关键词: 冠心病, 心绞痛, 大株红景天注射液, Meta分析, 有效性, 安全性, 系统评价（主题）

Abstract: Background　Coronary heart disease and angina is often encountered clinically，which is mainly caused by insufficient blood supply of coronary artery，impairing the cardiac function，quality of life，and even threatening the life. Existing routine treatment may produce adverse reactions such as hypotension，endothelial function damage，liver damage and myopathy. Rhodiola and its related preparations have been gradually used for cardiovascular disease，but relevant systematic evaluations are not comprehensive enough. Objective　To systematically assess the efficacy and safety of Rhodiola wallichiana injection（RWI）in coronary heart disease and angina. Methods　Databases of PubMed，The Cochrane Library，Embase，CNKI，CQVIP，SinoMed，and Wanfang Data were searched from inception to January 13th，2021 for randomized controlled trials（RCTs）about coronary heart disease and angina patients treated with RWI and routine therapy（experimental group）compared with those treated with routine therapy（control group）. Two researchers separately screened the literature，and extracted data from the included RCTs，including the first author，time of publication，size and age of the sample，interventions，course of treatment，outcome indicators〔angina response to treatment，and electrocardiographic response to treatment，hemorheological indices（whole blood viscosity at high and low shear rates，fibrinogen，D-dimer），oxidative stress markers（SOD，malondialdehyde），C-reactive protein，clinical response rate，and incidence of adverse reactions〕. The Cochrane risk-of-bias tool was used to evaluate the methodology quality. RevMan 5.3 was used for meta-analysis. Results　Altogether，28 RCTs involving 2 475 participants were finally included. The overall quality of the RCTs was rated as relatively low. Meta-analysis showed that compared with the control group，the experimental group had higher angina response to treatment〔RR=1.22，95%CI（1.13，1.31），P<0.000 01〕，higher electrocardiographic response rate to treatment〔RR=1.22，95%CI（1.16，1.29），P<0.000 01〕，greater decrease in whole blood viscosity at a high shear rate〔MD=-1.06，95%CI（-1.20，-0.91），P<0.05〕，and at a low shear rate〔MD=-1.61，95%CI（-1.90，-1.31），P<0.000 01〕，greater improvement in levels of fibrinogen〔MD=-0.36，95%CI（-0.48，-0.24），P<0.000 01〕，D-dimer〔MD=-19.84，95%CI（-45.58，-5.91），P=0.13〕，SOD〔SMD=2.52，95%CI（2.14，2.89），P<0.000 01〕，malondialdehyde 〔SMD=2.56，95%CI（-3.57，-1.56），P<0.000 01〕，and CRP〔MD=-2.15，95%CI（-2.62，-1.68），P<0.000 01〕，as well as higher clinical response rate〔RR=1.24，95%CI（1.17，1.30），P<0.000 01〕. The incidence of adverse reactions was lower in the experimental group〔RR=0.68，95%CI（0.35，1.35），P=0.27〕. Conclusion　Compared to routine treatment alone，its combination with RWI may generate better effect on improving the angina response to treatment，electrocardiographic response to treatment，hemorheological indices，CRP and oxidative stress markers，with lower incidence of adverse reactions.

Key words: Coronary disease, Rhodiola wallichiana injection, Coronary heart disease and angina, Meta-analysis, Effectiveness, Security, Systematic reviews as topic