复方丹参滴丸联合常规降压治疗高血压病左心室肥厚临床疗效和安全性的Meta分析  

Meta-analysis of clinical efficacy and safety of Compound Danshen Dripping Pills combined with conventional antihypertensive drugs in treatment of hypertensive left ventricular hypertrophy

作　　者：陈哲 彭莹莹 杨丰文[1,2] 胡海殷 刘春香 张俊华[1,2] CHEN Zhe;PENG Ying-ying;YANG Feng-wen;HU Hai-yin;LIU Chun-xiang;ZHANG Jun-hua(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Evidence-based Medicine Center,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China)

机构地区：[1]天津中医药大学,天津301617 [2]天津中医药大学循证医学中心,天津301617 [3]天津中医药大学第一附属医院,天津300381

出　　处：《中国中药杂志》2021年第10期2578-2587,共10页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(81804218);。

摘　　要：系统性评价复方丹参滴丸联合常规降压治疗高血压病左心室肥厚的临床疗效和安全性。计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、PubMed、EMbase、Cochrane Library、Ovid和Web of Science数据库。检索复方丹参滴丸联合常规降压治疗高血压病左心室肥厚的随机对照试验(RCT)。检索时间从建库至2020年7月。2名研究人员进行数据检索、数据提取与偏倚风险评价后,使用RevMan 5.3软件进行Meta分析。共纳入10篇RCTs文献,979例患者。Meta分析结果显示,复方丹参滴丸联合常规降压治疗在室间隔厚度(MD=-0.70, 95%CI[-1.15,-0.24],P=0.003)、左心室后壁厚度(MD=-0.81, 95%CI[-1.41,-0.21],P=0.008)、左心室重量指数(MD=-8.75, 95%CI[-17.40,-0.10],P=0.05)、收缩压(MD=-8.97, 95%CI[-13.46,-4.48],P<0.000 1)、舒张压(MD=-5.87, 95%CI[-8.39,-3.34],P<0.000 01)和左心室舒张末期内径(MD=-1.73, 95%CI[-2.38,-1.08],P<0.000 01)等方面优于常规降压治疗,差异有统计学意义,而左心室射血分数组间无统计学差异(MD=0.41,95%CI[-0.74,1.55],P=0.49)。安全性方面由于纳入文献较少,无法给出准确性定论。GRADE评分结果显示,证据等级为低和极低等级。结果表明,复方丹参滴丸联合西医常规降压治疗可能在一定程度上改善高血压病心室肥厚的临床疗效,安全性方面还需进一步探究。由于纳入的文献质量较低,还需要开展更多高质量的随机对照试验进行验证。To systematically evaluate the clinical efficacy and safety of Compound Danshen Dripping Pills combined with conventional antihypertensive drugs in the treatment of hypertensive left ventricular hypertrophy. China National Knowledge Infrastructure(CNKI), Wanfang, VIP, PubMed, EMbase, Cochrane Library, Ovid and Web of Science databases were searched by computer to retrieve the randomized controlled trials(RCTs) of Compound Danshen Dripping Pills combined with conventional antihypertensive drugs in the treatment of hypertensive left ventricular hypertrophy from the establishment of databases to July 2020. After two researchers performed data retrieval, data extraction, and risk assessment of bias, they used RevMan 5.3 software for Meta-analysis. A total of 10 RCTs were included, with a total of 979 patients. Meta-analysis results showed that in terms of interventricular septal thickness(MD=-0.70, 95%CI[-1.15,-0.24], P=0.003), left ventricular posterior wall thickness(MD=-0.81, 95%CI[-1.41,-0.21], P=0.008), left ventricular mass index(MD=-8.75, 95%CI[-17.40,-0.10], P=0.05), systolic blood pressure(MD=-8.97, 95%CI[-13.46,-4.48], P<0.000 1), diastolic blood pressure(MD=-5.87, 95%CI[-8.39,-3.34], P<0.000 01) and left ventricular end-diastolic diameter(MD=-1.73, 95%CI[-2.38,-1.08], P<0.000 01), Compound Danshen Dripping Pills combined with conventional antihypertensive drugs was superior to conventional antihypertensive drugs. In terms of left ventricular ejection fraction(MD=0.41, 95%CI[-0.74, 1.55], P=0.49), there was no statistical difference in treatment between the two groups. Because of the small amount of literatures included in the safety aspect, it is impossible to give an accurate conclusion. The GRADE score showed that the level of evidence was low and extremely low. The results show that the Compound Danshen Dripping Pills combined with conventional antihypertensive drugs may effectively improve the clinical efficacy for hypertensive ventricular hypertrophy, and the safety needs to be further explored. Due t

关 键 词：复方丹参滴丸 高血压病左心室肥厚 系统评价 META分析 疗效 安全性 

分 类 号：R544.1[医药卫生—心血管疾病]