摘要
目的系统评价振源胶囊联合常规西药治疗慢性心力衰竭(CHF)的临床疗效及其安全性。方法检索PubMed、Embase、Cochrane Library、中国生物医学文献数据库(CBM)、中国知识资源总库(CNKI)、中文科技期刊数据库(维普网)、中国学术期刊数据库(万方数据)自建库至2020年5月振源胶囊联合常规西药治疗CHF的临床随机对照试验。由2名研究人员独立筛选文献、提取有效数据资料,并根据Cochrane偏倚风险评估工具进行质量评估。采用Rev Man5.3进行Meta分析。结果共纳入18篇文献,涉及患者1871例。Meta分析结果显示,振源胶囊联合常规西药治疗CHF在改善心功能(RR=1.29,95%CI[1.16,1.43],P<0.00001),改善中医证候(RR=1.41,95%CI[1.23,1.61],P<0.00001),增加左室射血分数(MD=8.66,95%CI[5.15,12.18],P<0.00001),减小左室舒张末期内径(MD=-7.14,95%CI[-9.23,-5.06],P<0.00001),降低脑钠肽水平(SMD=-1.19,95%CI[-1.78,-0.60],P<0.0001),降低N-末端脑钠肽前体水平(SMD=-1.62,95%CI[-2.91,-0.32],P=0.01),增加6min步行距离(MD=44.12,95%CI[17.28,70.97],P=0.001)方面均显著优于单纯西药治疗,差异有统计学意义。结论基于目前证据,振源胶囊联合常规西药治疗CHF疗效显著,安全性良好。受纳入研究数量和质量限制,上述结论仍需更多高质量研究验证。
Objective To evaluate the clinical efficacy and safety of Zhenyuan Capsules combined with western medicine in the treatment of chronic heart failure(CHF).Methods A search of PubMed,Embase,Cochrane Library,Chinese Biology Medicine literature database(CBM),Chinese National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(VIP)and Wanfang Data was conducted to identify randomized controlled trials of Zhenyuan Capsules combined with western medicine for treatment of CHF.The retrieval time was from the establishment of the database to May 2020.Two reviewers screened literature,extracted data and carried out quality assessment according to Cochrane risk of bias assessment tool independently.Finally,Meta-analysis was performed by using RevMan 5.3 software.Results Totally 18 articles were included,involving 1871 cases.Meta-analysis results showed that treatment Zhenyuan Capsules combined with western medicine was superior to the control group in levels of cardiac function grading(RR=1.29,95%CI[1.16,1.43],P<0.00001),effect on TCM syndromes(RR=1.41,95%CI[1.23,1.61],P<0.00001),left ventricular ejection fraction(MD=8.66,95%CI[5.15,12.18],P<0.00001),left ventricular end-diastolic diameter(MD=-7.14,95%CI[-9.23,-5.06],P<0.00001),brain natriuretic peptide(SMD=-1.19,95%CI[-1.78,-0.60],P<0.0001),N-terminal brain natriuretic peptide precursor(SMD=-1.62,95%CI[-2.91,-0.32],P=0.01),and six-minute walk test(MD=44.12,95%CI[17.28,70.97],P=0.001),with statistical significance.Conclusion Based on the current evidence,Zhenyuan Capsules combined with western medicine has significant efficacy with high safety at the same time for CHF.Due to limited quality and quantity of included studies,more high-quality studies are required to verity above conclusion.
作者
王茹
王培利
陶庄
王承龙
WANG Ru;WANG Peili;TAO Zhuang;WANG Chenglong(Center of Cardiovascular Diseases,Xiyuan Hospital,China Academy of Chinese Medical Sciences,National Clinical Research Center for Chinese Medicine Cardiology,Beijing 100091,China;Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2022年第1期52-58,共7页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81874410)。
关键词
振源胶囊
慢性心力衰竭
心功能
随机对照试验
META分析
Zhenyuan Capsules
chronic heart failure
cardiac function
randomized controlled trial
Meta-analysis
