二仙汤治疗围绝经期高血压有效性与安全性的Meta分析

Effectiveness and safety of Erxian Decoction in the treatment of perimenopausal hypertension:A systematic Review and Meta-analysis

目的基于Meta分析探讨二仙汤治疗围绝经期高血压的临床疗效与安全性。方法检索中文数据库中国知识基础设施工程(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(WanFang)、中国生物医学文献服务系统(CBM)、中国临床试验注册中心及外文数据库PubMed、Embase、The Cochrane Library,检索时间段均为从各数据库建立至2022年3月,纳入使用二仙汤治疗围绝经期高血压的随机对照试验,使用Cochrane Handbook version 5.1.0评估偏倚风险,使用RevMan 5.4进行Meta分析。结果共纳入文献11篇,涉及病例1289例。Meta分析结果显示,治疗组总有效率[OR=5.12,95%CI(3.46,7.56),P<0.00001]、雌二醇水平[MD=14.61,95%CI(5.06,24.16),P=0.003]均高于对照组,收缩压[MD=-6.12,95%CI(-9.37,-2.51),P=0.0009]、舒张压[MD=-4.79,95%CI(-6.82,-2.76),P<0.00001]、卵泡刺激素水平[MD=-16.48,95%CI(-32.29,-0.67),P=0.004]、黄体生成激素水平[MD=-11.04,95%CI(-19.76,-2.31),P=0.01]、Kupperman评分[MD=-5.94,95%CI(-7.51,-4.37),P<0.00001]均低于对照组,仅有1项文献研究报道了不良事件。结论二仙汤治疗围绝经期高血压疗效确切,可有效降低患者收缩压和舒张压,降低Kupperman评分,改善患者围绝经期症状,升高雌二醇水平,降低卵泡刺激素及黄体生成激素水平,促进性激素水平平衡,且无明显不良反应。

Objective To systematically review the effectiveness and safety of Erxian Decoction in the treatment of perimenopausal hypertension.Methods Chinese databases of CNKI,Vip,Wanfang,CBM,ChiCRT and foreign language databases of PubMed,EMBase,the Cochrane Library were comprehensively searched to screen randomized controlled trials(RCTs)regarding Erxian Decoction in treating perimenopausal hypertension,the deadline is March 2022.The Cochrane Handbook version 5.1.0 was used for assessing risk of bias and Review Manager 5.4 was used for meta-analysis.Results Eligible 11 RCTs representing 1289 patients were included.The results of meta-analysis showed that the total effective rate of the test group(OR=5.12,95%CI[3.46,7.56],P<0.00001)and the estrogen(E 2)level(MD=14.61,95%CI[5.06,24.16],P=0.003)were higher than the control group;meanwhile,systolic blood pressure(SBP)(MD=-6.12,95%CI[-9.37,-2.51],P=0.0009),diastolic blood pressure(DBP)(MD=-4.79,95%CI[-6.82,-2.76],P<0.00001),follicle-stimulating hormone(FSH)level(MD=-16.48,95%CI[-32.29,-0.67],P=0.004),luteinizing hormone(LH)level(MD=-11.04,95%CI[-19.76,-2.31],P=0.01)and Kupperman score(MD=-5.94,95%CI[-7.51,-4.37],P<0.00001)were lower than the control group.Only one study reported adverse events.Conclusion Erxian Decoction in the treatment of perimenopausal hypertension has a definite curative effect,It can significantly reduce SBP,DBP,Kupperman score,thus improve perimenopausal symptoms,increase estradiol levels,and reduce the levels of FSH and LH,promote the balance of sex hormone levels,without obvious adverse reactions.