缬沙坦单用与联合用药治疗原发性高血压有效性和安全性的Meta分析  

Efficacy and Safety of Valsartan Alone or Combined Therapy in the Treatment of Essential Hypertension:A Meta-analysis

作　　者：杨玉[1] 黄璞[1] 于丽秀[1] 陈东生[1] 华小黎[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院药学部,武汉430022

出　　处：《华中科技大学学报（医学版）》2015年第6期725-730,736,共7页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家"十二五"科技支撑计划资助项目(No.2013BAI06B04)

摘　　要：目的评价缬沙坦单用与联合用药治疗原发性高血压的有效性与安全性。方法计算机检索Cochrane图书馆的Cochrane对照试验注册数据库(2015年第2期)、CBM、Medline、Embase、PubMed、CNKI、VIP、万方数据资源(截至2015年6月)。由2名评价者按Cochrane协作网推荐的简单评价法独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan 5.3.5软件进行Meta分析。结果共纳入21个随机对照试验,包括8 743例患者。Meta分析结果显示:缬沙坦单药治疗原发性高血压的有效率优于对照组,治疗后收缩压、舒张压及不良反应发生率无统计学差异;缬沙坦联合用药治疗后收缩压、舒张压及不良反应发生率明显优于缬沙坦单药治疗,差异有统计学意义。结论缬沙坦联合1种或1种以上的降压药治疗原发性高血压可能更安全有效,推荐临床在治疗原发性高血压时采用联合用药。Objective To evaluate the clinical efficacy and safety of valsartan alone or combined therapy in the treatment of essential hypertension.Methods The CENTRAL,CBM,Medline,Embase,PubMed,CNKI,VIP and Wanfang data were searched for RCTs published until June 2015 on valsartan monotherapy or combination therapy for the treatment of essential hypertension.Two reviewers independently retrieved RCTs based on inclusion and exclusion criteria,assessed the quality of included trials,and extracted relevant data.The data were analyzed by using RevMan 5.3.5software package.Results A total of21 RCTs,including 8 743 patients,were finally included.Meta-analysis results showed that the efficacy of valsartan monotherapy was superior to that in control group.There were no significant differences in the systolic blood pressure,diastolic blood pressure and the incidence of adverse side effects between valsartan monotherapy group and control group.However,the improvement in the systolic blood pressure,diastolic blood pressure and the incidence of adverse side effects were better in valsartan combination group than in valsartan monotherapy group and there was a statistically significant difference（P0.05）.Conclusion Valsartan combined with one or more antihypertensive drugs is more safe and effective than valsartan monotherapy in the treatment of essential hypertension.Valsartan combination administration is recommended to treat essential hypertension in clinical practice.

关 键 词：缬沙坦 联合用药 原发性高血压 随机对照试验 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]