文献类型：期刊文献

中文题名：真武汤合桂枝茯苓丸加减联合常规药物治疗慢性心力衰竭有效性的Meta分析

英文题名：A Meta-analysis of the efficacy of the Zhenwu decoction plus Guizhi Fuling Wan plus conventional drugs on chronic heart failure

作者：李倩蓉[1];支晓东[1];卢维杰[1];张晓刚[1];李应东[1]

第一作者：李倩蓉

机构：[1]甘肃中医药大学,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2024

卷号：16

期号：2

起止页码：61

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：甘肃省“双一流”科研重点项目(GSSYLXM-05);甘肃省中医药防治重大疾病科研项目(GZKZD-2018-02);中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者项目。

语种：中文

中文关键词：真武汤合桂枝茯苓丸;慢性心力衰竭;系统评价;Meta分析;随机对照试验

外文关键词：The Zhenwu decoction and Guizhi Fuling Wan;Chronic heart failure;Systematic review;Meta-analysis;Randomized controlled trial

摘要：目的:对真武汤合桂枝茯苓丸加减联合常规药物治疗慢性心力衰竭的有效性进行系统评价。方法:系统检索中国知网、万方医学、维普、中国生物医学文献数据库、Pub Med、Cochrane Library、Web of Science、Embase数据库,收集真武汤合桂枝茯苓丸加减治疗慢性心力衰竭的随机对照试验,搜索至2022年11月6日在库文章。由独立的2名研究者进行文献资料的筛选、资料的提取、评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果:7项纳入的随机对照试验,总样本量684例,其中试验组344例,对照组340例。Meta分析显示结果,治疗后试验组患者的临床综合疗效明显高于对照组,差异有统计学意义[比值比(OR)=4.77,95%置信区间(CI)(2.97,7.67),P<0.00001],降低血清B型脑钠肽水平[均数差(MD)=-70.90,95%CI(-122.89,-18.92),P=0.008]和血清N末端脑钠肽水平[MD=-0.66,95%CI(-1.27,-0.05),P=0.03],升高左心室射血分数[MD=4.64,95%CI(3.19,6.09),P<0.00001],降低左心室舒张末期内径[MD=-3.49,95%CI(-4.10,-2.88),P<0.00001],减少肿瘤坏死因子-α[MD=-4.05,95%CI(-6.18,-1.91),P=0.0002]和超敏C反应蛋白[MD=-2.23,95%CI(-2.99,-1.47),P<0.00001]。结论:当前证据显示,真武汤合桂枝茯苓丸联合常规药物治疗慢性心力衰竭具有较好的疗效,可以提高心功能,改善预后,效果优于单纯应用西药治疗。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
Objective:To evaluate the efficacy of the Zhenwu decoction(真武汤)and Guizhi Fuling Wan(桂枝茯苓丸)combined with conventional drugs on chronic heart failure.Methods:The databases of CNKI,Wanfang Data,VIP,CBM,PubMed,Cochrane Library,Web of Science,Embase were searched systematically,to collect the clinical RCTs of the Zhenwu decoction and Guizhi Fuling Wan on chronic heart failure.Related articles from the database inception to November 6,2022 were searched.A Meta-O analysis was carried out by RevMan 5.3 software after two independent researchers screened the literature,extracted the data and evaluated the risk of bias.Results:The total sample size of 7 included RCTs were 684 cases,including 344 cases in the experimental group and 340 cases in the control group.A Meta analysis showed that the clinical comprehensive effect in the experimental group was significantly higher than that in the control group after treatment,and the difference was statistically significant[OR=4.77,95%CI(2.97,7.67),P<0.00001].he level of serum BNP was decreased[MD=-70.90,95%CI(-122.89,-18.92),P=0.008].The serum NT-proBNP was decreased[MD=-0.66,95%CI(-1.27,-0.05),P<0.03].LVEF was elevated[MD=4.64,95%CI(3.19,6.09),P<0.00001].LVEDD was decreased[MD=-3.49,95%CI(-4.10,-2.88),P<0.00001].TNF-αwas reduced[MD=-4.05,95%CI(-6.18,-1.91),P=0.0002].The hs-CRP was reduced[MD=-2.23,95%CI(-2.99,-1.47),P<0.00001].Conclusion:The present evidence shows that the Zhenwu decoction plus Guizhi Fuling Wan combined with conventional medicine has a better therapeutic effect on chronic heart failure,which can improve cardiac function and prognosis,and the effect is better than that of western medicine alone.Due to the limitation of the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.