatory Effects of the Chinese Herbal Formula Sini Tang in Myocardial Infarction Rats", Evidence-Based Complementary and Alternative Medicine, 2014(1), pp.309378~ (2014)
  54. Liu J, "Traditional formula, modern application : chinese medicine formula sini tang improves early ventricular remodeling and cardiac function after myocardial infarction in rats", Evidence-Based Complementary and Alternative Medicine, 2014(1), pp.141938~ (2014)
  55. Jang IW, "Recent Research Trends of Sayeok-tang Used in Ischemic Heart Disease", The Journal of Korean Medical Association of Clinical Sanghan-Geumgwe, 13(1), pp.1~19 (2021)
  56. Jin W, "Sini decoction as an adjuvant therapy for angina pectoris : a systematic review of randomized controlled trials", Journal of Traditional Chinese Medicine, 37(1), pp.12~22 (2017)
  57. Ha TH, "Effects of Tong Xin Lou(TXL)on levels of serum lipid in high fat diet-induced dyslipidemia in mice", The Korea Journal of Herbology, 27(3), pp.107~112 (2012)
  58. Xin J, "Tongxinluo capsule as a multi-functional traditional Chinese medicine in treating cardiovascular disease : A review of components, pharmacological mechanisms, and clinical applications", Heliyon, 10(13), pp.e33309~ (2024)
  59. Xing J, "Clinical efficacy observation of Shexiang Baoxin pills on unstable angina", Tianjin J Tradit Chin Med, 32, pp.530~532 (2015)
  60. Zhang Y, "Influence of Shexiang Baoxin Pills on oxidative stress in patients with unstable angina pectoris of coronary heart disease", Chin J Exp Tradit Med Formul, 19, pp.334~336 (2013)

관련 논문AI추천

경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석김홍준, 안수빈, 장인수, 허나연대한한방내과학회 · 대한한방내과학회지2023 · 제44권 제3호변이형 협심증 환자의 흉통에 대한 한의치료 증례 1례석은주, 유재혁, 이영주, 이진영, 임성우, 최동준, 홍정화대한한방내과학회 · 대한한방내과학회지2024 · 제45권 제2호천식 증상을 가진 변형 협심증 환자에 대한 한방치료 증례보고권태하, 김민주대한한방내과학회 · 대한한방내과학회지2022 · 제43권 제5호협심증으로 발생한 호흡곤란, 흉통 및 피로 환자에 대한 생맥산 합 보중익기탕 가미 1례 증례보고노희정, 문향란, 박도연대한한방내과학회 · 대한한방내과학회지2024 · 제45권 제3호관상동맥질환으로 진단된 만성 비정형 흉통의 한의진료 경과 : 증례보고김은미, 조희근대한한방내과학회 · 대한한방내과학회지2020 · 제41권 제4호경피적 관상동맥중재술 후 스텐트 내 재협착 예방에 대한 심적환의 효과 : 무작위배정 대조 임상연구에 대한 체계적 문헌고찰 및 메타분석강세영, 김락형, 김명호, 김홍준, 장인수, 허나연대한한방내과학회 · 대한한방내과학회지2025 · 제46권 제3호

이 간행물의 다른 논문 (23건)

철결핍성 빈혈의 한약 치료에 대한 최근 중의 임상 연구 분석 : 체계적 문헌 고찰과 메타분석박현정, 이인, 박규현pp. 1100-1116실제 임상 현장에서 수행되는 당뇨 진료 프로그램에 대한 문헌고찰 : 국내 학술지에 보고된 증례보고 및 후향적차트리뷰를 중심으로박다솔, 박예은, 임정태, 송봉근, 안철우, 박규원pp. 1117-1135염증성 장질환 환자에서 저탄수화물 식이요법을 병행한 한약 치료의 체중 감량 효과 및 안전성 평가 : 후향적 다기관 연구이동훈, 김정상, 손지영, 강병수, 방민우, 강민휘, 전성현, 신수용, 김준호, 김충희pp. 1136-1146갑상선 결절에 대한 반하후박탕(半夏厚朴湯)가미방의 효과 : 체계적 문헌 고찰 및 메타 분석박소현, 진명호, 배보람pp. 1147-1163만성피로증후군의 한약치료에 대한 최신 임상 연구 동향 고찰선정흠, 공건식, 서민조, 박수나, 최요섭, 김수덕, 김소림, 하동현pp. 1164-1183
원문 보기