中医药治疗慢性心力衰竭系统评价/Meta分析现状调查

Meta Analysis on the Investigation of the Current Situation of Traditional Chinese Medicine in the Treatment of Chronic Heart Failure

目的中医药治疗慢性心力衰竭(chronic heart failure,CHF)的系统评价/Meta分析现状调查。方法计算机检索中国知网(China National Knowledge Infrastructure,CNKI)、万方数据库(WanFang Data)和Pubmed(2011年1月—2017年6月)中有关中医药治疗心力衰竭的系统评价、Meta分析,按纳入与排除标准选择文献并进行资料提取和质量评价。结果共纳入117篇系统评价。分析结果显示:中医药系统评价的认可度越来越高,文献发表数量越来越多,但大多数研究未能创造或利用最佳证据,方法学质量水平不高。结论中医药系统评价的认可度越来越高,对中医药的临床应用提供了大量证据。可能与临床研究发表数量的增加密切相关;也可能与系统评价方法学的推广有关。很多系统评价结果无法进行横向比较或纵向比较,存在同一药物同一年度发表多篇系统评价,其纳入研究对象相同,受纳入文献的质量限制及可能存在的发表偏倚影响,要充分体现中药在改善“证候”等方面的优势,重视观察对生活质量及预后指标(再次入院率、死亡率等)的影响。

Objective To systematically evaluate the current status of systematic evaluation/meta-analysis of traditional Chinese medicine in the treatment of chronic heart failure(CHF).Methods The Chinese HowNet(CNKI),Wan Fang Data and Pubmed(2011-2017.6)were retrieved by computer for systematic evaluation and meta-analysis of the treatment of heart failure with traditional Chinese medicine.Literatures were selected according to inclusion and exclusion criteria and the data were extracted and evaluated.Results A total of 117 systematic reviews were included.The results show that the recognition of TCM systematic evaluation is getting higher and higher,and the number of publications is increasing.However,most studies fail to create or utilize the best evidence,and the quality of methodology is not high.Conclusion The recognition of TCM systematic evaluation is getting higher and higher,which provides a lot of evidence for the clinical application of TCM.It may be closely related to the increase in the number of clinical studies published,or it may be related to the popularization of systematic evaluation methodology.Many systematic evaluation results can not be compared horizontally or vertically.There are many systematic evaluations of the same drug published in the same year.The subjects included are the same.They are affected by the quality limitation of the included literature and the possible publication bias.We should fully reflect the advantages of traditional Chinese medicine in improving"syndrome"and attach importance to observation.Influence on quality of life and prognosis indicators(re admission rate,mortality rate,etc.).