镇肝熄风汤治疗原发性高血压临床疗效的系统评价  

Efficacy of Zhengan Xifeng Decoction Treating Essential Hypertension: a Systematic Review

作　　者：鞠建庆[1] 李运伦[1,2] 沈真真[1] 丁学义[1] 

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院高血压国家中医临床研究基地,山东济南250011

出　　处：《中国中医急症》2014年第6期1060-1063,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：山东省高等学校科技计划项目(No:J12LK10)

摘　　要：目的系统评价镇肝熄风汤治疗原发性高血压的临床疗效。方法搜集镇肝熄风汤治疗原发性高血压的随机对照试验文献,按照Cochrane系统评价手册推荐的方法评估纳入研究的偏倚风险,运用RevMan5.2.8软件完成异质性检验、Meta分析、敏感性分析、倒漏斗图分析等相关统计分析。结果共纳入8项合格研究,共计714例患者,纳入研究均存在较高的方法学偏倚风险。Meta分析结果显示,镇肝熄风汤可降低原发性高血压患者的收缩压(WMD=4.76,95%CI[3.35,6.17]),改善临床症状(RR=1.19,95%CI[1.08,1.33]),且结果稳定性较好;镇肝熄风汤未提高降压总有效率(RR=1.07,95%CI[0.98,1.16]),未能有效降低舒张压(WMD=1.51,95%CI[-0.20,3.23]),但结果不稳定;倒漏斗图分析显示不对称。结论现有证据表明镇肝熄风汤可部分提高降压疗效,改善患者临床症状,小样本、异质性和高偏倚风险的原始研究影响了结果的可靠性,有必要开展样本量充足、设计合理、执行严格的临床试验进一步评价。Objective：To systematically assess clinical efficacy of Zhengan Xifeng decoction treating essential hypertension.Methods：Randomized controlled trials of Zhengan Xifeng decoction treating hypertension were selected.The risk of bias of included trials was assessed according to criteria recommended by Cochrane handbook for systematic reviews of interventions.Statistical analyses such as heterogeneity analysis,meta-analysis,sensitivity analysis and funnel plot analysis were performed by Review Manager 5.2.8 software.Results：8 qualified trials involving 714 participants were included and the risk of bias of these trials was high.Meta-analysis indicated that Zhengan Xifeng decoction can lower systolic blood pressure （WMD=4.76,95％CI [3.35,6.17]） and improve symptom of hypertension （RR=1.19,95％CI[1.08,1.33]）.But Zhengan Xifeng decoction cannot improve the total effective rate of antihypertension （RR=1.07,95％CI [0.98,1.16]）and lower diastolic blood pressure （WMD=1.51,95％CI[-0.20,3.23]）.But results were not stable：funnel plot showed asymmetry.Conclusion：Current evidence indicates that Zhengan Xifeng decoction can partially enhance antihypertensive efficacy and improve symptom of hypertension.The reliability of the results is affected by small sample,heterogeneity and high risk clinical trials.Clinical trials with adequate samples,rational design and strict execution shall be carried out to provide more reliable evidence.

关 键 词：镇肝熄风汤 原发性高血压 系统评价 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]