半夏白术天麻汤治疗痰湿壅盛型原发性高血压随机对照试验系统评价

Systematic Review of Randomized Controlled Trials of Banxia Baizhu Tianma Decoction on Essential Hypertension with Phlegm-dampness Pattern

目的:系统评价半夏白术天麻汤治疗痰湿壅盛型原发性高血压的有效性和安全性。方法:搜集半夏白术天麻汤治疗痰湿壅盛型原发性高血压的随机对照试验,运用RevMan 5.2软件进行异质性检验、Meta-分析、敏感性分析、倒漏斗图分析等统计评价。结果:共计10篇随机对照试验881例患者符合纳入标准,但纳入研究的方法学质量普遍较低,Meta-分析结果显示半夏白术天麻汤治疗痰湿壅盛型原发性高血压的降压总有效率合并效应量RR=1.17,95%CI[1.09,1.24],在证候改善方面合并效应量RR=1.38,95%CI[1.18,1.62],结果均具有统计学意义;倒漏斗图分析显示不对称;未见半夏白术天麻汤相关的不良反应报道。结论:半夏白术天麻汤治疗痰湿壅盛型原发性高血压在降压疗效和证候改善方面有显著作用,且较为安全,低质量的原始研究和研究间异质性影响了本系统评价的可靠性,有必要开展高质量、多中心、大样本的随机对照试验进一步评价。

Objective To evaluate systematically the clinical efficacy and safety of Banxia Baizhu Tianma deeoction（BBTD） for treating essential hypertension with phlegm-dampness pattern. Methods：Randomized con- trolled trials（RCT） of BBTD on essential hypertension with phlegm-dampness pattern were retrieved from the databases of China. The data were analyzed with the Review Manager 5.2 software,and heterogeneity analy- sis,meta-analyses,sensitivity analyses and funnel plot analyses were performed. Results：Ten qualified trials involving 881 patients were included. The methodological quality was generally low. Meta-analyses showed that BBTD could improve essential hypertension with phlegm-dampness pattem（RR=l.17,95%Cl[1.09,1.24]） and syndrome manifestations（RR=l.38,95%CI[1.18,1.62]）. The results had statistical significance. Funnel plot was asymmetry. And it had no adverse reaction reported. Conclusion：BBTD can improve the hyperten- sion and syndrome of essential hypertension with phlegm-dampness pattern. The reliability of systematic re- view is affected by the low quality of primary studies and heterogeneous included clinical trials. Further reasonably designed,multi-center and large-scale randomized controlled trials should be carried out.