中西医结合治疗慢性收缩性心力衰竭合并抑郁患者有效性的Meta分析

Meta-analysis on the Effect of Chinese Medicine Combined with Western Medicine in Treating Patients with Chronic Systolic Heart Failure Complicated with Depression

目的:评价西药基础上联合中药治疗慢性收缩性心力衰竭合并抑郁患者的临床疗效。方法:检索Cochrane Library、PubMed、CNKI、VIP、万方,采用RevMan5.3软件对疗效指标进行分析。结果:中药联合西药常规治疗提高了总有效率(6.38,95%CI3.82,10.65,P<0.00001)。增加了左心室射血分数(LVEF)(MD3.83,95%CI1.62,6.04,P<0.0007),降低了BNP(MD-53.5,95%CI-152.80,45.81,P=0.29)和NT-proBNP(MD-309.29,95%CI-727.15,108.56,P=0.15),降低了HAMD分值(MD-5.59,95%CI-7.33,-3.85,P<0.00001)和SDS分值(MD-9.65,95%CI-13.66,-5.65,P<0.00001)。结论:中药联合西药常规治疗可有效降低慢性收缩性心力衰竭合并抑郁症的患者的BNP及NT-proBNP水平,提高其LVEF,降低抑郁量表评分,总体临床疗效提高。

Objective: To evaluate the clinical efficacy of western medicine combined with traditional Chinese medicine in the treatment of chronic systolic heart failure with depression by systematic evaluation and meta analysis. Methods: A computer search was performed using Cochrane Library, PubMed, CNKI, VIP, Wanfang. The identified studies were finally selected after full-text search and quality assessment and then subjected to meta-analysis using Review Manager 5.3. Re-sults: The combined treatment of traditional Chinese medicine with western medicine improves the total effective rate(6.38,95% ci3.82, 10.65, P<0.00001).Compared with pure western medicine treatment, traditional Chinese medicine combined with western medicine conventional treatment increased LVEF(MD3.83, 95% CI 1.62, 6.04, P<0.0007), decreased BNP,(md-53.5, 95% CI-152.80, 45.81, P=0.29) and NT-probnp(MD 309.29, 95% CI 309.29, 108.56, P=0.15), reducing HAMD score(md-5.59, 95% CI-7.33,-3.85, P< 0.00001) and SDS score(md-9.65, 95% CI-13.66,-5.65, P<0.00001)Conclusion: Treatment of traditional Chinese medicine combined with conventional western medicine can effectively reduce the level of BNP and NT-proBNP, improve the LVEF, reduce depression scale score in patients with chronic systolic heart failure complicated with depression, and the overall clinical effect is improved.