文献类型：期刊文献

中文题名：益气养阴类中成药治疗慢性心力衰竭的网状Meta分析

英文题名：Network Meta-Analysis of Yiqiyangyin(益气养阴)Chinese Patent Medicine Treating on Chronic Heart Failure

作者：任鹏[1,2];韩艳萍[1,2];王薇[1,2];赵信科[1,2];刘凯[1,2]

第一作者：任鹏

机构：[1]甘肃中医药大学,兰州730000;[2]甘肃中医药大学循证医学中心,兰州730000

第一机构：甘肃中医药大学

年份：2023

卷号：39

期号：12

起止页码：95

中文期刊名：中药药理与临床

外文期刊名：Pharmacology and Clinics of Chinese Materia Medica

收录：北大核心:【北大核心2020】；CSCD:【CSCD2023_2024】；

基金：甘肃省“双一流”科研重点项目(编号:GSSYLXM-05);甘肃省中医药综合防治重大疑难疾病技术攻关项目(编号:GZKZD-2018-02);甘肃省高等学校创新基金项目(编号:2022CX45)。

语种：中文

中文关键词：中成药;慢性心力衰竭;网状Meta分析

外文关键词：Chinese patent medicine;Chronic heart failure;Network Meta-Analysis

摘要：目的:系统评价益气养阴类中成药治疗慢性心力衰竭的疗效和安全性。方法:计算机检索PubMed、The Cochrane Library、EMbase、Web of Science、WanFang Data、VIP、CNKI和CBM数据库,搜集建库至2022年1月30日所发表的中成药治疗慢性心力衰竭的随机对照试验(RCT),采用RevMan 5.3、Stata 15.0软件进行数据统计分析。结果:最终纳入200项RCT,包括19535例患者。试验组共涉及8种益气养阴类中成药,分别为参松养心胶囊、心悦胶囊、补益强心片、灯盏生脉胶囊、生脉饮、稳心颗粒、振源胶囊及益心舒胶囊。网状Meta分析疗效排序结果显示:①心功能改善有效率方面,累计概率排名曲线下面积(SUCRA)累计概率排序为心悦胶囊>灯盏生脉胶囊>补益强心片>稳心颗粒>益心舒胶囊>振源胶囊>参松养心胶囊>生脉饮;②提高左室射血分数(LVEF)方面,SUCRA累计概率排序为振源胶囊>生脉饮>心悦胶囊>灯盏生脉胶囊>稳心颗粒>补益强心片>参松养心胶囊>益心舒胶囊;③增加6 min步行试验(6 MWT)方面,SUCRA累计概率排序为稳心颗粒>参松养心胶囊>灯盏生脉胶囊>振源胶囊>益心舒胶囊>补益强心片>心悦胶囊;④降低超敏C-反应蛋白(hs-CRP)方面,SUCRA累计概率排序为参松养心胶囊>益心舒胶囊>振源胶囊>稳心颗粒>灯盏生脉胶囊;⑤降低脑钠肽(BNP)方面,SUCRA累计概率排序为:补益强心片>稳心颗粒>心悦胶囊>益心舒胶囊>生脉饮>灯盏生脉胶囊>振源胶囊>参松养心胶囊;⑥改善明尼苏达心力衰竭生活质量量表(mLHFQ)评分方面,SUCRA累计概率排序为:补益强心片>稳心颗粒>参松养心胶囊>振源胶囊>益心舒胶囊。安全性方面,试验组不良反应发生事件少于对照组。结论:在西医常规治疗的基础上,联合中成药治疗可提高慢性心力衰竭的临床效果。但鉴于不同治疗措施间纳入的质量、研究数量存在较大差异,中成药的SUCRA累计概率排序还有待今后开展高质量的多中心、大样本、随机双盲试验加以佐证。
Objective:To systematically evaluate the efficacy and safety of Yiqiyangyin(益气养阴)Chinese patent medicines in the treatment of chronic heart failure.Methods:Randomized controlled trials(RCTs)of Yiqiyangyin Chinese patent medicines in the treatment of chronic heart failure were collected by computer retrieval from PubMed,The Cochrane Library,EMbase,Web of Science,Wan Fang,CNKI,VIP,and CBM databases,from inception to January 30,2022.The resulting index data were analyzed by RevMan 5.3 and Stata 15.0.Results:A total of 200 RCTs were finally included,including 19535 patients.The experimental group consisted of 8 kinds of Yiqiyangyin Chinese patent medicines,including Shensong Yangxin Capsules(参松养心胶囊),Xinyue Capsules(心悦胶囊),Buyi Qiangxin Tablets(补益强心片),Dengzhan Shengmai Capsules(灯盏生脉胶囊),Shengmai Decoction(生脉饮),Wenxin Granules(稳心颗粒),Zhenyuan Capsules(振源胶囊),and Yixinshu Capsules(益心舒胶囊).The efficacy ranking results of the network Meta-analysis were as follows.①In terms of improving cardiac function,the cumulative probability ranking of the surface under the cumulative ranking area(SUCRA)was Xinyue Capsules>Dengzhan Shengmai Capsules>Buyi Qiangxin Tablets>Wenxin Granules>Yixinshu Capsules>Zhenyuan Capsules>Shensong Yangxin Capsules>Shengmai Decoction.②In terms of improving left ventricular ejection fraction(LVEF),the cumulative probability ranking of SUCRA was Zhenyuan Capsules>Shengmai Decoction>Xinyue Capsules>Dengzhan Shengmai Capsules>Wenxin Granules>Buyi Qiangxin Tablets>Shensong Yangxin Capsules>Yixinshu capsules.③In terms of increasing the 6-min walking test(6MWT),the cumulative probability ranking of SUCRA was Wenxin Granules>Shensong Yangxin Capsules>Dengzhan Shengmai Capsules>Zhenyuan Capsules>Yixinshu Capsules>Buyi Qiangxin Tablets>Xinyue Capsules.④In terms of reducing hypersensitivity C-reaction protein(hs-CRP),the cumulative probability ranking of SUCRA was Shensong Yangxin Capsules>Yixinshu Capsules>Zhenyuan Capsules>Wenxin Granules>Dengzhan Shengmai Capsules.⑤In terms of decreasing brain natriuretic peptide(BNP),the cumulative probability ranking of SUCRA was Buyiqiangxin Tablets>Wenxin Granules>Xinyue Capsules>Yixinshu Capsules>Shengmai Decoction>Dengzhan Shengmai Capsules>Zhenyuan Capsules>Shensong Yangxin Capsules.⑥In terms of improving the Minnesota Quality of Life Score(MLHFQ),the cumulative probability ranking of SUCRA was Buyi Qiangxin Tablets>Wenxin Granules>Shensong Yangxin Capsules>Zhenyuan Capsules>Yixinshu Capsules.In terms of safety,the incidence of adverse reactions in the treatment group was less than that in the control group.Conclusion:Based on conventional western medicine treatment,the treatment with Chinese patent medicine can improve the clinical effect of chronic heart failure.However,given the great differences in the quality and number of studies included among different therapeutic measures,the cumulative probability ranking of SUCRA of Chinese patent medicine needs to be further verified by high-quality randomized doubleblind trials with multiple centers and large samples.