西药联合芪苈强心胶囊与单纯西药治疗慢性心力衰竭疗效比较的Meta分析  

Meta analysis of the efficacy of western medicine combined with Qiliqiangxin capsule versus western medicine alone in the treatment of chronic heart failure

作　　者：杨敏 卢健棋[2] 庞延 周家谭 罗文宽 YANG Min;LU Jian-qi;PANG Yan;ZHOU Jia-tan;LUO Wen-kuan(Guangxi University of Traditional Chinese Medicine,Nanning 530001,China;National Center for Clinical Medical Research of Cardiovascular Diseases of Traditional Chinese Medicine,Department of Cardiology,First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学第一附属医院心内科国家中医心血管病临床医学研究中心分中心,广西南宁530023

出　　处：《海南医学院学报》2024年第1期50-59,共10页Journal of Hainan Medical University

基　　金：国家自然科学基金地区科学基金项目(82160887);广西自然科学基金项目面上项目(2021GXNSFAA220111);广西自然科学基金项目青年科学基金项目(2021GXNSFBA196018)。

摘　　要：目的:对常规西药联合芪苈强心胶囊与单用西药治疗慢性心力衰竭的临床疗效进行比较,证明芪苈强心胶囊联合西药治疗更具优势,为慢性心衰的临床治疗策略提供参考依据。方法:检索PubMed、Embase、Web of science、中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献(CBM)等数据库中常规西药治疗以及西药联合芪苈强心胶囊治疗慢性心衰的随机对照实验(RCTs),采用Cochrance推荐的RCT的工具进行偏倚风险评估后,用Rev Man 5.4及Stata 17软件进行Meta分析。比较常规西药联合芪苈强心胶囊组(以下简称治疗组)与常规西药组(以下简称对照组)的心功能疗效评价、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、心脏每搏输出量(SV)、6 min步行试验(6MWT)距离及N末端脑钠肽前体(NT-proBNP)指数。结果:纳入符合标准的RCTs共20篇,包括2953例患者,其中治疗组1508例,对照组1445例。Meta分析结果显示,治疗组的心功能疗效评价、LVEF、LVEDD、SV、6MWT及NT-proBNP改善情况均显著优于对照组。其中心功能疗效评价(OR=2.09,95%CI:1.71~2.55,P<0.001)、LVEF(WMD=7.05,95%CI:5.30~8.79,P<0.00001)、LVEDD(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、SV(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、6MWT(SMD=0.70,95%CI:0.54~0.87,P<0.00001)、NT-proBNP(SMD=-1.95,95%CI:-2.52~-1.38,P<0.0001),差异均有统计学意义。结论:常规西药联合芪苈强心胶囊能显著提高心力衰竭的临床疗效,改善LVEF、LVEDD、SV及NT-proBNP指数,提高运动耐量,在治疗中值得借鉴。Objective:To compare the clinical efficacy of conventional western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure,and to prove that Qiliqiangxin capsule combined treatment has more advantages,providing reference for clinical decision-making in the treatment of chronic heart failure.Methods:Randomized controlled trials(RCTs)of conventional western medicine treatment and western medicine combined with Qiliqiangxin capsule in the treatment of chronic heart failure were searched in databases such as PubMed,Embase,Web of science,CNKI,WanFang,VIP,and CBM.The bias risk assessment was conducted using the RCT tool recommended by Cochrane,and then the meta-analysis was performed using RevMan5.4 and Stata17 software.Compare the efficacy evaluation of cardiac function,left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),cardiac stroke output(SV),6-minute walking test(6MWT),and N-terminal proBNP in the conventional western medicine combined with Qiliqiangxin capsule group(hereinafter referred to as the treatment group)and the conventional western medicine group(hereinafter referred to as the control group).Results:A total of 20 RCTs meeting the criteria were included,including 2953 patients,including 1508 in the treatment group and 1445 in the control group.The results of meta-analysis showed that the treatment group had significantly better cardiac function evaluation,LVEF,LVEDD,SV,6MWT,and NT-proBNP improvement than the control group.Its central functional efficacy evaluation(OR=2.09,95%CI:1.71-2.55,P<0.001),LVEF(WMD=7.05,95%CI:5.30-8.79,P<0.00001),LVEDD(WMD=6.73,95%CI:3.18-10.29,P=0.0002),SV(WMD=6.73,95%CI:3.18-10.29,P=0.0002),6MWT(SMD=0.70,95%CI:0.54-0.87,P<0.00001),NT-proBNP(SMD=-1.95,95%CI:-2.52--1.38,P<0.0001),with statistically significant differences.Conclusion:Conventional western medicine combined with Qiliqiangxin capsule can significantly improve the clinical efficacy of heart failure,improve LVEF,LVEDD,SV,and NT-

关 键 词：芪苈强心胶囊 心力衰竭 META分析 随机对照试验 

分 类 号：R541.6[医药卫生—心血管疾病]