芪苈强心胶囊辅助治疗缺血性心肌病心力衰竭的有效性和安全性:一项系统评价和meta分析  

Efficacy and safety of Qili Qiangxin Capsule in the adjuvant treatment of ischemic cardiomyopathy with heart failure:a systematic review and meta-analysis

作　　者：尹紫薇 郑惠珍 郭志华[1] YIN Ziwei;ZHENG Huizhen;GUO Zhihua(Department of Cardiology,The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007,China;Graduate School,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]湖南中医药大学第一附属医院心血管内科,湖南长沙410007 [2]湖南中医药大学研究生院,湖南长沙410208

出　　处：《Digital Chinese Medicine》2023年第4期393-404,共12页数字中医药（英文）

基　　金：National Natural Science Foundation of China (81673955);Provincial Key Research and Development Project of Hunan (2022SK2012);Hunan University of Chinese Medicine Graduate Innovation Project (2022CX133)。

摘　　要：目的 本研究旨在评估芪苈强心胶囊(QLQXC)联合西药对缺血性心肌病(ICM)合并心力衰竭(HF)患者的有效性和安全性。方法 我们在国内数据库中国知网(CNKI)、维普(VIP)、万方和中国生物医学文献数据库(CBM),以及国外数据库Pub Med和Embase数据库检索了相关文献,时间为自数据库创建至2023年1月8日,无语言限制。本研究进行了亚组分析和敏感性分析等,所有统计分析均采用Review Manager 5.4和Stata 15.0进行。结果 与常规西药治疗相比,QLQXC联合西药明显提升了ICM患者的总有效率(ORR)(P <0.000 01)、左室射血分数(LVEF)(P <0.000 01)、明尼苏达州心力衰竭生存问卷(MLHFQ)分数(P=0.000 2)和6分钟步行距离(6MWD)(P <0.000 01),减少了左室舒张末期内径(LVEDD)(P <0.000 01)、左室收缩末期内径(LVESD)(P=0.03)和脑钠肽前体(pro-BNP)(P <0.000 01),同时降低了再住院事件发生率(P=0.000 3)和不良事件(AEs)发生率(P=0.000 6)。对于死亡率结局,QLQXC联合西药组与常规西药组间无明显差异(P=0.30)。结论 QLQXC联合常规西药可以显著改善ICM合并HF患者的心功能和生活质量。Objective To evaluate the efficacy and safety of Qili Qiangxin Capsule(QLQXC)combined with western medicine in patients with ischemic cardiomyopathy(ICM)comorbid with heart failure(HF)for clinical application.Methods We searched relevant references in Chinese databases including China National Knowledge Infrastructure(CNKI),China Scientific Journal Database(VIP),Wanfang Database,and China Biology Medicine(CBM),as well as English databases including PubMed and Embase,from the foundation of the database to January 8,2023,without language restrictions.All statistical analyses,including subgroup and sensitivity analyses,were performed using the Review Manager(version 5.4)and Stata(version 15.0).Results QLQXC combined with western medicine significantly increased the endpoints of overall response rate(ORR)(P<0.00001),left ventricular ejection fraction(LVEF)(P<0.00001),the score of Minnesota Living with Heart Failure Questionnaire(MLHFQ)(P=0.0002),and 6-minute walking distance(6MWD)(P<0.00001),decreased left ventricular end-diastolic diameter(LVEDD)(P<0.00001),left ventricular end-systolic diameter(LVESD)(P=0.03),and pro-brain natriuretic peptide(pro-BNP)(P<0.00001),and reduced the incidence of rehospitalization(P=0.0003)and adverse events(AEs)(P=0.0006)compared with those under the conventional western therapy alone.Nonetheless,no significant difference was observed in reducing the mortality between the QLQXC combined with western medicine group and the western medicine group(P=0.30).Conclusion The combination therapy of QLQXC with western medicine can potentiate cardiac function and raise the quality of life in patients with ICM comorbid with HF.

关 键 词：芪苈强心胶囊 缺血性心肌病 心力衰竭 META分析 中成药 左室射血分数 左室舒张末期内径 

分 类 号：R542.2[医药卫生—心血管疾病] R541.6[医药卫生—内科学]