中成药治疗射血分数保留的心力衰竭的网状Meta分析  

Network Meta-analysis of Chinese patent medicine in treatment of heart failure with preserved ejection fraction

作　　者：田晶 徐柏榕 邢作英[1] 邱伯雍 司春婴[1] 朱明军[1] 王永霞[1] TIAN Jing;XU Bai-rong;XING Zuo-ying;QIU Bo-yong;SI Chun-ying;ZHU Ming-jun;WANG Yong-xia(Heart Center of the First Affiliated Hospital,Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院心脏中心,河南郑州450000

出　　处：《中国中药杂志》2024年第3期819-835,共17页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(82074229);国家中医药管理局中医药循证能力建设项目(2019XZZX-XXG003);河南省卫生健康委国家中医临床研究基地科研专项重点项目(KY-B0357-002)。

摘　　要：系统评价不同中成药联合常规西医治疗射血分数保留的心力衰竭的疗效及安全性,并进行用药排序。全面检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、EMbase、Web of Science、Cochrane Library等建库至2022年10月9日涉及中成药治疗射血分数保留的心力衰竭的随机对照试验(randomized controlled trial,RCT),对纳入RCT使用R软件gemtc及rjags包进行网状Meta分析。共纳入74篇RCTs,7192例患者,涉及11种不同中成药(参附注射液、参麦注射液、芪苈强心胶囊、麝香保心丸、血脂康胶囊、丹参多酚酸盐注射液、丹参酮ⅡA磺酸钠注射液、心脉隆注射液、养心氏片、芪参益气滴丸、益心舒胶囊)。网状Meta分析疗效评价结果显示,①提高临床有效率方面,注射剂优选心脉隆注射液+常规西医,口服药选用麝香保心丸+常规西医、芪参益气滴丸+常规西医、芪苈强心胶囊+常规西医;②改善二尖瓣舒张早期血流峰值流速与舒张晚期血流峰值流速的比值(E/A)方面,注射剂选用参麦注射液+丹参多酚酸盐注射液+常规西医、参麦注射液+常规西医、参附注射液+常规西医,口服药优选益心舒胶囊+常规西医;③改善二尖瓣口舒张早期血流峰值速度与二尖瓣环舒张早期运动速度的比值(E/e′)方面,注射剂优选参附注射液+常规西医,口服药选用芪苈强心胶囊+常规西医、芪参益气滴丸+常规西医;④提高6 min步行试验(6MWT)方面,注射剂选用参麦注射液+常规西医、心脉隆注射液+常规西医,口服药选用芪参益气滴丸+常规西医、芪苈强心胶囊+常规西医;⑤降低N末端B型利钠肽前体(NT-proBNP)水平方面,口服药优选芪苈强心胶囊+常规西医;⑥降低B型利钠肽(BNP)方面,注射液优选心脉隆注射液+常规西医,口服药优选芪苈强心胶囊+常规西医。中成药联合常规西医不良反应与单纯常规西医相比,差异�This study systematically evaluated the efficacy and safety of different Chinese patent medicines combined with conventional western medicine in the treatment of heart failure with preserved ejection fraction(HFpEF)and ranked for the drug selection.Randomized controlled trial(RCT)on Chinese patent medicines in treatment of HFpEF were obtained from the CNKI,Wanfang,VIP,SinoMed,PubMed,Cochrane Library,EMbase,Web of Science,and other databases from the inception to October 9,2022.The included RCT was quantitatively analyzed using gemtc and rjags packages of R software for the network Meta-analysis.74 RCTs were included,with a total of 7192 patients enrolled,involving 11 different Chinese patent medicines(Shenfu Injection,Shenmai Injection,Qili Qiangxin Capsules,Shexiang Baoxin Pills,Xuezhikang Capsules,Salvia Miltiorrhiza Polyphenols Injection,TanshinoneⅡA Sulfonate Injection,Xinmailong Injection,Yangxinshi Tablets,Qishen Yiqi Dripping Pills,and Yixinshu Capsules).The results of network Meta-analysis are shown as followed.①In terms of improving clinical effective rate,for injection preparations,Xinmailong Injection+conventional western medicine was recommended.while for oral preparations,Shexiang Baoxin Pills+conventional western medicine,Qishen Yiqi Dripping Pills+conventional western medicine,and Qili Qiangxin Capsules+conventional western medicine were preferred.②In terms of improving the mitral ratio of peak early to late diastolic filling velocity(E/A),for injection preparations,Shenmai Injection+Salvia Miltiorrhiza Polyphenols Injection+conventional western medicine,Shenmai Injection+conventional western medicine,Shenfu Injection+conventional western medicine were preferred.While for oral preparations,Yixinshu Capsules+conventional western medicine was preferred.③In terms of reducing the ratio of early diastolic mitral inflow to early diastolic mitral annular velocity(E/e′),Shenfu Injection+conventional western medicine could be used as injection preparation,and Qili Qiangxin Capsules+conventional we

关 键 词：中成药 射血分数保留的心力衰竭 网状Meta分析 

分 类 号：R259[医药卫生—中西医结合]