养心氏片治疗心力衰竭临床疗效的Meta分析

Efficacy of Yangxinshi Pill in the Treatment of Heart Failure: A Meta-analysis

目的:系统评价养心氏片治疗心力衰竭的临床疗效。方法:检索中国知网、VIP、万方数据医药期刊数据网、中国生物医学文献光盘数据库(CBM)、Pub Med、Cochrane Library数据库。筛选合格研究,进行文献质量评价,运用异质性检验、Meta分析、敏感性分析等方法统计相关数据。结果:纳入6项研究,共计559例患者,文献质量偏低;Meta分析结果显示,与对照药物比较,养心氏片能提高6分钟步行距离[WMD=49.97,95%CI:33.22~66.71,P<0.00001],改善心功能[OR=2.50,95%CI:1.43~4.38,P=0.001],改善中医症状(胸闷[WMD=-0.53,95%CI:-0.76^-0.31,P<0.00001]、心悸[WMD=-0.31,95%CI:-0.53^-0.08,P=0.007]、乏力[WMD=-0.52,95%CI:-0.97^-0.06,P=0.03]、气促[WMD=-0.45,95%CI:-0.88^-0.02,P=0.04]),但在改善左心室射血分数(LVEF)方面与常规治疗药物效果比较,差异无统计学意义(P>0.05)。结论养心氏片较常规治疗心力衰竭可进一步提高临床疗效,上述结论仍需更多高质量、大样本量的论据加以论证。

Objective： To evaluate the clinical curative effect of Yangxinshi Pill in the treatment of chronic heart failure with metaanalysis. Methods： CNKI,VIP,CBM,Wan Fang,Pub Med and Cochrane Library were electronically searched to collect qualified researches for evaluation. The data was analyzed by the heterogeneity test,meta-analysis and sensitivity analysis. Results： Six randomized controlled trials（ RCTs） involving 559 patients with poor general quality were included. Results of meta-analyses showed that compared with the control drug group,Yangxinshi Pill could significantly improve the efficacy of 6 minutes＇ walk distance[WMD = 49. 97,95% CI（ 33. 22 - 66. 71）,P 〈0. 00001],cardiac function[OR = 2. 50,95% CI（ 1. 43 - 4. 38）,P =0. 001],traditional Chinese medicine（ TCM） syndrome（ chest tightness[WMD =-0. 53,95% CI（-0. 76 --0. 31）,P 〈0. 00001],palpitation[WMD =-0. 31,95% CI（-0. 53 --0. 08）,P = 0. 007 ],hypodynamic[WMD =-0. 52,95% CI（-0. 97 --0. 06）,P = 0. 03],anhelation[WMD =-0. 45,95% CI（-0. 88 --0. 02）,P = 0. 04]）. There was no significant difference in left ventricular ejection fraction between two groups. Conclusion： Yangxinshi Pill is effective in the treatment of HF. However rigorously designed RCTs with large sample are still needed to support its clinical effectiveness.