芪苈强心胶囊联合曲美他嗪治疗慢性心力衰竭的Meta分析  

Meta-analysis of Qiliqiangxin Capsules Combined with Trimetazidine in the Treatment of Chronic Heart Failure

作　　者：李可歆 肖琨珉[2] 郭淑贞 马雪玲[2] 王娟[2] 赵慧辉[2] 王伟[2,3] LI Ke-xin;XIAO Kun-min;GUO Shu-zhen;MA Xue-ling;WANG Juan;ZHAO Hui-hui;WANG Wei(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100102;Beijing University of Chinese Medi-cine,Beijing 100029;Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006)

机构地区：[1]北京中医药大学东直门医院,北京100102 [2]北京中医药大学,北京100029 [3]广州中医药大学,广东广州510006

出　　处：《世界中西医结合杂志》2023年第3期465-471,491,共8页World Journal of Integrated Traditional and Western Medicine

基　　金：国家重点研发计划(2017YFC1700100)。

摘　　要：目的 观察芪苈强心胶囊联合曲美他嗪治疗慢性心力衰竭(Chronic heart failure, CHF)的临床疗效。方法 检索中国学术期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)及英文数据库PubMed、Embase、Web of Science(WOS)建库至2022年12月2日期间关于芪苈强心胶囊联合曲美他嗪治疗CHF的文献资源。由2名作者独立完成文献提取和质量评价。根据研究是否存在异质性分别采用固定效应模型或随机效应模型进行荟萃分析,探讨芪苈强心胶囊联合曲美他嗪对CHF患者临床疗效、左心室射血分数(Left ventricular ejection fraction, LVEF)、左心室舒张末期内径(Left ventricular end diastolic diameter, LVEDd)、N末端B型利钠肽前体(N-terminal pro-B-type natriuretic peptide, NT-proBNP)、二尖瓣舒张早期血流速度峰值/晚期血流速度峰值(E/A)及6 min步行距离(6MWD)的影响。采用Revman 5.4.1进行荟萃分析。结果 共纳入15项研究,荟萃分析结果显示,芪苈强心胶囊联合曲美他嗪可明显改善CHF患者临床疗效[OR=4.64,95%CI:3.08~6.97,P<0.000 01]、提高LVEF[MD=5.18,95%CI(4.40~5.95),P<0.000 01]、降低LVEDd[MD=-2.87,95%CI(-3.70~-2.04),Z=6.80,P<0.000 01]、提高E/A峰[MD=0.35,95%CI(0.12~0.57),P<0.002]、降低NT-proBNP[SMD=-1.87,95%CI(-2.88~-0.85),Z=3.59,P=0.0003]、延长6MWD[MD=59.69,95%CI[36.39~82.99],P<0.000 01]。结论 芪苈强心胶囊联合曲美他嗪可提高CHF患者临床疗效、左室射血分数、E/A峰、心功能水平、6 min步行距离,降低左室舒张末期内径、NT-proBNP。Objective To observe the efficacy of Qiliqiangxin Capsules combined with trimetazidine in the treatment of chronic heart failure(CHF).Methods The relevant articles were retrieved from China National Knowledge Infrastructure(CNKI),VIP,Wanfang Data,China Biology Medicine disc(CBM),Pubmed,Excerpta Medica Database(EMbase),and Web of Science(WOS)from inception to December 2,2022.Two authors independently completed the literature extraction and quality evaluation.According to the heterogeneity of the study,the fixed effect model or random effect model was used for meta-analysis to explore the effects of Qiliqiangxin Capsules combined with trimetazidine on the clinical efficacy,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),N-terminal pro-B-type natriuretic peptide(NT-proBNP),ratio of early to late peak mitral diastolic blood flow velocity(E/A ratio),and 6-minute walking distance(6MWD).Revman 5.4.1 was used for meta-analysis.Results A total of 15 studies were included.The meta-analysis results showed that Qiliqiangxin Capsules combined with trimetazidine improved the clinical efficacy[OR=4.64,95%CI:(3.08,6.97),P<0.00001],elevated LVEF[MD=5.18,95%CI:(4.40,5.95),P<0.00001],lowered LVEDd[MD=-2.87,95%CI:(-3.70,-2.04),Z=6.80,P<0.00001],improved E/A ratio[MD=0.35,95%CI:(0.12,0.57),P<0.002],lowered NT-proBNP[SMD=-1.87,95%CI:(-2.88,-0.85),Z=3.59,P=0.0003],and extended 6MWD[MD=59.69,95%CI:(36.39,82.99),P<0.00001].Conclusion Qiliqiangxin Capsules combined with trimetazidine can improve the clinical effects LVEF,E/A ratio,cardiac function,6MWD and lower LVEDd and NT-proBNP in CHF patients.

关 键 词：慢性心力衰竭 芪苈强心胶囊 曲美他嗪 META分析 

分 类 号：R541.6[医药卫生—心血管疾病]