摘要
【目的】系统评价芪苈强心胶囊联合常规西医疗法治疗心肾综合征Ⅱ型的有效性及安全性。【方法】检索Central、Embase、PubMed、中国知网(CNKI)、维普科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)和万方数据库(Wanfang Data)中有关芪苈强心胶囊联合常规西医疗法治疗心肾综合征Ⅱ型的随机对照研究,按照Cochrane手册推荐的质量评价工具对纳入文献进行质量评价,采用Review Manager(RevMan)5.3软件进行Meta分析。【结果】经过文献筛选,共纳入8个研究,涉及639例患者。Meta分析结果显示,芪苈强心胶囊联合西医常规治疗在提高总有效率[OR=3.38,95%CI(1.85,6.17),P<0.0001]与心脏射血分数[MD=5.39,95%CI(3.81,6.97),P<0.00001]以及降低血清肌酐水平[MD=-15.57,95%CI(-23.39,-7.75),P<0.0001]方面均优于单纯常规西医治疗,但两组在降低左室舒张末期内径[MD=-0.40,95%CI(-0.95,0.16),P=0.16]与脑钠肽(BNP)[MD=-346.18,95%CI(-775.76,83.39),P=0.11]方面差异无统计学意义。所有纳入研究未见严重不良反应。【结论】芪苈强心胶囊联合常规西医疗法治疗心肾综合征患者在提高临床总有效率与心脏射血分数,以及降低血清肌酐水平方面优于单纯常规西药治疗,安全性较好。但因纳入研究的质量较低,研究结果有待高质量的多中心、大样本的临床随机对照试验加以验证。
Objective To systematically evaluate the clinical efficacy and safety of Qi Li Qiangxin Capsules(a herbal capsule with the actions of replenishing qi and warming yang,activating blood to unblock collaterals,and inducing diuresis to relieve edema)combined with rowtine western medicine therapy in the treatment of typeⅡcardiorenal syndrome.Methods Randomized controlled studies on the treatment of typeⅡcardiorenal syndrome with Qi Li Qiangxin Capsules combined with conventional western medicine were retrieved from the primary databases of Central,Embase,PubMed,CNKI,VIP,CBM and Wanfang Data.The quality of the included literature was evaluated with the quality evaluation tools recommended by the Cochrane Handbook,and metaanalysis was performed using Review Manager(RevMan)5.3 software.Results The literature screening results showed that a total of 8 studies were included,involving 639 cases.Meta-analysis results showed that the effect of Qi Li Qiangxin Capsules combined with conventional western medicine was superior to that of conventional western medicine alone on improving overall efficiency[OR=3.38,95%CI(1.85,6.17),P<0.0001]and cardiac ejection fraction[MD=5.39,95%CI(3.81,6.97),P<0.00001],and on decreasing serum creatinine level[MD=-15.57,95%CI(-23.39,-7.75),P<0.0001].However,there was no statistically significant difference between the two groups in reducing left ventricular end-diastolic diameter[MD=-0.40,95%CI(-0.95,0.16),P=0.06]and brain natriuretic peptide(BNP)level[MD=-346.18,95%CI(-775.76,83.39),P=0.11].No severe adverse reaction was found in all of the included studies.Conclusion The combination of Qi Li Qiangxin Capsules with conventional western medicine therapy is effective and safe on enhancing overall clinical efficacy and cardiac ejection fraction and on decreasing serum creatinine levels in patients with cardiorenal syndrome in comparison with conventional western medicine therapy alone.However,due to the low quality of the included studies,the results of the study still need to be validated by more high-quality multicenter,large sample-size clinical randomized controlled trials.
作者
张晶晶
李涛
刘誉华
代德明
钟黎
ZHANG Jing-Jing;LI Tao;LIU Yu-Hua;DAI De-Ming;ZHONG Li(The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001 Guizhou,China;The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001 Guizhou,China;Qamdo Sub-division of Tibet Military Region,Changdu 854000 Tibet,China)
出处
《广州中医药大学学报》
CAS
2022年第3期712-718,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
贵州省科技支撑计划项目(黔科技合支撑[2021]一般413号)。
关键词
芪苈强心胶囊
心肾综合征Ⅱ型
疗效
安全性
META分析
Qi Li Qiangxin Capsules
typeⅡcardiorenal syndrome
therapeutic efficacy
safety
meta-analysis
