温胆汤治疗高血压病有效性及安全性的Meta分析

Efficacy and Safety of Wendan Decoction(温胆汤) in the Treatment of Hypertension:A Meta-analysis

目的 系统评价温胆汤治疗高血压病的有效性与安全性。方法 计算机全面检索中国知网、万方数据库、维普期刊数据库、PubMed和Web of science 5个数据库从建库起至2021年10月温胆汤治疗高血压病的随机对照研究,通过纳入和排除标准筛选文献后,提取有效数据并根据Cochrane Handbook 5.1.0进行系统评价,利用Revman 5.4.1软件进行Meta分析。结局指标包括血压水平变化、降压疗效、临床疗效、中医证候积分改善情况和不良反应发生情况。结果 最终纳入9篇研究,总样本共计719例,观察组361例,对照组358例。Meta分析显示:与对照组单独西药治疗相比,联合温胆汤治疗能明显降低收缩压[MD=-7.07,95%CI(-9.29,-4.85),P<0.000 01],降低舒张压[MD=-7.08,95%CI(-8.06,-6.11),P<0.000 01],提高临床疗效[OR=4.52,95%CI(2.42,8.46),P<0.000 01],改善中医证候积分,且不良反应发生率更低[OR=0.34,95%CI(0.13,0.91),P=0.03]。结论 温胆汤联合西药治疗高血压病在调控血压水平和提高临床疗效等方面均优于单独西药治疗,且安全性更好,具有一定的临床应用前景。

Objective To systematically evaluate the efficacy and safety of Wendan Decoction(温胆汤) in the treatment of hypertension.Methods 5 databases of CNKI,WF,VIP,PubMed,and Web of Science were comprehensively searched by computer to collect randomizedcontrolled studies of Wendan Decoction in the treatment of hypertension,the retrieval timewas from these databases inception to October 2021.After screening studies by inclusion and exclusion criteria,valid data were extracted and systematic review was performed according to the Cochrane Handbook 5.1.0,and meta-analysis was conducted using Revman 5.4.1.The outcome measures included changes in blood pressure level,antihypertensive efficacy,clinical effectiveness,improvement in traditional Chinese medicine syndrome scores,and occurrence of adverse reactions.Results A total of 9 studies involving 719 participants were included,with 361 participants in the observation group and 358 participants in the control group.Meta-analysis showed that compared with western medicine treatment alone in the control group,combined with Wendan Decoction can significantly reduce systolic blood pressure [MD=-7.07,95%CI(-9.29,-4.85),P<0.000 01],reduce the diastolic blood pressure [MD=-7.08,95%CI(-8.06,-6.11),P<0.000 01],improve clinical effectiveness [OR=4.52,95%CI(2.42,8.46),P<0.000 01],improve TCM syndrome scores,and the occurrence of adverse reactions was lower [OR=0.34,95%CI(0.13,0.91),P=0.03].Conclusion Wendan Decoction combined with western medicine in the treatment of hypertension is better than western medicine alone in regulating blood pressure level and improving clinical effectiveness,it also demonstrates good safety and has certain clinical application prospects.