中成药治疗扩张型心肌病的网状Meta分析

Reticular Meta-Analysis of Chinese Patent Medicine in the Treatment of Dilated Cardiomyopathy

运用网状Meta分析对比中成药的治疗扩张型心肌病(Dilated cardiomyopathy, DCM)的疗效与心功能改善情况。从PubMed、Cochrane Library、Embase、知网、万方数据库、中国生物医学文献数据库(sinomed)等数据库中检索了中成药和常规西药联合治疗扩张型心肌病的研究,检索时间为建库至2022年10月。两位评审员分别规定了研究选择、数据提取、偏差评估的风险。应用Stata 16.0和Review Manager软件5.3进行网状Meta分析。此外,依据Cochrane系统评价员手册推荐的偏倚风险评估工具对纳入的随机对照实验(RCT)进行质量评价。最终纳入文献28篇,样本量2914例,有3种常用治疗扩张型心肌病的中成药。网状Meta显示心功能疗效有效率SUCRA累计概率排序为稳心颗粒 + 西医治疗 > 芪苈强心胶囊 + 通心络胶囊 + 西医治疗 > 芪苈强心胶囊 + 西医治疗 > 通心络胶囊 + 西医治疗 > 西医治疗,左室射血分数(LVEF) SUCRA累计概率排序为稳心颗粒 + 西医治疗 > 芪苈强心胶囊 + 通心络胶囊 + 西医治疗 > 通心络胶囊 + 西医治疗 > 芪苈强心胶囊 + 西医治疗 > 西医治疗。左室舒张末期内径(LVEDD) SUCRA累计概率排序稳心颗粒 + 西医治疗 > 通心络胶囊 + 西医治疗 > 芪苈强心胶囊 + 通心络胶囊 + 西医治疗 > 芪苈强心胶囊 + 西医治疗 > 西医治疗。结果表明,在西医治疗基础上联合中成药均可提升DCM的临床疗效,其中稳心颗粒联合西医治疗SUCRA累计概率排序均位于首位,但由于不同3种中成药纳入文献的数量等存在不同,其排序结果需要进一步验证。

The reticular Meta-analysis was used to compare the efficacy and cardiac function improvement of Chinese patent medicine in the treatment of Dilated cardiomyopathy (DCM). Studies on the treat-ment of dilated cardiomyopathy with the combination of Chinese patent medicine and conventional western medicine were retrieved from databases such as PubMed, Cochrane Library, Embase, CNKI, Wanfang Database, and sinomed. The retrieval time was from the database establishment to Octo-ber 2022. Two reviewers defined the risks for study selection, data extraction, and bias assessment, respectively. The Meta meta-analysis was performed using Stata 16. 0 and Review Manager soft-ware 5.3. In addition, the quality of included RCTs was evaluated using the bias risk assessment tool recommended in the Cochrane System Appraiser’s Handbook. Finally, 28 articles were included, with a sample size of 2914 cases, and there were three commonly used Chinese patent medicines for the treatment of dilated cardiomyopathy. According to the reticular Meta-analysis, the effective rates of cardiac function and curative effects were ranked as: Wenxin Granule + Western Medicine Treatment > Qiliqiangxin Capsule + Tongxinluo Capsule + Western Medicine Treatment > Qiliqi-angxin Capsule + Western Medicine Treatment > Tongxinluo Capsule + Western Medicine Treat-ment > Western Medicine Treatment, and the cumulative probability of left ventricular ejection fraction (LVEF) SUCRA was ranked as: Wenxin Granule + Western Medicine Treatment > Qiliqiang-xin Capsule + Tongxinluo Capsule + Western Medicine Treatment > Tongxinluo Capsule + Western Medicine Treatment > Qiliqiangxin Capsule + Western Medicine Treatment > Western Medicine Treatment. The cumulative probability of LV EDD and SUCRA was ranked as Wenxin Granules + western medicine treatment > Tongxinluo Capsule + western medicine treatment > Qiliqiangxin Capsule + Tongxinluo Capsule + western medicine treatment > Qiliqiangxin Capsule + western medicine treatment > western medicine treatment. The results showed that the combination of Chinese patent medicine on the basis of western medicine treatment could improve the clinical ef-ficacy of DCM. The cumulative probability of SUCRA in the combination of Wenxin Granule and western medicine was ranked first. However, due to the difference in the number of articles in-cluded in different three Chinese patent medicines, the ranking results need to be further verified.