摘要
目的采用证据图的方法,系统检索和整理中医药防治心力衰竭临床研究文献,分析心力衰竭领域证据分布情况。方法计算机检索PubMed、Web of Science、EMbase、CNKI、WanFang Data和VIP数据库,检索时限均从2000年1月至2020年1月。纳入中医药防治心力衰竭相关临床研究、系统评价、指南及临床路径的文献,运用图表结合文字的方式对证据分布特点进行分析。结果共纳入文献8580篇,包括8398篇临床研究(随机对照试验6821篇,非随机对照试验1109篇,观察性研究468篇),160篇系统评价及22篇指南、专家共识和路径研究。国内外临床研究的数量总体呈增长趋势,单个研究样本量多集中在60~100例,冠心病是心力衰竭合并最多的疾病,系统评价的AMSTAR量表评分多集中在4~8分。高质量随机对照试验和系统评价结果显示,中医疗法联合常规西药治疗心力衰竭在改善心功能、提高生活质量、改善预后等方面具有一定优势。结论高质量临床研究显示中医药防治心力衰竭在有效性和安全性方面具有一定优势,但方法学质量高的研究较少,未来需要进行多中心、大样本、方法学质量高的临床研究,以便进一步探索中医药疗法在心力衰竭领域(包括非药物疗法)的有效性和安全性等方面的优势。
Objective To retrieve and summarize the clinical studies on traditional Chinese medicine for heart failure prevention and treatment and to observe the distribution of evidence in the field of heart failure by using the method of evidence map.Methods PubMed,Web of Science,EMbase,CNKI,WanFang Data and VIP databases were searched from January 2000 to January 2020.Clinical studies,systematic reviews,guidelines,and clinical pathways related to traditional Chinese medicine for heart failure prevention and treatment were included,and the distribution characteristics of evidence were analyzed by using charts and text descriptions.Results A total of 8580 papers were included,including 8398 clinical studies(6821 randomized controlled trials,1109 non-randomized controlled trials and 468 observational studies),160 systematic reviews,and 22 guidelines,expert consensus and pathway studies.The number of clinical studies domestically and abroad showed an overall growth trend.The sample size was concentrated in 60-100 cases.Coronary atherosclerotic heart disease was the most common comorbidity of heart failure.AMSTAR scores of systematic reviews were primarily 4 to 8.The results of high-quality randomized controlled trials and systematic reviews showed that traditional Chinese medicine combined with conventional Western medicine in the treatment of heart failure had certain advantages in improving heart function,quality of life and prognosis.Conclusions High-quality clinical studies show that traditional Chinese medicine has certain advantages in the efficacy and safety of heart failure prevention and treatment;however,few studies have high methodological quality.In the future,multi-center,large sample size,and high methodological quality clinical studies are needed to further explore the efficacy and safety of traditional Chinese medicine therapy in the field of heart failure.
作者
鞠春晓
张瑶
施玥
程百如
贾子君
王碧晴
张艳
刘璐
赵俊男
梅俊
刘玥
徐凤芹
JU Chunxiao;ZHANG Yao;SHI Yue;CHENG Bairu;JIA Zijun;WANG Biqing;ZHANG Yan;LIU Lu;ZHAO Junnan;MEI Jun;LIU Yue;XU Fengqin(Graduate School,Beijing University of Chinese Medicine,Beijing 100029,P.R.China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,P.R.China;Graduate School,China Academy of Chinese Medical Sciences,Beijing 100700,P.R.China;Institute of Gerontology,China Academy of Chinese Medical Sciences,Beijing 100091,P.R.China;National Clinical Research Center for Chinese Medicine Cardiology,Beijing 100091,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2021年第8期964-972,共9页
Chinese Journal of Evidence-based Medicine
基金
国家重点研发计划“中医药现代化”项目(编号:2017YFC1700301)
中医药传承与创新“百千万”人才(岐黄工程)岐黄学者项目
中国中医科学院自主课题项目(编号:ZZ13-024-4)。
关键词
心力衰竭
中医
证据图
临床研究
系统评价再评价
Heart failure
Traditional Chinese medicine
Evidence map
Clinical study
Overview of systematic review
