心可舒联合常规降压治疗高血压病左心室肥厚的疗效和安全性的Meta分析

Efficacy and safety of Xinkeshu combined with conventional antihypertensive therapy forleft ventricular hypertrophy in patients with hypertension: a meta analysis

目的 运用Meta分析评估心可舒联合常规降压方案治疗高血压病左心室肥厚(LVH)的疗效和安全性。方法 通过中国知网(CNKI)、万方(Wanfang)、维普(VIP)、SinoMed、PubMed、EMbase和Web of Science、Cochrane Library数据库从建库起至2022年9月对心可舒联合常规降压方案治疗高血压病左心室肥厚的随机对照试验(RCT)进行系统的文献检索。由两名独立的研究人员筛选文献后进行数据提取和偏倚风险的评价,采用RevMan 5.4软件进行Meta分析。结果 最终确定了9项研究,包括797名患者。Meta分析显示,与常规降压治疗相比,心可舒联合常规降压治疗可显著改善室间隔厚度(IVST)[MD=-1.33,95%CI(-1.87,-0.79),P<0.00001],左心室后壁厚度(LVPWT)[MD=-1.64,95%CI(-1.96,-1.32),P<0.00001],左心室质量指数(LVMI)[MD=-7.60,95%CI(-10.25,-4.95),P<0.00001],收缩压(SBP)[MD=-17.73,95%CI(-23.11,-12.34),P<0.00001],舒张压(DBP)[MD=-10.55,95%CI(-14.07,-7.04),P<0.00001],左心室射血分数(LVEF)[MD=3.60,95%CI(1.24,5.95),P=0.003],左心室舒张末期内径(LVEDD)[MD=-2.03,95%CI(-2.58,-1.48),P<0.00001]。两组不良反应发生率差异无统计学意义[RR=0.86,95%CI(0.24,3.04),P=0.82]。其安全性上无严重不良事件发生,临床应用的安全性较好。结论 心可舒联合西医常规降压治疗高血压病左心室肥厚的疗效在一定程度上优于单用常规降压治疗,且具有良好的安全性。

Objective To evaluate the efficacy and safety of Xinkeshu combined with conventional antihypertensive regimen in the treatment of left ventricular hypertrophy(LVH)in patients with hypertension through meta-analysis.Methods A systematic literature search was conducted on the randomized controlled trial(RCT)of Xinkeshu combined with conventional antihypertensive regimen for LVH in hypertension from the establishment of CNKI,Wanfang,VIP,SinoMed,PubMed,EMbase,the Web of Science,and Cochrane Library databases until September 2022.Data extraction and bias risk assessment were conducted after literature screening by two independent researchers,and meta-analysis was performed with RevMan 5.4 software.Results 9 studies were ultimately identified,involving 797 patients.Meta analysis showed that compared with conventional antihypertensive regimen,Xinkeshu combined with conventional antihypertensive therapy could significantly improve ventricular septal thickness(IVST)(MD=-1.33,95%CI[-1.87,-0.79],P<0.00001),left ventricular posterior wall thickness(LVPWT)(MD=-1.64,95%CI[-1.96,-1.32],P<0.00001),left ventricular mass index(LVMI)(MD=-7.60,95%CI[-10.25,-4.95],P<0.00001),systolic blood pressure(SBP)(MD=-17.73,95%CI[-23.11,-12.34],P<0.00001),diastolic blood pressure(DBP)(MD=-10.55,95%CI[-14.07,-7.04],P<0.00001),left ventricular ejection fraction(LVEF)(MD=3.60,95%CI[1.24,5.95],P=0.003),and left ventricular end diastolic diameter(LVEDD)(MD=-2.03,95%CI[-2.58,-1.48],P<0.00001).There was no statistically significant difference in the incidence of adverse reactions between the two groups(RR=0.86,95%CI[0.24,3.04],P=0.82).In terms of safety,there were no serious adverse events,and the clinical application has good safety.Conclusion The therapeutic effect of Xinkeshu combined with conventional antihypertensive regimen of Western medicine on left ventricular hypertrophy in patients with hypertension is superior to that of conventional antihypertensive regimen alone to some extent,with good safety.