芪苈强心胶囊治疗慢性心力衰竭疗效及安全性的Meta分析

Meta-analysis for the Efficacy and Safety of Qiliqiangxin Capsule in Treating the Patients With Chronic Heart Failure

目的:评价芪苈强心胶囊治疗慢性心力衰竭(CHF)的疗效及安全性。方法:检索2007-01至2017-03期间Pubmed、EMBASE、Web of Science、万方、维普、CBM、中国知网数据库,收集芪苈强心胶囊治疗CHF的研究。比较分析芪苈强心组及对照组B型利钠肽(BNP)、6分钟步行距离(6MWD)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及改善心力衰竭生活质量量表(MLHFQ)评分。结果:共纳入22项随机对照研究,1 988例患者,其中芪苈强心组1 002例,对照组986例,平均随访6.5个月。与对照组相比,芪苈强心组BNP水平降低(均值差=-194.97,95%CI:-287.95^-101.99),LVEF增加(均值差=5.24,95%CI:3.38%~7.11%),LVEDD减小(均值差=-0.94,95%CI:-1.46^-0.43),6MWD增加(均值差=53.81,95%CI:46.9~60.73),MLHFQ评分降低(均值差=-8.11,95%CI:-10.23^-6.0),不良事件发生率显著降低(比值比=0.44,95%CI:0.25~0.79,P<0.01)。结论:芪苈强心胶囊对于改善CHF患者心功能和生活质量是安全有效的。

Objective： To evaluate the efficacy and safety of qiliqiangxin capsule in treating the patients with chronic heart failure（CHF）.Methods： We searched the databases of Pubmed, EMBASE, Web of science, Wanfang, VIP, CBM and CNKI from 2007-01 to 2017-03 to collect the randomized trials of qiliqiangxin capsule in treating CHF patients. Blood levels of NT-pro BNP, 6 minutes walkingdistance（6 MWD）, left ventricular ejection fraction（LVEF）, left ventricular end-diastolic diameter（LVEDD） and Minnesota living with heart failure questionnaire（MLHFQ） scores were compared between qiliqiangxin capsule treated patients and control patients.Results： A total of 22 randomized trials were finally enrolled which included 1 988 patients by 2 groups： Qiliqiangxin capsule group, n=1 002 and Control group, n=986. Patients were followed-up at the mean 6.5 months. Compared with Control group, Qiliqiangxin capsule group had decreased blood level of NT-pro BNP, weighted mean difference（WMD）=-194.97, 95% CI（-287.95 to-101.99）, increased LVEF, WMD=5.24, 95% CI（3.38-7.11）, reduced LVEDD, WMD=-0.94, 95% CI（-1.46 to-0.43）, elevated 6 MWD, WMD=53.81, 95% CI（46.9-60.73）, lower MLHFQ score WMD=-8.11, 95% CI（-10.23 to-6.0） and less adverse events occurrence, OR=0.44, 95% CI（0.25-0.79）, P0.01.Conclusion： Qiliqiangxin capsule was safe and effective for improving the cardiac function and quality of life in CHF patients.