摘要
目的:系统评价脑心通胶囊治疗慢性心力衰竭的临床有效性和安全性。方法:计算机检索中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、The Cochrane Library等数据库,收集脑心通胶囊辅助治疗慢性心力衰竭相关的随机对照试验(RCT),检索日期截止于2019年7月。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件对数据进行Meta分析。结果:共纳入11项随机对照试验,涉及1467例患者。与心衰常规治疗相比,常规治疗加用脑心通胶囊能提高心功能疗效(RR=1.26,95%CI:1.18~1.35,P<0.00001),提高左室射血分数(LVEF)(MD=8.22,95%CI:6.51~9.94,P<0.00001),降低B型利钠肽(BNP)(SMD=-1.58,95%CI:-1.86^-1.31,P<0.00001);缩小左室舒张末期内径(LVEDd)(MD=-5.69,95%CI:-6.54^-4.84,P<0.00001);降低左室质量指数(LVMI)(MD=-7.29,95%CI:-12.86^-1.72,P=0.01);改善生活质量(MD=-10.17,95%CI:-13.53^-6.80,P<0.00001)。安全性方面,加用脑心通胶囊治疗未增加不良反应发生率,且无严重心脑血管事件发生。结论:在当前证据下,常规治疗基础上加用脑心通胶囊能进一步提高慢性心力衰竭的心功能,延缓心室重构,改善生活质量,对临床有一定的指导作用,且安全性较好。但由于纳入文献质量不高且数量较少,还需更多高质量的研究进一步证实其疗效。
Objective:To systematically evaluate the clinical efficacy and safety of Naoxintong capsule in the treatment of chronic heart failure.Methods:Databases such as CNKI,WanFang,VIP,CBM,PubMed and the Cochrane Library were searched to collect the randomized controlled trials(RCT)of Naoxintong capsules in the treatment of chronic heart failure.The retrieval date was up to July 2019.The literature was screened and extracted by two researchers independently,then the risk of bias was assessed when data included in studies,Meta analysis was performed by RevMan 5.3 software.Results:A total of 11 randomized controlled trials involving 1467 patients were included.Compared with the routine treatment for heart failure,the routine treatment with Naoxintong capsule improved the efficacy of cardiac function(RR=1.26,95%CI:1.18~1.35,P<0.00001),it increased left ventricular ejection fraction(LVEF)(MD=8.22,95%CI:6.51~9.94,P<0.00001),,and reduced B-type natriuretic peptide(BNP)(SMD=-1.58,95%CI:-1.86^-1.31,P<0.00001).Also it reduced left ventricular end diastolic diameter(LVEDd)(MD=-5.69,95%CI:-6.54^-4.84,P<0.00001).It decreased lower left ventricular mass index(LVMI)(MD=-7.29,95%CI:-12.86^-1.72,P=0.01),and improved the quality of life(MD=-10.17,95%CI:-13.53^-6.80,P<0.00001).In terms of safety,the addition of Naoxintong capsule did not increase the incidence of adverse reactions,and no serious cardiovascular and cerebrovascular events occurred.Conclusion:Under the current evidence,Naoxintong capsule combined with the routine treatment can further improve the cardiac function of patients with chronic heart failure,delay ventricular remodeling and improve the quality of life.It has a certain clinical guiding effect with better safety.However,due to the low quality and quantity of the included literatures,more high-quality studies are needed to further confirm its efficacy.
作者
彭广操
朱明军
王建茹
李彬
王永霞
王新陆
于瑞
Peng Guangcao;Zhu Mingjun;Wang Jianru;Li Bin;Wang Yongxia;Wang Xinlu;Yu Rui(Department of Cardiology,The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan Zhengzhou 450000)
出处
《中药药理与临床》
CAS
CSCD
北大核心
2020年第2期221-226,共6页
Pharmacology and Clinics of Chinese Materia Medica
基金
国家重点研发计划(编号:2019YFC1710000、2019YFC1710001、2019YFC1710003)
河南省创新型科技团队(编号:C20130050)
河南省高校科技创新团队支持计划(编号:13IRTSTHN012)。
关键词
脑心通胶囊
慢性心力衰竭
系统评价
Naoxintong capsule
Chronic heart failure
System evaluation
