摘要
目的:系统评价从心肝火盛、热毒内生论治原发性高血压的疗效和安全性,探讨其发病机制。方法:制定高敏感检索策略,全面检索截至2009年10月从心肝火盛、热毒内生论治原发性高血压的中医药临床对照研究文献,电子检索数据库包括:①Co.chrane对照试验注册资料库;②Pubmed;③中国生物医学文献数据库;④中国期刊网;⑤维普数据库;⑥万方数据库。手工检索17种中医药期刊。利用Rev Man4.2.2软件对多个研究结果的总体效应进行Meta分析,并进行敏感性分析;用漏斗图分析发表性偏倚。结果:最终10项研究纳入本研究,共纳入患者496例。有2项试验得分为3分,属高质量文献,其余属低质量文献。Meta分析降压疗效评价合并效应量RR(fixed)及95%可信区间(CI)为1.19(1.10,1.29),中医症状疗效评价合并效应量RR(fixed)及95%可信区间(CI)为1.27(1.14,1.41),安全性评价合并效应量RR(fixed)及95%可信区间(CI)为0.24(0.09,0.63),不良反应主要表现为轻微恶心,发生率为2.352%。结论:清肝宁心、清热解毒方药治疗原发性高血压均安全有效,且其Meta-分析结果稳定可靠。按照以方测证原则分析,认为原发性高血压心肝火盛、热毒内生的病机学说具有科学性。
Objective：To evaluate the efficacy and safety of essential hypertension treated in light of the pathogenetic theory of excessive heart-liver fire（EHLF） and endogenous heat-toxin（EHT）. Methods：A high sensitive retrieval strategy was adopted for literatures of clinical controlled trial in essential hypertension treated according to EHLF and EHT theory until October 2009. The electronic retrieval databases included：①Co.chrane database of reg-istered controlled trials;②Pubmed;③Chinese Biomedical Literature Database;④Chinese Journal Full-text Database;⑤ Vip Chinese Periodical Database;⑥Wanfang Digitized Journal Full-text Database. Seventeen TCM journals not included in databases were searched manually. By means of Rev Man 4.2.2 software,the overall effect of results from multiple studies were analyzed by Meta-analysis. Meanwhile,a sensitivity analysis was also done. A funnel plot was applied to analyze the publication bias. Results：There were 10 studies with a total of 496 cases were included finally. Two trials scored 3 were high quality literatures,while the rest of literatures were low-quality. Meta analysis suggested the overall effect（fixed） was 1.19,95% confidence interval（CI）[1.10-1.29] as for therapeutic evaluation of lowering blood pressure,1.27（95%CI,1.14-1.41） in light of therapeutic evaluation of clinical symptoms,and 0.24（95% CI,0.09-0.63）according to safety evaluation. The main adverse event was mild nausea with occurrence of 2.352 percent. Conclusion：Qinggan Ningxing and Qingre Jiedu prescription were safe and effective herbs to treat essential hypertension,and the results analyzed by Meta-analysis were stable and reliable. In accordance with the principle of syndrome certificated by prescription,we believed that the mechanism of excessive heart-liver fire and endogenous heat toxin in essential hypertension was scientific.
出处
《山东中医药大学学报》
2010年第5期397-400,共4页
Journal of Shandong University of Traditional Chinese Medicine
基金
山东省科技厅重点课题(编号:2005-103)
关键词
原发性高血压
心肝火盛
热毒内生
系统评价
META分析
essential hypertension
excessive heart-liver fire
endogenous heat-toxin
systematic review
meta analysis
