温阳活血中药治疗冠心病心力衰竭临床疗效Meta分析

Meta-analysis of Wenyang Huoxue Decoction in treatment of coronary heart disease heart failure

目的通过Meta分析明确温阳活血中药治疗冠状动脉粥样硬化性心脏病(冠心病)心力衰竭(心衰)的临床疗效。方法采用计算机检索Cochrane library、Embase、PubMed、CNKI、WanFang Data、VIP、CBM中关于温阳活血中药治疗冠心病心衰的随机对照试验并行Meta分析。检索时间为2000年1月1日至2020年3月31日。根据纳入排除标准遴选文章,提取数据,采用Cochrane系统评价手册偏倚风险评估工具进行质量评价,运用Review Manager 5.3软件进行Meta分析。结果最终纳入12篇研究文献,共1031例冠心病心力衰竭患者。Meta分析结果显示,与西药常规治疗相比,加用温阳活血中药治疗冠心病心衰患者能够改善心功能(RR=1.24,95%CI:1.15~1.34),提高6分钟步行距离(MD=38.37,95%CI:24.97~51.78),增加左室射血分数(MD=2.65,95%CI:2.03~3.28)。结论西药治疗基础上加用温阳活血中药疗效确切,具有较好的安全性,是治疗冠心病心衰的有效方法,还需更高质量更大样本量的临床研究加以验证。

Objective To systematically evaluate the efficacy and safety of Wenyang Huoxue decoction in the treatment of coronary heart disease(CHD)Heart Failure.Methods A meta-analysis of CHD heart failure studies using Wenyang Huoxue Method were performed by reviewing Cochrane library,Embase,PubMed,CNKI,Wanfang Data,Vip database,and CBM.The retrieval time was from January 1,2000 to March 31,2020.Articles were selected according to inclusion and exclusion criteria,quality evaluation was conducted by Cochrane systematic evaluation manual risk assessment tool for bias,and meta-analysis was performed by Review Manager 5.3.Results 12 randomized controlled trials with a total of 1031 patients on Wenyang Huoxue decoction were included in this study.Meta-analysis revealed that Wenyang Huoxue decoction in combination with conventional western medicines was more effective in improving the cardiac function(RR=1.24,95%CI:1.15~1.34),6 MWT(MD=38.37,95%CI:24.97~51.78),and LVEF(MD=2.65,95%CI:2.03~3.28)with CHD heart failure patients.Conclusion Wenyang Huoxue Method in combination with conventional western medicines had a more positive effect on patients with CHD heart failure.It is necessary to carry out a large sample and high-quality randomized controlled trial to verify it.