平肝潜阳法治疗原发性高血压的疗效和安全性Meta分析

A Meta-analysis on the Efficacy and Safety of Pinggan Qianyang Method in the Treatment of Essential Hypertension

目的系统评价“平肝潜阳”法治疗原发性高血压(essential hypertension,EH)的有效性和安全性。方法计算机检索Cochrane图书馆、Pubmed、Em-base、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(维普数据库)、万方数据库、中国生物医学文献服务系统,检索时间均从数据库建库至2018年11月。纳入运用“平肝潜阳”法中药治疗与西药规范治疗原发性高血压的临床随机对照研究,并依据Cochrane协作网制定的偏倚风险评估工具对纳入文献进行方法学质量评价,采用Revman 5.3软件对患者治疗后降压疗效、收缩压及舒张压水平、中医症状改善情况及不良反应进行Meta分析。结果共纳入26篇文献,共纳入2973例患者。Meta分析结果显示,在治疗原发性高血压时,运用“平肝潜阳”法中药治疗比仅使用西药规范治疗更有效[OR=2.02,95%CI(1.61,2.54),P<0.00001],尤其能降低EH患者的收缩压水平[SMD=-0.25,95%CI(-0.40,-0.09),P=0.002],在降低舒张压方面,运用“平肝潜阳”法中药治疗与西药治疗,差异无统计学意义[SMD=-0.43,95%CI(-0.95,-0.09),P=0.11]。平肝潜阳法还可有效改善EH患者的临床症状[OR=5.57,95%CI(4.04,7.70),P<0.00001],并改善EH患者的症候积分[SMD=-1.15,95%CI(-1.55,-0.74),P<0.00001],与西药比较,其安全性高,不良反应发生率更低[OR=0.22,95%CI(0.10,0.46),P<0.0001]。结论平肝潜阳法治疗原发性高血压是相对有效且安全的。

Objective To systematically evaluate the efficacy and safety of“PingganQianyang”method in the treatment of essential hypertension(EH).Methods Computer retrieval of Cochrane Library,Pubmed,Em-base,Chinese Journal Full-text Database(CNKI),Chinese Science and Technology Journal Full-text Database(Vip Database),Wanfang Database,China Biomedical Literature Service System,retrieval time were from database to Nov.2018.The quality of inclusive literatures was assessed by methods from Cochrane Handbook.Patients′antihypertensive effect,systolic and diastolic blood pressure levels,improvement of symptoms of traditional Chinese medicine and adverse reactions after treatment were extracted and analyzed by Meta-analysis using RevMan 5.3 Software.Results A total of 26 articles were included,including 2973 patients.The results of meta-analysis showed that in the treatment of essential hypertension,the treatment of traditional Chinese medicine with PingganQianyang was more effective than the treatment with Western medicine only[OR=2.02,95%CI(1.61,2.54),P<0.00001]In particular,it can reduce the systolic blood pressure level of patients with EH[SMD=-0.25,95%CI(-0.40,-0.09),P=0.002].In the reduction of diastolic blood pressure,the use of“PingganQianyang”Chinese medicine treatment and western medicine There was no significant difference in treatment and it was not statistically significant[SMD=-0.43,95%CI(-0.95,-0.09),P=0.11].PingganQianyang method can also effectively improve the clinical symptoms of patients with EH[OR=5.57,95%CI(4.04,7.70),P<0.00001],and improve the syndrome score of patients with EH[SMD=-1.15,95%CI(-1.55,-0.74),P<0.00001],comparedwith western medicine,its safety was higher and the incidence of adverse reactions was lower[OR=0.22,95%CI(0.10,0.46),P<0.0001].Conclusion PingganQianyang method is relatively effective and safe in the treatment of essential hypertension.