益气温阳、活血利水法治疗慢性心力衰竭心肾阳虚证的Meta分析

Meta-analysis of Heart and Kidney Yang Deficiency Syndrome in Chronic Heart Failure Treated by the Method of Benefiting qi and Warming Yang, Activating Blood Circulation and Diuresis

目的:系统评价益气温阳、活血利水法治疗慢性心力衰竭心肾阳虚证的疗效与安全性。方法:计算机检索国内外数据库及手动检索国内核心期刊(检索期限为2017年8月以前),纳入以益气温阳、活血利水为组方治疗慢性心力衰竭的临床随机对照试验,提取资料,用Cochrane系统评价的方法对文献质量进行评分,采用RevMan5.3统计软件对纳入研究的结果进行Meta分析。结果:Meta分析显示,与对照组比较,治疗组疗效显著提高,差异具有统计学意义[OR=3.39,95%CI=(2.35,4.91)];治疗组心功能提高明显高于对照组,差异具有统计学意义[OR=3.47,95%CI=(2.46,4.90)];治疗组左室射血分数明显高于对照组,差异具有统计学意义[MD=4.42,95%CI=(1.91,6.93)];治疗组6分钟步行试验明显高于对照组,差异具有统计学意义[MD=45.49,95%CI=(27.39,63.60)];治疗组脑利钠肽明显低于对照组,差异具有统计学意义[MD=-195.73,95%CI=(-272.38,-119.09)]。结论:益气温阳、活血利水法治疗慢性心力衰竭心肾阳虚证疗效显著。

Objective:To systematically evaluate the efficacy and safety of the method of benefiting qi and warming yang,activating blood circulation and diuresisin the treatment of heart and kidney yang deficiency syndrome of chronic heart failure.Methods:Computerized search of domestic and foreign databases and manual search of domestic core journals(before August,2017)were included in the clinical randomized controlled trials of chronic heart failure with benefiting qi and warming yang,activating blood circulation and diuresis as the prescription.Data were extracted and the quality of literature was scored by Cochrane system evaluation method.RevMan 5.3 statistical software was used to make a Meta-analysis of the results of the study.Results:Meta-analysis showed that compared with the control group,the therapeutic effect of the treatment group was significantly improved,with statistical significance[OR=3.39,95%CI=(2.35,4.91)];the improvement of cardiac function in the treatment group was significantly higher than that in the control group,with statistical significance[OR=3.47,95%CI=(2.46,4.90)];the left ventricular ejection fraction in the treatment group was significantly higher than that in the control group.The difference was statistically significant in the control group[MD=4.42,95%CI=(1.91,6.93)];the 6-minute walking test in the treatment group was significantly higher than that in the control group,with statistical significance[MD=45.49,95%CI=(27.39,63.60)];and the brain natriuretic peptide in the treatment group was significantly lower than that in the control group,with statistical significance[MD=-195.73,95%CI=(-272.38,-119.09)].Conclusion:The method of benefiting qi and warming yang,activating blood circulation and diuresis is effective in treating heart and kidney yang deficiency syndrome of chronic heart failure.