中成药治疗心力衰竭的临床用药推荐

Recommendations on clinical treatment of heart failure with Chinese patent medicines

本研究通过对中成药治疗心力衰竭的临床随机对照试验(randomized controlled trial,RCT)进行系统收集与分析,拟制定治疗心力衰竭的中成药推荐意见,为临床医生合理使用中成药提供参考。基于3个国际电子数据库(PubMed,Embase和Cochrane library)和3个中文文献数据库[中国期刊全文数据库、万方医学数据库和中文科技期刊数据库(维普)],纳入各数据库建立至2022年7月1日所有相关的RCTs,共检索到83种中成药,最终纳入15种中成药作为心力衰竭的临床用药推荐,包括注射液7种和口服中成药8种。对比分析了15种中成药的基本信息、研究规模、干预方案及结局指标,采用GRADE(Grades of Recommendations Assessment Development and Evaluation)分级方法对纳入中成药疗效的证据质量进行评价,评估其对射血分数降低的心力衰竭(heart failure with reduced ejection fraction,HFrEF)、射血分数保留的心力衰竭(heart failure with preserved ejection fraction,HFpEF)及急性心力衰竭(acute heart failure,AHF)的疗效和安全性。本研究结合循证医学方法,综合评价目前使用较多、证据较为充足的治疗心力衰竭的15种中成药,拟为临床医师合理使用中成药提供一定依据。

To provide recommendations for clinicians on rational use of Chinese patent medicine for treatment of heart failure,the study was conducted by systematically collecting and analyzing clinical randomized controlled trials(RCTs).Based on three international electronic databases(PubMed,Embase and Cochrane library)and three Chinese literature databases(Chinese Journal Full Text Database,Wanfang Medical Database and Chinese Science and Technology Journal Database(Weipu)),all relevant RCTs from the beginning of the establishment of each database to July 1,2022 were included,a total of 83 proprietary Chinese medicines were retrieved,and finally 15 proprietary Chinese medicines were chosen to be recommended for treatment of heart failure,including 7 injections and 8 oral proprietary Chinese medicines.The basic information,sample size,intervention and outcome indicators of the 15 proprietary Chinese medicines were compared and analyzed,and the quality of evidence for the efficacy of the included proprietary Chinese medicines was evaluated using the GRADE classification method to assess their efficacy and safety on heart failure with reduced ejection fraction(HFrEF),heart failure with preserved ejection fraction(HFpEF)and acute heart failure(AHF).Combined with the evidence-based medicine approach,a comprehensive evaluation of 15 proprietary Chinese medicines currently in use and with sufficient evidence for the treatment of heart failure were conducted,with the intention to provide some basis for clinicians to use proprietary Chinese medicines rationally.