保元汤治疗气虚血瘀型慢性心力衰竭临床观察

System Evaluation on the Clinical Curative Effect of Baoyuan Decoction in the Treatment of Chronic Heart Failure Caused by Qi Deficiency and Blood Stasis

目的对保元汤加减方治疗慢性心力衰竭的疗效与安全性进行系统评价。方法用Cochrane协作网系统评价方法,检索CNKI、Wan Fang Data、VIP、CBM、Pub Med、Cochrane Library、EMBASE等关于保元汤治疗慢性心力衰竭的随机对照试验。检索时限均从建库至2021年1月。据改良Jadad量表评价纳入研究的方法学质量,采用Rev Man 5.3软件进行偏倚风险评估以及Meta分析。结果共收集保元汤治疗慢性心力衰竭文献112篇,经过严格初筛和阅读全文,共纳入26篇RCT文献,共1857例(治疗组936例,对照组921例)患者。Meta分析结果,提示相较于对照组,治疗组在总有效率、LVEF、NT-proBNP、BNP、中医证候积分、生存质量积分等指标方面优于西医治疗,差异有统计学意义(P<0.00001)。结论常规治疗基础上联合保元汤可明显提高患者临床有效率和左室射血分数,降低血清NT-proBNP和BNP水平,同时提高患者生存质量。

Objective By using meta-analysis and systematic reviews to evaluate the efficacy and safety of Baoyuan decoction on chronic heart failure.Methods By using Cochrane systematic evaluation method to retrieve CNKI,Wanfang database,VIP,CBM,Pub Med,the Cochrane Library,EMBASE about Baoyuan decoction on the treatment of CHF,all relevant RCTs literature was analyzed.They were all searched from inception to January 2021.According to the improved Jadad scale and the evaluation of the methodological quality of the included studies,Rev Man5.3 software was used to assess the risk of bias and meta-analysis.Results A total of 26 RCTs,including 1857samples(936 samples in the treatment group,921 samples in the control group)were collected.Meta-analysis results showed that compared with the control group,the treatment group improved the cardiac function effect and LVEF,the TCM syndrome integral,reduced the NTpro BNP and BNP,ultimately improve the quality of life score index were superior to that of simple western medicine treatment.The difference was statistically significant(P<0.00001).Conclusion Baoyuan Decoction combined with conventional western medicine can improve the clinical effect and LVEF of the patients with CHF,reduced serum NT-proBNP and BNP level,ultimately improve the life quality.