摘要
目的:分析目前中医药治疗冠心病心衰临床研究存在的问题,探讨和提出冠心病心衰中医防治方案循证优化的思路和方法。方法:系统检索PubMed、EMBASE、Cochrane Library、CNKI、WanFang、VIP和CBM数据库,筛选中医药治疗冠心病心衰的临床研究,评价研究的风险偏倚和结局指标,与慢性心衰的Cochrane系统综述的结局指标进行比较分析,以发现目前研究存在的问题,并针对问题提出改进方法。结果:纳入32篇中医药治疗冠心病心衰的临床研究,各研究的方法学质量普遍偏低,且研究对病死率、再入院率的终点事件结局报道很少,与Cochrane系统综述所关注的结局指标存在较大差距。在冠心病心衰的中医防治方案中,应加强完善临床研究设计和方法,选择冠心病心衰的终点事件作为研究的主要结局指标。结论:在冠心病心衰中医防治方案循证优化中,提高试验的方法学质量和终点事件结局指标的选择至关重要,更有价值的研究证据才能为冠心病心衰患者提供更佳的治疗方案。
Objective: This paper analyzed the present clinical researches of traditional Chinese medicine(TCM) in the treatment of heart failure caused by coronary heart disease and discusses the ideas and methods of evidence-based optimization. Methods: PubMed, EMBASE, Cochrane Library, CNKI, WanFang, VIP and CBM were searched to screen the clinical studies of TCM for treating heart failure caused by coronary heart disease. The problems and solutions were discussed by evaluating the risk of bias of the studies and analyzing the outcomes compared with the Cochrane systematic reviews of chronic heart failure. Results: A total of 32 clinical researches were included and the methodological quality of the studies was generally low. In addition, few studies assessed the endpoint events, mortality and readmission, as the primary outcomes in their trials, which is significantly different from the outcomes concerned in the Cochrane systematic reviews. Conclusion: It is really critical to improve the methodological quality of the trials and to choose the endpoint events as the primary outcomes in the evidence-based optimization of the prevention and treatment of TCM for heart failure caused by coronary heart disease Chinese medicine.
作者
胡嘉元
代倩倩
邱瑞瑾
孙杨
张晓雨
田贵华
商洪才
Hu Jiayuan;Dai Qianqian;Qiu Ruijin;Sun Yang;Zhang Xiaoyu;Tian Guihua;Shang Hongcai(Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 100700, China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2018年第12期2119-2125,共7页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家科技部重点研发计划子课题(2017YFC1700402):心肌梗死介入围手术期中医通治方案循证优化研究
负责人:商洪才
国家自然科学基金委青年项目基金(81725024):中医内科学
负责人:商洪才
关键词
冠心病
心力衰竭
中医
循证医学
临床研究
终点事件
Coronary heart disease
heart failure
traditional Chinese medicine
evidence-based medicine
clinical research
endpoint events