中医药辅助治疗难治性高血压病临床疗效的Meta分析  

Meta-analysis for clinical efficacy of traditional Chinese medicine in treating resistant hypertension

作　　者：王梦玺 吴晨洁 曹培华 陈晓虎[1] WANG Meng-xi;WU Chen-jie;CAO Pei-hua;CHEN Xiao-hu(Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Province Hospital of Chinese Medicine),Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院),江苏南京210029

出　　处：《中国中药杂志》2021年第3期685-693,共9页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(81973824);国家中医药管理局中医药循证能力建设项目(2019XZZX-XXG004)。

摘　　要：为系统评价中医药疗法对难治性高血压病患者的疗效及安全性,使用计算机检索中国知网、万方、维普、CBM、PubMed、Web of Science、Cochrane Library、EMbase等数据库,筛选出应用中医药疗法辅助治疗难治性高血压病的随机对照试验,采用Cochrane Handbook评价标准对纳入文献进行质量评价,运用RevMan 5.3和Stata 12.0软件进行Meta分析。最终纳入符合标准的文献11篇,包含1023例患者,Meta分析结果显示,在标准三联降压方案基础上,联合使用中医药疗法能进一步降低难治性高血压病患者的收缩压(MD=-16.69,95%CI[-22.21,-11.16],P<0.00001)、降低舒张压(MD=-7.51,95%CI[-8.26,-6.76],P<0.00001)、提高降压有效率(OR=5.16,95%CI[3.01,8.84],P<0.00001)、提高血压达标率(OR=3.01,95%CI[1.49,6.09],P=0.002)、提高临床症状有效率(OR=4.48,95%CI[2.31,8.68],P<0.00001),但对血肌酐水平无显著影响(MD=-2.51,95%CI[-6.91,1.89],P=0.26)。结果表明,在标准三联降压方案基础上联用中医药疗法可以进一步改善难治性高血压病患者的临床疗效且具有良好的安全性,但仍需更多高质量的临床研究加以验证。To systematically evaluate the efficacy and safety of traditional Chinese medicine in treating patients with resistant hypertension.CNKI,Wanfang,VIP,CBM,PubMed,Web of Science,Cochrane Library,EMbase and other databases were retrieved by computers to screen out the randomized controlled trial of traditional Chinese medicine in treating resistant hypertension.Cochrane Handbook was used to evaluate the quality of the included literature,RevMan 5.3 and Stata 12.0 was used for Meta-analysis.Finally,11 literatures meeting the criteria were included,involving 1023 patients.The results of Meta-analysis showed that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further reduce systolic blood pressure of patients with resistant hypertension(MD=-16.69,95%CI[-22.21,-11.16],P<0.00001),reduce diastolic blood pressure(MD=-7.51,95%CI[-8.26,-6.76],P<0.00001),improve the effective rate of anti-hypertension(OR=5.16,95%CI[3.01,8.84],P<0.00001),improve the up-to-standard rate of blood pressure(OR=3.01,95%CI[1.49,6.09],P=0.002),and improve the effectiveness of clinical symptoms(OR=4.48,95%CI[2.31,8.68],P<0.00001),with no significant effect on creatinine level(MD=-2.51,95%CI[-6.91,1.89],P=0.26).The results of this study indicated that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further improve the clinical efficacy in patients with resistant hypertension with a good safety,but more high-quality clinical studies are still needed to verify this conclusion.

关 键 词：中医药 难治性高血压病 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]