益气温阳、活血利水方药治疗慢性心力衰竭大鼠实验效应的系统评价

Systemic review on rat experiment of chronic heart failure cured by Yiqi Wenyang Huoxue Lishui drugs

目的:通过系统评价验证益气温阳、活血利水方药治疗慢性心力衰竭大鼠的疗效与机制。方法:通过检索有关益气温阳、活血利水方药治疗慢性心力衰竭大鼠的随机对照实验研究文献,进行质量评价、数据提取,并利用Revman 5.2.6软件进行Meta分析。结果:有7篇文献纳入评价,与正常组比较,模型组病死率增加,LVSP降低,LVEDP升高,心重指数增加,血浆AngⅡ水平增加,提示造模成功,且能够模拟人体慢性心衰RAAS激活的机制。与模型组比较,治疗组死亡率显著减低(OR=3.19,95%CI[1.04,9.75],Z=2.03,P=0.04),LVSP显著增加(MD=-20.17,95%CI[-30.17,-10.18],Z=3.95,P<0.0001),LVEDP显著降低(MD=2.43,95%CI[1.59,3.26],Z=5.69,P<0.00001),心重指数减低(MD=0.53,95%CI[0.24,0.82],Z=3.58,P=0.0003),血浆AngⅡ水平降低(MD=218.62,95%CI[19.33,417.91],Z=2.15,P=0.03)。结论:益气温阳、活血利水方药能够改善心衰大鼠的心功能,减低心重指数,降低病死率,且与抑制RAAS激活有一定的关系。

Objective： To evaluate the efficacy of Yiqi Wenyang Huoxue Lishui （YWHL） drugs treating chronic heart failure. Methods： Search for domestic randomized controlled experimental studies. Further, carry on quality evaluation, data extraction, and Meta analysis on Revman 5.2.6 software. Results： 7 studies were included in this review. The fatality rate, LVSP, LVEDP, heart weight index, and Ang II of model group were different from control group, which illustrating that the heart failure model was successful and related to RAAS activation. Compared to model group, fatality rate of treating group was lowered （OR=3.19, 95%CI[1.04, 9.75], Z=2.03, P=0.04）, LVSP was increased （MD=-20.17, 95%CI[-30.17, -10.18], Z=3.95, P〈0.0001）, LVEDP was lowered （MD=2.43, 95%CI[1.59, 3.26], Z=5.69, P〈0.00001）, heart weight index was lowered （MD=-0.53, 95%CI[0.24, 0.82], Z=3.58, P=0.0003）, and Ang II was lowered （MD=218.62, 95%CI[19.33,417.91], Z=2.15, P=0.03）. Conclusion： YWHL drugs could improve heart function, decrease heart weight index and fatality rate, and the mechanism is linked with RAAS inhibition.