复方丹参滴丸联合西药常规治疗心力衰竭疗效的系统评价

Systematic Reviews on Curative Effect of Compound Danshen Dripping Pills Combined with Routine Western Medicine for Heart Failure

目的:对使用复方丹参滴丸联合西药常规治疗心力衰竭的临床研究进行Meta分析,评价其临床疗效。方法:通过检索Pub Med、Coc hra n e临床对照试验中心注册库(CE NTRAL)、荷兰医学文摘(E m ba se)、中国知网(CNKI)、万方(Wa n Fa n g)、维普(VIP)和中国生物医学文摘(CBM)等数据库,选择符合纳入标准的研究,进行Meta分析。结果:共纳入21个随机对照试验(RCTs),16 9 1例患者。通过牛津评分系统Ja da d标准量表进行文献质量评价,显示均为低质量文章。Meta分析结果显示:治疗心力衰竭的实验观察指标显示西药常规联合复方丹参滴丸,能提高治疗心力衰竭的有效率,临床综合疗效[相对危险度(RR)=1.21,9 5%可信区间(CI)(1.16,1.27)],左室射血分数[均数差(MD)=4.6 7,9 5%CI(3.3 1,6.02)],6 m i n步行距离[MD=4 4.89,9 5%CI(3 2.59,57.18)],B型脑钠肽[MD=-29 7.84,9 5%CI(-24 1.3 5,-154.3 3)]等指标上均表明比单用西药治疗好,差异均有统计学意义(P<0.05)。在安全性方面[RR=1.25,9 5%CI(0.57,2.75)],差异无统计学意义(P>0.05)。结论:复方丹参滴丸联合西药常规治疗心力衰竭的临床疗效优于单用西药,安全性相当。

Objective：To conduct a meta-analysis on compound Danshen dripping pills combined with routine western medicine for heart failure and evaluate its clinical effect. Methods：Searched databases as Pub Med, Cochrane Central Register of Controlled Trials（CENTRAL）, Excerpta Medica Database（Embase）, China National Knowledge Infrastructure（CNKI）, Wan Fang, VIP and China Biology Medicine（CBM）, selected researches that met the inclusion criteria and conducted a meta-analysis. Results： Twenty one randomized controlled trials（RCTs） and 1691 cases of patients were included in total. Evaluated the quality of literature by Oxford scoring system（Jadad scale）,and the result showed that all the literature was of low quality. The result of the meta-analysis showed that indicated by the experimental observation indexes of the treatment of heart failure, the therapy of routine western medicine combined with compound Danshen dripping pills can improve the effective rate in treating heart failure and improve the comprehensive curative effect[relative risk（RR）=1.21,95%,confidence interval（CI）（1.16,1.27）],left ventricular ejection fraction [mean difference（MD） =4.67, 95% CI（3.31, 6.02）], 6-minute walking distance [MD=44.89, 95% CI（32.59, 57.18）] and B-type natriuretic peptide [MD=-297.84,95%CI（-241.35,-154.33）]. The indexes proved that the curative effect of the therapy was better than that of the western medicine,differences being significant（P〈0.05）. No significant difference was found in the comparison of the safety [RR=1.25, 95% CI（0.57, 2.75）] between the two groups（P〉0.05）. Conclusion： The clinical effect of the therapy of compound Danshen dripping pills combined with routine western medicine for heart failure is superior to that of the western medicine, and the safety of them is equivalent.