真武汤加减治疗扩张型心肌病临床疗效的Meta分析

Meta-analysis of Clinical Efficacy of Zhenwu Decoction in Treating Dilated Cardiomyopathy

目的观察真武汤加减治疗扩张型心肌病(Dilated cardiomyopathy,DCM)的临床疗效。方法检索2000年1月1日—2023年10月31日期间万方、维普、中国学术期刊全文数据库(CNKI)及PubMed数据库收录的真武汤加减治疗DCM的研究。同质性研究采用固定效应模型、异质性研究采用随机效应模型进行荟萃分析。采用Revman 5.3软件评价文献质量,应用Stata15.1软件合并分析数据,并用TSA 0.9软件对治疗有效率进行序贯分析。结果最终纳入12项研究,共666例患者,Meta分析结果显示,真武汤加减联合西药治疗可更有效的提高DCM患者左室射血分数(Left ventricular ejection fraction,LVEF)(SMD=4.27,95%CI:2.07~6.48,P<0.0001);更大程度缩小左室舒张末期内径(Left ventricular end diastolic dimension,LVEDd)(SMD=-7.74,95%CI:-8.37~-7.11,P<0.00001);显著提高治疗有效率(OR=3.62,95%CI:2.16~6.08,P<0.0001)。结论真武汤加减联合西药常规治疗DCM,在提高总有效、改善LVEF、缩小LVEDd方面优于常规西药治疗。

Objective To systematically evaluate the clinical efficacy of Zhenwu Decoction in treating dilated cardiomyopathy.Methods The studies about the treatment of dilated cardiomyopathy with modified Zhenwu Decoction were retrieved from Wanfang Data,VIP,China National Knowledge Infrastructure(CNKI),and PubMed with the time interval from January 1,2000 to October 31,2023.Meta-analysis was carried out with the fixed effect model for homogenous studies and the random effect model for heterogeneous studies.Revman5.3 was used to evaluate the quality of the included studies.Stata15.1 was employed to analyze the data,and TSA 0.9 was used for sequential analysis of the response rate.Results A total of 12 randomized controlled trials(RCTs)were included,involving 666 patients.The results of meta-analysis showed that modified Zhenwu Decoction combined with Western medicine outperformed Western medicine alone in elevating the left ventricular ejection fraction(SMD=4.27,95%CI:2.07-6.48,P<0.0001),reducing the left ventricular end-diastolic diameter(SMD=-7.74,95%CI:-8.37 to-7.11,P<0.00001),and improving the total response rate(OR=3.62,95%CI:2.16-6.08,P<0.0001)in the patients with dilated cardiomyopathy.Conclusion Zhenwu Decoction combined with Western medicine is superior to Western medicine alone in elevating left ventricular ejection fraction,reducing left ventricular end-diastolic diameter,and improving the total response rate in the treatment of dilated cardiomyopathy.