补中益气五苓汤治疗慢性心力衰竭随机对照临床试验研究Meta分析

Meta-Analysis of Randomized Controlled Clinical Trials of Buzhong Yiqi Wuling Decoction in Treating Chronic Heart Failure

目的运用Meta分析补中益气五苓汤(Buzhong Yiqi Wuling Decoction,BWD)治疗慢性心力衰竭(chronic heart failure,CHF)的临床疗效。方法检索中国知识资源总库(CNKI)、中国生物医学文献服务系统(SinoMed)、维普中文期刊服务平台(VIP)、中国学术期刊数据库(Wanfang Data)、Pubmed、Embase、Cochrance数据库,从建库至2019年12月公开发表与BWD治疗慢性心力衰竭的临床试验(Randomized Controlled Trial,RCT),运用Review Manager 5.3软件进行分析。结果7项临床试验(686例受试者)疗效表明,与单纯常规西药治疗相比,BWD能够提高CHF有效率[OR=4.04,95%CI(2.53,6.47),P<0.000]、改善超声心动图左心室射血分数(LVEF)[MD=4.90,95%CI(3.51,6.00),P<0.000]、改善6分钟步行实验(6 Minutes Walk Test,6MWT)[MD=68.81,95%CI(51.07,86.55),P<0.000]、降低血浆B型氨基端利钠肽原(NT-proBNP)[SMD=-4.15,95%CI(-6.54,-1.75),P<0.000],试验组中医证候积分结果评价明显优于对照组[MD=3.09,95%CI(0.77,5.40),P=0.009]。结论现有治疗CHF的临床试验表明,联合BWD其疗效优于单纯运用常规西药治疗,鉴于纳入研究文献质量一般,需要设计严谨、方法学规范、报告明确的高质量RCT验证。

Objective To systematically evaluate the effectiveness and safety of Buzhong Yiqi Wuling Decoction(BWD)in treating Chronic Heart Failure(CHF). Methods The databases of China Knowledge Resources(CNKI), China Biomedical Literature Service(SinoMed), VIP Chinese Journal Service Platform(VIP), Chinese Academic Journal Database(Wanfang Data), PubMed, Embase, and Cochrane were searched from the establishment of the database to December 2019 for publicly published trials related to BWD for the treatment of chronic Heart failure clinical trials(Randomized Controlled Trial, RCT), were analyzed using Review Manager 5.3 software. Results Compared with conventional western medicine treatment, the efficacy of 7 clinical trials(686 subjects) shows that BWD can improve the efficiency of chronic heart failure[OR = 4.04,95%CI(2.53, 6.47), P < 0.000], Echocardiography left ventricular ejection fraction(LVEF) [MD = 4.90,95%CI(3.51, 6.00), P < 0.000], the 6-minute walk experiment(6 MWT) [MD = 68.81,95%CI(51.07, 86.55), P < 0.000], Reduced plasma B-amino-terminated natriuretic peptide(NT-proBNP) [SMD =-4.15,95%CI(-6.54,-1.75), P < 0.000], which is Significantly difference[MD = 3.09, 95%CI(0.77, 5.40), P = 0.009].Conclusion In the treatment of CHF, BWD is better than conventional western medicine alone, the quality of the included research literature is mediocre, requiring high-quality RCT validation with rigorous design, methodological specifications, and clear reporting.