益气活血法治疗慢性心力衰竭疗效Meta分析

Effect of supplementing qi and activating blood circulation methodon chronic heart failurea: a Meta-analysis

目的以Meta分析法为依据,客观评价益气活血法治疗慢性心力衰竭(CHF)的疗效及安全性。方法检索万方数据知识服务平台、中国学术期刊全文数据库(CNKI)、PubM ed,选择益气活血法治疗CHF的随机对照试验研究,用RveMan 5.3分析软件对纳入的随机对照试验文献进行Meta分析。结果本研究共纳入16个随机对照试验文献。Mete分析结果显示,与常规单纯西药治疗相比,合并益气活血法试验组总体临床疗效更佳[比值比(OR)=4.18,95%可信区间(CI)(2.91,5.98),P<0.000 01],提高左室射血分数(LVEF)[加权均数差(WMD)=3.35,95%CI(1.83,4.87),P<0.000 1]及6 min步行试验(6MWT)距离[WMD=42.97,95%CI(22.94,63.01),P<0.000 1],降低血浆N末端B型利钠肽原(NT-proB NP)水平[WMD=-313.01,95%CI(-347.72,-278.29),P<0.000 01]方面效果更明显。结论从统计结果分析,联合使用益气活血法中药治疗CHF可有效改善患者临床症状及心功能,效果优于单纯西药治疗,但所纳入文献质量较低,样本量较小,在一定程度上影响了结果的论证强度。因此,需要更多高质量的随机对照试验。

Objective Evidence-based medical system evaluation( Meta Analysis) was used as a basis to objectively evaluate the efficacy and safety of supplementing qi and activating blood circulation method in the treatment of chronic heart failure( CHF). Methods Randomized controlled trials of chronic heart failure treated by supplementing qi and activating blood circulation method were selected from Wanfang Database,China Academic Journal Full-text Database( CNKI),and Pubmed Meta-analysis of 16 randomized controlled trials was performed using RveMan 5. 3 analysis software. Results Compared with conventional western medicine,the overall clinical effect of the combination of supplementing qi and activating blood circulation method Chinese medicine test group was better [OR = 4. 18,95% CI( 2. 91,5. 98),P < 0. 000 01],the effect of improving the left ventricular ejection fraction( left ventricular ejection fraction,LVEF) [WMD = 3. 35,95% CI( 1. 83,4. 87),P < 0. 000 1 ],and 6 minutes walk test( 6-min walk test,6 MWT) distance [WMD = 42. 97,95% CI( 22. 94,63. 01),P < 0. 000 1],reduce the level of B type natriuretic peptide( N-terminal pro-B-type natriuretic peptide,NT-proB NP) level [WMD =-313. 01,95% CI(-347. 72,-278. 29),P < 0. 000 1] is more obvious. Conclusion Analysis from statistical results,the combined use of traditional Chinese medicine of supplementing qi and activating blood circulation method in the treatment of CHF can effectively improve the clinical symptoms,cardiac function,the effect is better than that of western medicine alone,but the quality of the included and literature is poor and the small sample size affects the strength of the results to a certain extent. Therefore,more high quality randomized controlled trails are needed.