益气养阴法辅助治疗扩张型心肌病有效性的系统评价  

Systematic Review on Efficacy of Yiqi Yangyin Method in Adjuvant Treatment of Dilated Cardiomyopathy

作　　者：史海波[1] 程嵩奕 杨莉 刘晴晴[2] 俞鹏[1] 陈晓虎[1] SHI Haibo;CHENG Songyi;YANG Li;LIU Qingqing;YU Peng;CHEN Xiaohu(Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing 210029 ,Jiangsu, China;Nanjing University of Chinese Medicine, Nanjing 210023 ,Jiangsu, China;Daguang Road Community Health Service Center of Qinhuai District, Nanjing 210001, Jiangsu, China)

机构地区：[1]江苏省中医院,江苏南京210029 [2]南京中医药大学,江苏南京210023 [3]秦淮区大光路社区卫生服务中心,江苏南京210001

出　　处：《辽宁中医杂志》2018年第5期920-925,共6页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81573908);江苏省中医药管理局(YB2015011);江苏省科技厅项目(BK20171099)

摘　　要：目的：评价益气养阴法辅助治疗扩张型心肌病的临床疗效。方法：计算机检索Pubmed数据库、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献光盘数据库、中文科技期刊全文数据库等文献数据库,辅以手工检索,搜索扩张型心肌病（dilated cardiomyopathy,DCM）标准治疗加益气养阴类中药与单纯标准治疗扩张型心肌病的随机对照试验（RCT）,按照Cochrane协作网和隐蔽分组相关方法评价纳入文献质量和提取有效数据,采用Rev Man 5.3软件进行Meta分析。结果：纳入28篇随机对照试验,共2121位临床诊断为DCM患者,Meta分析提示：益气养阴类中药与标准治疗联用可以显著提高DCM的临床综合疗效[RR=1.31,95%CI（1.25,1.38）,P〈0.00001],增加左室射血分数（LVEF）[MD=5.41,95%CI（3.87,6.96）,P〈0.00001],缩小左室舒张末期内径（LVIDd）[MD=-4.03,95%CI（-6.04,-2.01）,P〈0.00001],降低血浆NT-pro BNP的表达[MD=-146.16,95%CI（-203.30,-89.02）,P〈0.00001]以及增加6 min步行距离（6MWT）[MD=37.63,95%CI：（19.29,55.98）,P〈0.00001]。结论：益气养阴法作为DCM标准治疗的辅助方法,在改善DCM的临床症状、心功能指标、相关实验室检查指标及运动耐量等方面优于单纯标准治疗。Objective： To evaluate the assistant effect of Yiqi Yangyin method in treating dilated cardiomyopathy. Methods： The databases of Pubmed,Cochrane library,CNKI,CBM and VIP were retrieved for collecting the randomized-controlled trails（RCT） about treatment of dilated cardiomyopathy（DCM） with Yiqi Yangyin method and standard treatment. We evaluated the quality of the literature and extracted the valid data according to the Cochrane collaboration network and the hidden grouping,and then a Meta-analysis was conducted with Rev Man5. 3 software. Results： There were totally 28 RCTs included involving 2121 subjects. The results of Meta-analysis showed that the combination of Yiqi Yangyin method and standard therapy can significantly improve the clinical efficacy of DCM[RR = 1. 31,95% CI（1. 25,1. 38）,P〈0. 00001],increase left ventricular ejection fraction（LVEF） [RR = 5. 41,95% CI（3. 87,6. 96）,P〈0. 00001],reduce left ventricular end diastolic diameter（LVIDd） [RR =-4. 03,95% CI（-6. 04,-2. 01）,P〈0. 00001],downregulate the expression of plasma NT-pro BNP[RR =-146. 16,95% CI（-203. 30,-89. 02）,P〈0. 00001] and increase 6-minute walking distance（6 MWT） [RR = 37. 63,95% CI（19. 29,55.98）,P〈0. 00001]. Conclusion： As an adjunctive method of DCM standard therapy,Yiqi Yangyin method is superior to standard treatment in improving the clinical symptoms,cardiac function indexes,related laboratory test indexes and exercise tolerance of DCM.

关 键 词：益气养阴法 扩张型心肌病 系统评价 

分 类 号：R542.2[医药卫生—心血管疾病]