天麻钩藤饮联合西药治疗原发性高血压的Meta分析

A Meta-Analysis of Tianma Gouteng Drink Combined with Western Medicine in the Treatment of Essential Hypertension

目的:评价天麻钩藤饮联合西药治疗原发性高血压的临床疗效。方法:检索收集天麻钩藤饮联合西药治疗原发性高血压的随机对照试验(RCTs)。按照纳入文献标准进行筛选并根据改良后的Jadad量表进行质量评价,采用Revman 5.4.1进行meta分析。结果:共纳入25项研究,均为中文文献,总计2450例患者。Meta分析结果显示,在西药基础上加用天麻钩藤饮能够明显提高降压疗效(OR=4.25,95%CI:3.24,5.57,P<0.00001),降低收缩压(SMD=-0.52,95%CI:-0.71,-0.33,P<0.00001)、舒张压(SMD=-0.76,95%CI:-1.04,-0.49,P<0.00001)和内皮素1水平(SMD=-1.00,95%CI:-1.35,-0.66,P<0.00001),提升一氧化氮水平(SMD=1.23,95%CI:0.29,2.17,P=0.01),减少不良反应发生率(OR=0.51,95%CI:0.26,0.99,P=0.046)。结论:天麻钩藤饮联用西药治疗原发性高血压在疗效性、安全性、改善血管内皮功能方面均优于单用西药。

Objective:To evaluate the clinical efficacy of Tianma Gouteng Drink combined with western medicine in the treatment of essential hypertension.Methods:Randomized controlled trials of Tianma Gouteng Drink combined with western medicine in the treatment of hypertension were searched and collected.Literatures were screened according to the criteria of inclusion and evaluated by the Jadad scale.Revman 5.4.1 was used to perform meta-analysis.Results:A total of 25 studies were included,which were Chinese literatures,including 2450 patients.The results showed that Tianma Gouteng Drink could significantly improve the anti-hypertensive effect(OR=4.25,95%CI:3.24,5.57,P<0.00001),reduce systolic blood pressure(SMD=-0.52,95%CI:-0.71,-0.33,P<0.00001),diastolic blood pressure(SMD=-0.76,95%CI:-1.04,-0.49,P<0.00001),and the levels of endothelin-1(SMD=-1.00,95%CI:-1.35,-0.66,P<0.00001),increase the level of nitric oxide(SMD=1.23,95%CI:0.29,2.17,P=0.01),and reduce the incidence of adverse reactions(OR=0.51,95%CI:0.26,0.99,P=0.046).Conclusion:Tianma Gouteng Drink combined with western medicine is superior to western medicine alone in the efficacy,safety and improvement of vascular endothelial function in the treatment of essential hypertension.