摘要
目的对苓桂术甘汤加减联合常规西药治疗慢性心力衰竭的临床疗效进行系统评价。方法计算机检索中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库(WANFANG DATE)、中国生物医学文献数据库(CBM)、PubMed数据库和Cochrane图书馆,所有数据库检索时限均为建库至2018年3月31日,以苓桂术甘汤加减联合常规西药治疗慢性心力衰竭的随机对照试验为研究对象,对照组采用西药常规治疗,治疗组在对照组基础上加用苓桂术甘汤加减,并对纳入文献进行质量评价和资料提取,采用RevMan 5. 3软件进行数据分析。结果共纳入8项研究,834例患者。Meta分析结果显示:治疗组临床有效率优于对照组[RR=1. 18,95%CI (1. 11,1. 25),P <0. 00001];治疗组提高患者左室射血分数优于对照组[MD=8. 38,95%CI (2. 65,14. 11),P=0. 004];治疗组减少患者左室舒张末内径优于对照组[MD=-6. 82,95%CI (-12. 52,-1. 11),P=0. 02];治疗组降低患者血清N末端脑钠肽(NT-proBNP)血清水平优于对照组[SMD=-3. 53,95%CI (-5. 31,-1. 74),P <0. 001];治疗组增加患者6分钟步行距离效果优于对照组[MD=56. 87,95%CI (25. 18,88. 55),P=0. 0004]。证据等级显示,总有效率、血清NT-proBNP水平和患者6分钟步行距离为极低级,左室射血分数和左室舒张末内径为低级,推荐强度均为弱推荐。结论苓桂术甘汤加减联合常规西药治疗慢性心力衰竭可明显提高患者临床有效率和左室射血分数,减小左室舒张末期内径,降低血清NT-proBNP水平,增加患者的6分钟步行试验距离。
Objective To systematically evaluate the clinical effects of Modified Linggui Zhugan Decoction(苓桂术甘汤)in the treatment of chronic heart failure(CHF).Methods The Chinese National Knowledge Infrastructure(CNKI),VIP Database,WANFANG Database,China Biology Medicine(CBM),PubMed and Cochrane library were searched for randomized controlled trials of Modified Linggui Zhugan Decoction in the treatment of CHF by computers,with retrieval time from database establishment to March 31,2018.The control group was treated with routine western medicine,while the treatment group was additionally treated with modified Linggui Zhugan Decoction.The quality evaluation and data extraction were conducted to included literature.The RevMan 5.3 software was used for data analysis.Results A total of 8 studies were included with 834 cases.Meta-analysis showed that the clinical effective rate of the treatment group was better than the control[RR=1.18,95%CI(1.11,1.25),P<0.00001].The treatment group improved left ventricular ejection fraction(LVEF),which was better than the control group[MD=8.38,95%CI(2.65,14.11),P=0.004].The treatment group reduced the left ventricular end-diastolic dimension(LVEDD),which was better than that of the control group[MD=-6.82,95%CI(-12.52,-1.11),P=0.02].The treatment group reduced the serum NT-proBNP level,which was better than that of the control group[SMD=-3.53,95%CI(-5.31,-1.74),P<0.0001].The effect of the treatment group on increasing CHF patients’6 minutes walking distance was better than that of the control group[MD=56.87,95%CI(25.18,88.55),P=0.0004].The grade of evidence showed that the total effective rate,the serum NT-proBNP level and the 6 minute walk distance were extremely low,and LVEF and LVEDD were low.The recommended intensity was weak recommendation.Conclusion Modified Linggui Zhugan Decoction combined with conventional western medicine in the treatment of chronic heart failure can significantly improve the clinical effective rate and LVEF,reduced LVEDD and serum NT-proBNP level,increase
作者
张洪源
刘悦
王洋
刘光辉
张哲
杨关林
ZHANG Hongyuan;LIU Yue;WANG Yang;LIU Guanghui;ZHANG Zhe;YANG Guanlin(Liaoning University of Traditional Chinese Medicine,Shenyang 110032;The Affiliated Hospital of Liaoning Univereity of TraditionalChinese Medicine)
出处
《中医杂志》
CSCD
北大核心
2019年第6期492-496,共5页
Journal of Traditional Chinese Medicine
基金
国家重点基础研究发展计划("973"项目)(2013CB531704)
关键词
慢性心力衰竭
苓桂术甘汤
随机对照试验
META分析
chronic heart failure
Linggui Zhugan Decoction(苓桂术甘汤)
randomized controlled trials
Metaanalysis
