摘要
目的:系统评价加味四逆汤治疗慢性心力衰竭的疗效。方法:检索CNKI、PubMed、WANFANG Data、VIP、EMbase、SinoMed、The Cochrane Library、Web of science自建库以来至2019年3月18日公开发表的与四逆汤治疗慢性心力衰竭相关的随机对照试验。由2名研究者根据纳排标准对相关文献进行筛选,完成资料提取、质量评价,运用Revman5.3对纳入文献进行Meta分析。结果:纳入22篇文献,共计1597例患者。Meta分析结果显示:加味四逆汤联合常规西药治疗慢性心力衰竭有效率优于单用常规西药观察组[RR=1.25,95%CI(1.19,1.32),P<0.00001],加味四逆汤联合常规西药改善左室射血分数(LVEF%)较常规西药更明显[MD=6.84,95%CI(3.30,10.37),P=0.0001]。结论:常规西药合加味四逆汤治疗可以提高慢性心力衰竭临床有效率,在提高患者每搏输出量及EF%、降低脑钠肽(BNP)、缩小左心室舒张/收缩期末内径(LVEDD/LVESD)、延长6 min步行距离、减低Lee心衰评分及减低中医证候评分等方面优于单纯应用西药治疗。由于纳入研究样本量和质量的限制,还需更多高质量临床试验提供证据支持。
Objective:To systematically review the efficacy of Jiawei Sini Decoction in the treatment of chronic heart failure.Methods:Randomized controlled trials(RCTs)related to treatment of chronic heart failure with Sini Decoction in the database of CNKI,WANFANG Data,VIP,EMbase,SinoMed,the Cochrane Library and Web of Science were searched online from the establishment of the database to March 18th 2019.A total of 2 researchers independently screened literature according to inclusion and exclusion criteria,and the extracted data and quality evaluation were finished.Meta-analysis of the included papers was performed with Revman5.3.Results:A total of 22 papers were included,totally 1597 cases of patients.The results of Meta-analysis showed that Jiawei Sini Decoction combined with conventional Western medicine was more effective than conventional Western medicine(RR=1.25,95%CI(1.19,1.32),P<0.00001).Jiawei Sini Decoction combined with conventional Western medicine could significantly improve left ventricular ejection fraction than conventional Western medicine(MD=6.84,95%CI(3.30,10.37),P=0.0001).Conclusion:On the basis of conventional Western medicine treatment,Jiawei Sini Decoction has better efficacy,which is more effective in improving stroke output and ejection fraction(EF%),reducing brain natriuretic peptide(BNP),reducing left ventricular end-diastolic/systolic inner diameter(LVEDD/LVESD),extending 6-minute walking distance,reducing Lee heart failure score and traditional Chinese medicine syndrome scores and other aspects than pure Western medicine.Due to the limitations of the sample sizes and quality of the included study,more high-quality clinical trials are needed to provide evidence.
作者
谭雨晴
田盼盼
吴晓博
陈恒文
李军
TAN Yuqing;TAN Panpan;WU Xiaobo;CHEN Hengwen;LI Jun(Guang′anmen Hospital,China Academy of Chinese Medicine Science,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《世界中医药》
CAS
2020年第8期1144-1150,共7页
World Chinese Medicine
基金
国家自然科学基金项目(81503421)
中央级公益性科研院所基本科研业务费专项资金资助(ZZ0808005)
国家中医药管理局国家中医临床研究基地业务建设科研专项(JDZX2015249)
中国科协青年人才托举工程(2017QNRC001)。
关键词
四逆汤
慢性心力衰竭
系统评价
Meta分析
循证医学
联合用药
心功能
随机对照试验
Sini Decoction
Chronic heart failure
Systematic review
Meta-analysis
Evidence-based medicine
Drug combination
Cardiac function
Randomized controlled trial
