目的探讨参附注射液联合富马酸比索洛尔片治疗慢性心力衰竭的临床疗效。方法选取2015年9月—2016年8月在成都体育学院附属体育医院收治的慢性心力衰竭患者106例作为研究对象,根据随机数字表法将患者分为对照组和治疗组,每组各53例。对...目的探讨参附注射液联合富马酸比索洛尔片治疗慢性心力衰竭的临床疗效。方法选取2015年9月—2016年8月在成都体育学院附属体育医院收治的慢性心力衰竭患者106例作为研究对象,根据随机数字表法将患者分为对照组和治疗组,每组各53例。对照组口服富马酸比索洛尔片,5 mg/次,1次/d。治疗组在对照组治疗的基础上静脉滴注参附注射液,30 m L加入到5%葡萄糖注射液中,300 m L/次,1次/d。两组均连续治疗4周。观察两组患者的临床疗效,比较两组的明尼苏达心力衰竭生活质量量表(MLHFQ)评分、6 min步行试验(6WMT)、心功能指标和血清学指标。结果治疗后,对照组和治疗组的总有效率分别为71.70%、94.34%,两组比较差异有统计学意义(P<0.05)。治疗后,两组MLHFQ评分明显降低,6WMT距离均显著增加,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组治疗后MLHFQ评分和6WMT距离显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)显著降低,左心室射血分数(LVEF)显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组治疗后心功能指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清N末端脑钠肽(NT-pro BNP)、同型半胱氨酸(HCY)、血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组血清学指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论参附注射液联合富马酸比索洛尔片治疗慢性心力衰竭患者的疗效显著,能够改善患者的生活质量,提高运动耐量,有效防治心肌损害的进一步加重,且安全可靠,具有一定的临床推广应用价值。展开更多
Objective: This study aimed to assess and compare the clinical efficacy and safety of acupuncture and related therapies(ARTs) add-on to conventional treatment(CT) for heart failure(HF) through pairwise and network met...Objective: This study aimed to assess and compare the clinical efficacy and safety of acupuncture and related therapies(ARTs) add-on to conventional treatment(CT) for heart failure(HF) through pairwise and network meta-analyses.Methods: Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials(CENTRAL), EMBASE, Chinese Biomedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI) and Wanfang Database were searched from inceptions to December 2017. Randomized controlled trials(RCTs) regarding ARTs combining with CT for HF were eligible. The primary outcomes were changes in heart function classification(HFC) according to New York Heart Association class and left ventricular ejection fraction(LVEF). Risk of bias assessment was conducted by two independent authors.Pairwise and network meta-analyses were performed using STATA 13.0 and WinBUGS 1.4.3 software.Results: A total of 26 RCTs were enrolled for analyses, with 5 kinds of ARTs and 2116 patients in all. Pairwise meta-analyses showed that acupoint application(OR: 3.28, 95%CI[2.26, 4.76]), acupuncture(OR: 2.78, 95%CI[1.21, 6.41]), acupoint injection(OR: 3.33, 95%CI[1.85, 6.00]) and moxibustion(OR: 2.51,95%CI[1.02, 6.21]) could significantly improve HFC when they were used as add-on to CT. Acupoint application(MD: 3.57, 95%CI[ 1.45, 5.70]),acupuncture(MD: 7.75, 95%CI[2.33. 13.17]). acupoint injection(MD:4.81, 95%CI[2.99, 6.63]) and moxibustion(MD: 6.99, 95%CI[3.62, 10.36]) were significantly beneficial in improving LVEF. Network meta-analyses showed that acupoint injection(SUCRA = 70.0%) and acupuncture(SUCRA = 90.4%) respectively had the greatest probability in improving HFC and LVEF.Conclusion: Most of the included ARTs add-on to CT was effective in improving HFC and LVEF. Acupoint injection and acupuncture may respectively have better effect than others for HFC and LVEF. However,due to the small sample size and poor quality of the included studies, hence well-designed RCTs are needed to confirm our findings.This study was registered in PROSPERO, CRD42018087700.展开更多
文摘目的探讨参附注射液联合富马酸比索洛尔片治疗慢性心力衰竭的临床疗效。方法选取2015年9月—2016年8月在成都体育学院附属体育医院收治的慢性心力衰竭患者106例作为研究对象,根据随机数字表法将患者分为对照组和治疗组,每组各53例。对照组口服富马酸比索洛尔片,5 mg/次,1次/d。治疗组在对照组治疗的基础上静脉滴注参附注射液,30 m L加入到5%葡萄糖注射液中,300 m L/次,1次/d。两组均连续治疗4周。观察两组患者的临床疗效,比较两组的明尼苏达心力衰竭生活质量量表(MLHFQ)评分、6 min步行试验(6WMT)、心功能指标和血清学指标。结果治疗后,对照组和治疗组的总有效率分别为71.70%、94.34%,两组比较差异有统计学意义(P<0.05)。治疗后,两组MLHFQ评分明显降低,6WMT距离均显著增加,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组治疗后MLHFQ评分和6WMT距离显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)显著降低,左心室射血分数(LVEF)显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组治疗后心功能指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清N末端脑钠肽(NT-pro BNP)、同型半胱氨酸(HCY)、血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组血清学指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论参附注射液联合富马酸比索洛尔片治疗慢性心力衰竭患者的疗效显著,能够改善患者的生活质量,提高运动耐量,有效防治心肌损害的进一步加重,且安全可靠,具有一定的临床推广应用价值。
基金Supported by the National Natural Science Foundation of China:81473544~~
文摘Objective: This study aimed to assess and compare the clinical efficacy and safety of acupuncture and related therapies(ARTs) add-on to conventional treatment(CT) for heart failure(HF) through pairwise and network meta-analyses.Methods: Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials(CENTRAL), EMBASE, Chinese Biomedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI) and Wanfang Database were searched from inceptions to December 2017. Randomized controlled trials(RCTs) regarding ARTs combining with CT for HF were eligible. The primary outcomes were changes in heart function classification(HFC) according to New York Heart Association class and left ventricular ejection fraction(LVEF). Risk of bias assessment was conducted by two independent authors.Pairwise and network meta-analyses were performed using STATA 13.0 and WinBUGS 1.4.3 software.Results: A total of 26 RCTs were enrolled for analyses, with 5 kinds of ARTs and 2116 patients in all. Pairwise meta-analyses showed that acupoint application(OR: 3.28, 95%CI[2.26, 4.76]), acupuncture(OR: 2.78, 95%CI[1.21, 6.41]), acupoint injection(OR: 3.33, 95%CI[1.85, 6.00]) and moxibustion(OR: 2.51,95%CI[1.02, 6.21]) could significantly improve HFC when they were used as add-on to CT. Acupoint application(MD: 3.57, 95%CI[ 1.45, 5.70]),acupuncture(MD: 7.75, 95%CI[2.33. 13.17]). acupoint injection(MD:4.81, 95%CI[2.99, 6.63]) and moxibustion(MD: 6.99, 95%CI[3.62, 10.36]) were significantly beneficial in improving LVEF. Network meta-analyses showed that acupoint injection(SUCRA = 70.0%) and acupuncture(SUCRA = 90.4%) respectively had the greatest probability in improving HFC and LVEF.Conclusion: Most of the included ARTs add-on to CT was effective in improving HFC and LVEF. Acupoint injection and acupuncture may respectively have better effect than others for HFC and LVEF. However,due to the small sample size and poor quality of the included studies, hence well-designed RCTs are needed to confirm our findings.This study was registered in PROSPERO, CRD42018087700.
