半夏白术天麻汤联合血府逐瘀汤治疗高血压合并高脂血症临床疗效的Meta分析  

Clinical Effects of Banchsia Baizhu Tianma Decoction Combined with Xuefu Zhuyu Decoction in the Treatment of Hypertension Complicated with Hyperlipidemia:a Meta-analysis

作　　者：刘逸南 雷燕[1] 杨静[1] 修成奎[1] 王雪[1] 胡艳红 刘奕清 吴丹 吴烨 LIU Yinan;LEI Yan;YANG Jing;XIU Chengkui;WANG Xue;HU Yanhong;LIU Yiqing;WU Dan;WU Ye(Experimental Research Center,China Academy of Chinese Medical Sciences,Beijing Key Laboratory of Basic Research on Prevention and Treatment of Major Diseases by Traditional Chinese Medicine,Beijing 100700,China)

机构地区：[1]中国中医科学院医学实验中心,北京市中医药防治重大疾病基础研究重点实验室,北京100700

出　　处：《中西医结合心脑血管病杂志》2021年第15期2481-2488,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金面上项目(No.81673822);中国中医科学院自主选题项目(No.ZZ2019012)。

摘　　要：目的系统评价半夏白术天麻汤联合血府逐瘀汤(BX+XF)治疗高血压合并高脂血症(HTN-HLP)的临床疗效。方法检索PubMed、The Cochrane Library、EMbase、中国知网等8个数据库,收集从建库至2020年4月6日BX+XF治疗HTN-HLP的随机对照试验(RCT)。以临床总有效率、中医证候积分、血压、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及不良反应作为结局指标。采用Cochrane系统评价员手册5.1.0版偏倚风险评估工具对纳入的研究进行质量评价,使用RevMan 5.3软件进行Meta分析。结果共纳入7项研究,总计653例病人,对照组324例,治疗组329例。Meta分析结果显示:与对照组相比,治疗组临床总有效率更高[OR=4.54,95%CI(2.02,10.20),P=0.0003],收缩压和舒张压明显降低[MD=-8.80,95%CI(-13.89,-3.71),P=0.0007;MD=-1.12,95%CI(-2.02,-0.22),P=0.01],LDL-C[MD=-0.48,95%CI(-0.61,-0.36),P<0.00001]、TG[MD=-0.55,95%CI(-0.68,-0.42),P<0.00001]及TC[MD=-0.80,95%CI(-0.94,-0.66),P<0.00001]均明显下降,而HDL-C高于对照组[MD=0.39,95%CI(0.26,0.52),P<0.00001]。治疗组不良反应发生事件与对照组相比差异无统计学意义[OR=0.94,95%CI(0.32,2.79),P=0.91]。结论现有证据表明,BX+XF治疗HTN-HLP有较好的临床疗效,能降低血压,改善高脂血症;但在不良事件发生方面未呈现明显优势。Objective To systematically evaluate the clinical effects of Banchsia Baizhu Tianma Decoction combined with Xuefu Zhuyu Decoction(BX+XF)in the treatment of hypertension complicated with hyperlipidemia(HTN-HLP).Methods Eight databases including PubMed,Cochrane Library,EMbase and China National Knowledge Infrastructure(CNKI)were searched to collect randomized controlled trials(RCTs)of BX+XF in the treatment of HTN-HLP from the establishment to April 6,2020.The clinical efficacy,traditional Chinese medicine syndrome score,blood pressure,high-density lipoprotein(HDL-C),total cholesterol(TC),Triglyceride(TG),low density lipoprotein(LDL-C)and adverse reactions were used as outcome indexes.The quality of the included studies was assessed using the Cochrane Handbook 5.1.0,and RevMan 5.3 software was used for Meta-analysis.Results A total of 7 literatures were included,involving 653 patients,329 cases in the control group and 324 cases in the treatment group.The result of Meta-analysis showed that compared with the control groups,the clinical efficacy in the treatment group was higher[OR=4.54,95%CI(2.02,10.20),P=0.0003],systolic blood pressure[MD=-8.80,95%CI(-13.89,-3.71),P=0.0007]and diastolic blood pressure[MD=-1.12,95%CI(-2.02,-0.22),P=0.01]in the treatment group significantly were decreased,LDL-C[MD=-0.48,95%CI(-0.61,-0.36),P<0.00001],TG[MD=-0.55,95%CI(-0.68,-0.42),P<0.00001]and TC[MD=-0.80,95%CI(-0.94,-0.66),P<0.00001]in the treatment group were decreased,HDL-C[MD=0.39,95%CI(0.26,0.52),P<0.00001]in the treatment group was increased.There was no significant difference in the incidence of adverse reactions between the treatment group and the control group[OR=0.94,95%CI(0.32,2.79),P=0.91].Conclusion Current evidence showed that BX+XF with better clinical effect in the treatment of hypertension complicated with hyperlipidemia,which could reduce blood pressure and improve hyperlipidemia.There was no obvious advantage in the occurrence of adverse events.

关 键 词：高血压 高脂血症 半夏白术天麻汤 血府逐瘀汤 META分析 

分 类 号：R54[医药卫生—心血管疾病]