贝那普利联合氨氯地平治疗轻中度高血压的Meta分析

A Meta-analysis on treatment of mild and moderate hypertension with benazpril combining amlodipine

目的评价贝那普利联合氨氯地平治疗轻中度高血压的临床疗效和安全性。方法检索中国期刊全文数据库、中国生物医学文献数据库、中文期刊全文数据库、万方数据库、Pubmed、EMBASE、ISIWeb of knowledge、Cochrane Library(从建库至2010年12月)并辅以手工检索。纳入贝那普利联合氨氯地平(联合组)与单用贝那普利(单药组)比较治疗原发性高血压的随机对照试验,由两位研究员独立筛选并提取资料,采用Cochrane handbook5.1.0推荐的质量标准评价纳入研究的质量,采用RevMan5.1.0软件进行统计学处理。结果纳入7项研究。Meta分析结果显示:①两组经药物干预后收缩压:联合组比单药组降低收缩压更明显(MD=-6.08,95%CI:-9.03～-3.13,P<0.01);②两组经药物干预后舒张压:联合组比单药组降低舒张压更明显(MD=-4.88,95%CI:-6.63～-3.12,P<0.01);③两组治疗措施对心率的影响无统计学差异(MD=0.09,95%CI:-1.28～1.46,P=0.90);④不良反应:联合组总不良低于单药组。结论现有证据表明,贝那普利联合氨氯地平治疗轻中度高血压效果优于贝那普利单药。

Objective To review the curative effect and safety of benazpril combining amlndipine in the treatment of mild and moderate hypertension. Methods The databases of CJFD, CBM, CSJD, WanFang Database, PubMed. EMbase. ISI Web of Knowledge and Cochrane Library were retrieved and supplemented by manual retrieval. The randomized controlled trials （RCT） ablout the comparison treatment of primary hypertension with benazpril combining amlodipine （combining group） or single benazpril （single group） were included. The data were screened and extracted by two researches independently, and then the quality was reviewed by using quality standard recommended by Cochrane handbook 5.1.0 and treated by using RevMan 5.1.0 software. Results There were totally 7 studies included and the results of Meta-analysis showed as follows： ①The systolic blood pressure decreased more significantly in combining group than that in single group （MD=-6.08, 95%C1：-9.03 to -3.13, P〈0.01）. ②The diastolic blood pressure deereased more significantly in combining group than that in single group （MD=-4.88, 95%C/： -6.63 to -3.12, P〈0.01）.③There was no statistical difference in heart rate between two groups （MD=0.09, 95%C1：-1.28 to 1.46, P=0.90）. ④The incidence of adverse events was lower in combining group than that in single group. Conclusion The current evidences indicate that henazpril combining am/odipine has better curative effect than single benazpril in the treatment of ufild and moderate hypertension.