天麻钩藤饮加减对原发性高血压患者血管内皮功能调节作用的Meta分析

Meta-analysis of regulating effect of modified Tianma Gouteng decoction on vascular endothelial function of patients with essential hypertension

目的:通过观察天麻钩藤饮加减对原发性高血压患者血浆内皮素、一氧化氮、超氧化物歧化酶水平的影响评价其对血管内皮功能的调节作用与安全性。方法:根据循证医学系统评价的要求,检索各数据库中收录的天麻钩藤饮对原发性高血压患者血浆内皮素、一氧化氮、超氧化物歧化酶调节作用的临床随机对照试验文献,运用Rev Man软件进行数据分析。结果:共检索相关文献279篇,最终纳入符合文献14篇,所有纳入文献Jadad得分均≥1分。天麻钩藤饮加减干预的治疗组与常规降压药治疗的对照组相比较,在调节患者血一氧化氮、超氧化物歧化酶方面的效应合并值均P﹤0.05,在调节血管内皮素方面的合并效应值P﹥0.05。治疗组不良反应报道共6例(恶心、心悸、乏力、面红、头痛),明显低于对照组。结论:天麻钩藤饮加减在调节原发性高血压患者血浆内皮素、一氧化氮、超氧化物歧化酶方面有较好作用,但文献总体质量偏低,且受发表性偏倚等多种因素的影响,结果的稳定性和可靠性仍有待进一步证实。

Objective:To evaluate the regulating effect of modified Tianma Gouteng decoction on vascular endothelial function,based on the effects of modified Tianma Gouteng decoction on levels of plasma endothelin,nitric oxide and superoxide dismutase in plasma of patients with essential hypertension and its safety.Methods:According to the requirements of systematic evaluation of evidence-based medicine,the literatures on clinical randomized controlled trials of regulating effect of Tianma Gouteng decoction on plasma endothelin,nitric oxide and superoxide dismutase of patients with essential hypertension were retrieved from various databases.The data analysis was made by Rev Man software.Results:A total of 279 related literatures were retrieved,and 14 compliant literatures were included finally.Jadad score of all included literatures was≥1.Compared treatment group intervened by modified Tianma Gouteng decoction with control group treated with conventional antihypertensive drugs,the effect-combined values in regulating blood nitric oxide and superoxide dismutase in plasma of patients were P﹤0.05;the effect-combined value in regulating vascular endothelin was P﹥0.05.There were 6 related reports on adverse reactions of the treatment group(nausea,palpitation,fatigue,flushing,headache),which was significantly lower than the control group.Conclusion:Tianma Gouteng decoction has a good effect on regulating plasma endothelin,nitric oxide and superoxide dismutase in plasma of patients with essential hypertension.But the overall quality of literatures included in this study is slightly low,and it is affected by many factors such as publication bias etc.Therefore,the stability and reliability of results still need to be further confirmed.