摘要
目的:应用Meta分析法系统评价温阳利水活血汤治疗阳虚水泛血瘀证心力衰竭的临床疗效及安全性。方法:检索万方数据库、中国学术期刊全文数据库、维普数据库、The Cochrane Library、PubMed、EMbase数据库中关于温阳利水活血汤治疗阳虚水泛血瘀证心力衰竭的临床随机对照研究文献,经过文献筛选和质量评价提取有效研究,应用Rveman 5.3分析软件对纳入文献进行Meta分析。结果:经筛选最终本研究共纳入20篇临床随机对照研究,均为中文文献,总计1733例样本,所纳入的文献总体质量偏低。Meta分析结果显示:相比较对照组,试验组在总的临床疗效显效率(RR=1.25,95%CI:[1.15,1.35],P<0.00001)、6min步行距离(MD=61.48,95%CI:[12.15,110.81],P=0.01)、脑钠利尿肽(MD=-137.73,95%CI:[-177.86,-97.60],P<0.00001)、左室舒张末期内径(MD=-4.04,95%CI:[-4.70,-3.37],P<0.00001)、左室射血分数(MD=6.31,95%CI:[4.68,7.95],P<0.00001)、血浆N末端脑钠肽前体(MD=-242.62,95%CI:[-348.70,-136.54],P<0.00001)、中医证候积分(MD=-1.63,95%CI:[-2.49,-0.77],P=0.0002)等指标均优于单纯西医治疗,其差异均具有统计学意义(P<0.05)。结论:西医常规治疗加用温阳利水活血汤加减对治疗阳虚水泛血瘀证心力衰竭患者其疗效优于单纯西医常规治疗;由于目前纳入本次Meta分析的文献质量偏低、评价方法不规范、证据质量不足,导致本次评价的可靠性降低,因此上述结论尚需更多高质量研究予以验证。
Objective:To evaluate the clinical efficacy and safety of Wenyang Lishui Huoxue decoction(WYLSHXT)in the treatment of heart failure caused by Yang deficiency and Water Surplus Blood stasis.Methods:to retrieve database of Wanfang,China academic journal full-text database(CNKI),VIP database,The Cochrane Library,PubMed,EMbase database about WYLSHXT in the treatment of Yang deficiency and Water Surplus blood stasis syndrome of heart failure in clinical randomized controlled research,through screening and evaluation to extract the effective articles,application Rveman 5.3 to analyze the effective articles.Results:A total of 20 clinical randomized controlled articles were included in this study,all of which were Chinese literature with 1733 samples.The quality of the literature was low.Meta-analysis results showed significant of clinical efficacy(RR=1.25,95%CI:[1.15,1.35],P<0.00001),6min walking distance(MD=61.48,95%CI:[12.15,110.81],P=0.01),brain natriuretic peptide(MD=-137.73,95%CI:[-177.86,-97.60],P<0.00001),and left ventricular end-diastolic diameter(MD=-4.04,95%CI:[-4.70,-3.37],P<0.00001),left ventricular ejection fraction(MD=6.31,95%CI:[4.68,7.95],P<0.00001),N-terminal pro B-type natriuretic peptide(MD=-242.62,95%CI:[-348.70,-136.54],P<0.00001),TCM syndrome integral(MD=-1.63,95%CI:[-2.49,-0.77],P=0.0002)were better than the control group,and the differences were statistically significant(P<0.05).Conclusion:the effect of traditional western medicine treatment combine with WYLSHXT was better;the reliability of this meta-analysis is reduced due to the low quality of the article,non-standard evaluation methods and insufficient evidence quality in this meta-analysis.So the above conclusions need to be verified by more high-quality studies.
作者
祁鹏
巩倩惠
刘明怀
黄路梅
QI Peng;GONG Qianhui;LIU Minghuai;HUANG Lumei(Hunan University of Chinese Medicine,Hu’nan Changsha 410208,China;Dianjiang Hospital of Traditional Chinese Medicine,Chongqing Dianjiang 408300,China)
出处
《中医药临床杂志》
2020年第2期277-284,共8页
Clinical Journal of Traditional Chinese Medicine
基金
重庆市垫江县科技专项资金支持项目(djkjxm2018jsyfysfyy048)。
关键词
温阳利水活血汤
阳虚水泛血瘀证
心力衰竭
META分析
循证医学
Wenyang Lishui Huoxue decoction
Yang deficiency Water Surplus and blood stasis syndrome
Heart failure
Meta analysis
Evidence-based medicine