芪苈强心胶囊治疗慢性心力衰竭的Meta分析

The Meta-analysis of the treatment of chronic heart failure with qili cardiac capsule

目的评价芪苈强心胶囊治疗慢性心力衰竭的临床疗效和安全性。方法纳入13个随机对照试验,采用RevMan5.2.4软件进行Meta分析。结果共纳入13个研究试验,共计1 154例患者,其研究质量偏低。Meta分析显示在心衰患者常规治疗的基础上加入芪苈强心胶囊后能够改善心衰患者的临床症状[RR=1.24,95%CI(1.17,1.31)];增加心室射血分数[WMD=6.04,95%CI(4.57,7.52)];减小左室舒张末期内径[WMD=4.28,95%CI(2.14,6.41)];降低B型脑钠肽[WMD=113.78,95%CI(32.82,194.75)]和脑钠肽前体N末端片段[WMD=90.21,95%CI(60.07,120.35)]的水平;同时能够显著增加患者的6分钟步行距离[WMD=39.39,95%CI(30.61,48.16)];降低明尼苏达生活质量表积分[WMD=4.20,95%CI(0.36,8.05)]并没有得到理想的结果;对于心血管事件发生情况、AngII、左室短轴缩短率、IL-6、二尖瓣舒张早期血流与二尖瓣运动速度比值等指标有统计学意义(P<0.05);此外针对个别芪苈强心胶囊所产生的不良反应,患者均能耐受并且与对照组没有统计学差异。结论使用芪苈强心胶囊治疗慢性心力衰竭是安全和可靠的,应该推广其临床使用范围,弘扬中医药的优势。

Objective To evaluate clinical efficacy and safety of cardiac Qili capsule treatment of chronic heart failure. Methods A total of 13 randomized controlled trials was reviewed, and recta-analysis was performed with RevMan5.2.4 software. Results Thirteen research trials with the low quality were included involving 1154 patients. Meta-analysis showed patients with heart failure could improve their clinical symptoms after receiving Qili capsules on the basis of conventional therapy[ RR = 1.24,95% CI（ 1.17,1.31 ） ], increase ventricular ejection fraction [ WMD = 6.04,95 % CI （4.57,7.52） ], reduce left ventrieular end-diastolic internal diameter [ WMD = 4.28, 95 % CI （ 2.14,6.41 ） ], lower B-type natriuretic peptide [ WMD = 113.78,95 % CI （ 32± 82,194.75 ） ], and brain natriuretic peptide precursor N-terminal fragment [ WMD = 90.21,95 % CI （ 60.07,120.35 ） J, and be able to significantly increase the patient＇ s 6-minute walk distance [ WMD = 39.39,95% CI （ 30.61,48.16 ） ], but did not get the desired results of reducing the quality of life in Minnesota table integral [ WMD = 4.20,95% CI （0.36,8.05） ]. Cardiovascular events, AngII, left ventricular fractional shortening fraction of IL＇ 6, mitral early diastolic blood flow and the ratio of the speed of movement mitral indicators were statistically significant （ P 〈 0.05 ）. In addition,as for individual Qili cardiac capsules adverse reaction, patient were well tolerated and had no significant difference from the control group. Results The use of the Qili cardiac capsule to treat chronic heart failure is safe and reliable,which should be promoted in clinical use, to promote the advantages of traditional Chinese medicine.