Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin caps...Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin capsule combined treatment has more advantages, providing reference for clinical decision-making in the treatment of chronic heart failure. Methods: Randomized controlled trials (RCTs) of conventional Western medicine treatment and Western medicine combined with Qiliqiangxin capsule in the treatment of chronic heart failure were searched in databases such as PubMed, Embase, Webofscience, CNKI, WanFang, VIP, and CBM. The bias risk assessment was conducted using the RCT tool recommended by Cochrane, and then the meta-analysis was performed using RevMan5.4 and Stata17 software. Compare the efficacy evaluation of cardiac function, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), cardiac stroke output (SV), 6-minute walking test (6MWT), and N-terminal proBNP in the conventional western medicine combined with Qiliqiangxin capsule group (hereinafter referred to as the treatment group) and the conventional western medicine group (hereinafter referred to as the control group). Results: A total of 20 RCTs meeting the criteria were included, including 2953 patients, including 1508 in the treatment group and 1445 in the control group. The results of meta-analysis showed that the treatment group had significantly better cardiac function evaluation, LVEF, LVEDD, SV, 6MWT, and NT-proBNP improvement than the control group. Its central functional efficacy evaluation (OR=2.09,95% CI: 1.71-2.55, P<0.001), LVEF (WMD=7.05,95% CI: 5.30-8.79, P<0.00001), LVEDD (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), SV (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), 6MWT (SMD=0.70,95% CI: 0.54-0.87, P<0.00001), NT-proBNP (SMD=-1.95,95% CI: -2.5 2 to 1.38 (P<0.0001), with statistically significant differences. Conclusion: Conventional western medicine combined with Qiliqiangxin capsule can significantly improve the clinical efficacy of heart failure, improve LVEF, LVEDD, SV, and NT-proBNP index, and improve exercise tolerance. It is worth using for reference in the treatment.展开更多
Heart failure(HF)is a kind of continuous development syndrome of cardiac insufficiency caused by various heart diseases.Not only does the prevalence continue to rise,but the mortality rate and readmission rate remain ...Heart failure(HF)is a kind of continuous development syndrome of cardiac insufficiency caused by various heart diseases.Not only does the prevalence continue to rise,but the mortality rate and readmission rate remain high.Heart failure is also the end-stage of cardiovascular disease and the main cause of death of patients,which seriously affects the health and quality of life of people all over the world.Ventricular remodeling plays a key role in the occurrence and development of heart failure.Therefore,by improving ventricular remodeling,it is of important research value to explore the intervention of traditional Chinese medicine in the development of heart failure.Studies have shown that the mediation of multiple signaling pathways can lead to progressive aggravation of ventricular remodeling,and experimental studies often confirm the therapeutic effects of traditional Chinese medicine.Traditional Chinese medicine usually achieves the therapeutic effect of heart failure through multiple targets and multiple approaches.In recent years,there have been more and more researches on the role and mechanism of Chinese medicine intervention in heart failure.However,it is concluded that Chinese medicine intervention has less influence on heart failure signal pathways.This article summarizes the understanding of Chinese medicine on heart failure and the five signal pathways related to Chinese medicine intervention in heart failure.The 5 signaling pathways in the world,namely transforming growth factor-β1(TGF-β1)/signal transduction protein(Smads)signaling pathway,Toll-like receptor(TLR)/nuclear transcription factor-κB(NF-κB)inflammation signaling pathway,Renin-angiotensinaldosterone(RAAS)system,phosphoinositide 3-kinase(PI3K)-serine/threonine protein kinase(AKT)signaling pathway and mitogen-activated protein kinase(MAPK)dependent signaling pathway.展开更多
目的:对常规西药联合芪苈强心胶囊与单用西药治疗慢性心力衰竭的临床疗效进行比较,证明芪苈强心胶囊联合西药治疗更具优势,为慢性心衰的临床治疗策略提供参考依据。方法:检索PubMed、Embase、Web of science、中国知网(CNKI)、万方(WanF...目的:对常规西药联合芪苈强心胶囊与单用西药治疗慢性心力衰竭的临床疗效进行比较,证明芪苈强心胶囊联合西药治疗更具优势,为慢性心衰的临床治疗策略提供参考依据。方法:检索PubMed、Embase、Web of science、中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献(CBM)等数据库中常规西药治疗以及西药联合芪苈强心胶囊治疗慢性心衰的随机对照实验(RCTs),采用Cochrance推荐的RCT的工具进行偏倚风险评估后,用Rev Man 5.4及Stata 17软件进行Meta分析。比较常规西药联合芪苈强心胶囊组(以下简称治疗组)与常规西药组(以下简称对照组)的心功能疗效评价、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、心脏每搏输出量(SV)、6 min步行试验(6MWT)距离及N末端脑钠肽前体(NT-proBNP)指数。结果:纳入符合标准的RCTs共20篇,包括2953例患者,其中治疗组1508例,对照组1445例。Meta分析结果显示,治疗组的心功能疗效评价、LVEF、LVEDD、SV、6MWT及NT-proBNP改善情况均显著优于对照组。其中心功能疗效评价(OR=2.09,95%CI:1.71~2.55,P<0.001)、LVEF(WMD=7.05,95%CI:5.30~8.79,P<0.00001)、LVEDD(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、SV(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、6MWT(SMD=0.70,95%CI:0.54~0.87,P<0.00001)、NT-proBNP(SMD=-1.95,95%CI:-2.52~-1.38,P<0.0001),差异均有统计学意义。结论:常规西药联合芪苈强心胶囊能显著提高心力衰竭的临床疗效,改善LVEF、LVEDD、SV及NT-proBNP指数,提高运动耐量,在治疗中值得借鉴。展开更多
基金National Natural Science Foundation of China Regional Science Foundation Project(No.82160887)General Project of Guangxi Natural Science Foundation(No.2021GXNSFAA220111)Guangxi Natural Science Foundation Project Youth Science Foundation Project(No.2021GXNSFBA196018)。
文摘Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin capsule combined treatment has more advantages, providing reference for clinical decision-making in the treatment of chronic heart failure. Methods: Randomized controlled trials (RCTs) of conventional Western medicine treatment and Western medicine combined with Qiliqiangxin capsule in the treatment of chronic heart failure were searched in databases such as PubMed, Embase, Webofscience, CNKI, WanFang, VIP, and CBM. The bias risk assessment was conducted using the RCT tool recommended by Cochrane, and then the meta-analysis was performed using RevMan5.4 and Stata17 software. Compare the efficacy evaluation of cardiac function, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), cardiac stroke output (SV), 6-minute walking test (6MWT), and N-terminal proBNP in the conventional western medicine combined with Qiliqiangxin capsule group (hereinafter referred to as the treatment group) and the conventional western medicine group (hereinafter referred to as the control group). Results: A total of 20 RCTs meeting the criteria were included, including 2953 patients, including 1508 in the treatment group and 1445 in the control group. The results of meta-analysis showed that the treatment group had significantly better cardiac function evaluation, LVEF, LVEDD, SV, 6MWT, and NT-proBNP improvement than the control group. Its central functional efficacy evaluation (OR=2.09,95% CI: 1.71-2.55, P<0.001), LVEF (WMD=7.05,95% CI: 5.30-8.79, P<0.00001), LVEDD (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), SV (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), 6MWT (SMD=0.70,95% CI: 0.54-0.87, P<0.00001), NT-proBNP (SMD=-1.95,95% CI: -2.5 2 to 1.38 (P<0.0001), with statistically significant differences. Conclusion: Conventional western medicine combined with Qiliqiangxin capsule can significantly improve the clinical efficacy of heart failure, improve LVEF, LVEDD, SV, and NT-proBNP index, and improve exercise tolerance. It is worth using for reference in the treatment.
基金National Natural Science Foundation of China(No.81673891,No.81560760)Guangxi Medical and Health Appropriate Technology Research and Development Project(No.S201532)Guangxi Zhuang Yao Pharmaceutical Preparation Improvement Project of Traditional Chinese Medicine(No.GZZJ16-03)。
文摘Heart failure(HF)is a kind of continuous development syndrome of cardiac insufficiency caused by various heart diseases.Not only does the prevalence continue to rise,but the mortality rate and readmission rate remain high.Heart failure is also the end-stage of cardiovascular disease and the main cause of death of patients,which seriously affects the health and quality of life of people all over the world.Ventricular remodeling plays a key role in the occurrence and development of heart failure.Therefore,by improving ventricular remodeling,it is of important research value to explore the intervention of traditional Chinese medicine in the development of heart failure.Studies have shown that the mediation of multiple signaling pathways can lead to progressive aggravation of ventricular remodeling,and experimental studies often confirm the therapeutic effects of traditional Chinese medicine.Traditional Chinese medicine usually achieves the therapeutic effect of heart failure through multiple targets and multiple approaches.In recent years,there have been more and more researches on the role and mechanism of Chinese medicine intervention in heart failure.However,it is concluded that Chinese medicine intervention has less influence on heart failure signal pathways.This article summarizes the understanding of Chinese medicine on heart failure and the five signal pathways related to Chinese medicine intervention in heart failure.The 5 signaling pathways in the world,namely transforming growth factor-β1(TGF-β1)/signal transduction protein(Smads)signaling pathway,Toll-like receptor(TLR)/nuclear transcription factor-κB(NF-κB)inflammation signaling pathway,Renin-angiotensinaldosterone(RAAS)system,phosphoinositide 3-kinase(PI3K)-serine/threonine protein kinase(AKT)signaling pathway and mitogen-activated protein kinase(MAPK)dependent signaling pathway.
文摘目的:对常规西药联合芪苈强心胶囊与单用西药治疗慢性心力衰竭的临床疗效进行比较,证明芪苈强心胶囊联合西药治疗更具优势,为慢性心衰的临床治疗策略提供参考依据。方法:检索PubMed、Embase、Web of science、中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献(CBM)等数据库中常规西药治疗以及西药联合芪苈强心胶囊治疗慢性心衰的随机对照实验(RCTs),采用Cochrance推荐的RCT的工具进行偏倚风险评估后,用Rev Man 5.4及Stata 17软件进行Meta分析。比较常规西药联合芪苈强心胶囊组(以下简称治疗组)与常规西药组(以下简称对照组)的心功能疗效评价、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、心脏每搏输出量(SV)、6 min步行试验(6MWT)距离及N末端脑钠肽前体(NT-proBNP)指数。结果:纳入符合标准的RCTs共20篇,包括2953例患者,其中治疗组1508例,对照组1445例。Meta分析结果显示,治疗组的心功能疗效评价、LVEF、LVEDD、SV、6MWT及NT-proBNP改善情况均显著优于对照组。其中心功能疗效评价(OR=2.09,95%CI:1.71~2.55,P<0.001)、LVEF(WMD=7.05,95%CI:5.30~8.79,P<0.00001)、LVEDD(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、SV(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、6MWT(SMD=0.70,95%CI:0.54~0.87,P<0.00001)、NT-proBNP(SMD=-1.95,95%CI:-2.52~-1.38,P<0.0001),差异均有统计学意义。结论:常规西药联合芪苈强心胶囊能显著提高心力衰竭的临床疗效,改善LVEF、LVEDD、SV及NT-proBNP指数,提高运动耐量,在治疗中值得借鉴。
