振源胶囊辅助治疗慢性心力衰竭有效性比较的Meta分析(1)
[摘要] 计算机检索PubMed，EMbase，the Cochrane Library，CBM，CNKI，VIP，Wanfang Data数据库，收集振源胶囊辅助治疗慢性心力衰竭的相关随机对照试验(RCT)，检索时间限制从建库至2016年10月。由2位评价者独立筛选文献、提取资料和评价纳入文献的偏倚风险后，采用RevMan 5.3软件进行Meta分析，系统评价振源胶囊对慢性心力衰竭病人疗效。最终纳入14个RCT，共1 204例慢性心力衰竭患者。Meta分析结果显示，振源胶囊组的心功能疗效[RR=1.27，95%CI(1.20，1.35)，P<0.000 01]，每搏输出量[WMD=7.62，95%CI(6.39，8.84)，P<0.000 01]，HAMA评分[WMD=-4.16，95%CI(-5.59，-2.72)，P<0.000 01]，HAMA心理疗效[RR=1.47，95%CI(1.15，1.89)，P=0.002]，中医症候疗效[RR=1.46，95%CI(1.25，1.72)，P<0.000 01]均显著优于对照组，且差异具有统计学意义。现有证据表明，在常规西药治疗基础上联用振源胶囊可以改善慢性心力衰竭患者心功能、心理状态，提高生活質量，且安全性好。受纳入研究质量和数量的限制，仍需大规模高质量RCT予以验证。
, http://www.100md.com
[关键词] 振源胶囊；慢性心力衰竭；心功能；Meta分析；系统评价；随机对照试验
[Abstract] To systematically review the adjuvant effects of Zhenyuan capsule on improving the cardiac function of patients with chronic heart failure. Databases including PubMed， EMbase， the Cochrane Library， CBM， CNKI， VIP and Wanfang Data were searched electronically from inception to October 2016 to collect randomized controlled trials (RCTs) about Zhenyuan capsule for adjuvant treatment of chronic heart failure. Two reviewers independently screened literature， extracted data and assessed the risk of bias of included studies. Then， Meta-analysis was performed by using RevMan 5.3 software. A total of 14 RCTs involving 1 204 patients were included. The results of Meta-analysis showed that the Zhenyuan capsule group had significantly better effectiveness in cardiac function (RR=1.27， 95%CI 1.20 to 1.35， P<0.000 01)， stroke volume (WMD=7.62， 95%CI 6.39 to 8.84，P<0.000 01)， scores of HAMA (WMD=-4.16， 95%CI -5.59 to -2.72， P<0.000 01)， psychological effect of HAMA (RR=1.47， 95%CI 1.15 to 1.89， P=0.002)， and traditional Chinese medical syndrome (RR=1.46， 95%CI 1.25 to 1.72， P<0.000 01) than those of the control group， with statistically significant differences. Current evidence showed that Zhenyuan capsule combined with routine treatment could improve the cardiac function and quality of life of patients with chronic heart failure， and with high safety. Due to the limited quantity and quality of the included studies， the above conclusion still needs to be verified by carrying out more high-quality RCTs.
, 百拇医药
[Key words] Zhenyuan capsule；chronic heart failure；cardiac function；Meta-analysis；systematic review；randomized controlled trial
慢性心力衰竭是冠心病、高血压病、瓣膜病、心肌病等多种基础心脏疾病的终末阶段，具有病死率高、致残率高、再住院率高等特点，严重影响患者生活质量，给社会和家庭带来巨大的经济负担。目前慢性心力衰竭的治疗是以血管紧张素转化酶抑制剂(ACEI)、β受体阻滞剂、醛固酮受体拮抗剂、利尿剂、洋地黄类等为基础的西药治疗[1]。尽管这些药物的使用明显降低了慢性心衰病人的死亡率、致残率，改善了生活质量，但由于慢性心力衰竭是一个不断进展且不可逆的过程，所以慢性心力衰竭的死亡率仍然很高。近年来很多试验证明中医药在辅助治疗慢性心力衰竭具有独特的优势，可以明显改善患者心衰症状、精神状态及生活质量[2]。, http://www.100md.com(曹野 王伟琼 卢力 郭小梅)
, http://www.100md.com
[关键词] 振源胶囊；慢性心力衰竭；心功能；Meta分析；系统评价；随机对照试验
[Abstract] To systematically review the adjuvant effects of Zhenyuan capsule on improving the cardiac function of patients with chronic heart failure. Databases including PubMed， EMbase， the Cochrane Library， CBM， CNKI， VIP and Wanfang Data were searched electronically from inception to October 2016 to collect randomized controlled trials (RCTs) about Zhenyuan capsule for adjuvant treatment of chronic heart failure. Two reviewers independently screened literature， extracted data and assessed the risk of bias of included studies. Then， Meta-analysis was performed by using RevMan 5.3 software. A total of 14 RCTs involving 1 204 patients were included. The results of Meta-analysis showed that the Zhenyuan capsule group had significantly better effectiveness in cardiac function (RR=1.27， 95%CI 1.20 to 1.35， P<0.000 01)， stroke volume (WMD=7.62， 95%CI 6.39 to 8.84，P<0.000 01)， scores of HAMA (WMD=-4.16， 95%CI -5.59 to -2.72， P<0.000 01)， psychological effect of HAMA (RR=1.47， 95%CI 1.15 to 1.89， P=0.002)， and traditional Chinese medical syndrome (RR=1.46， 95%CI 1.25 to 1.72， P<0.000 01) than those of the control group， with statistically significant differences. Current evidence showed that Zhenyuan capsule combined with routine treatment could improve the cardiac function and quality of life of patients with chronic heart failure， and with high safety. Due to the limited quantity and quality of the included studies， the above conclusion still needs to be verified by carrying out more high-quality RCTs.
, 百拇医药
[Key words] Zhenyuan capsule；chronic heart failure；cardiac function；Meta-analysis；systematic review；randomized controlled trial
慢性心力衰竭是冠心病、高血压病、瓣膜病、心肌病等多种基础心脏疾病的终末阶段，具有病死率高、致残率高、再住院率高等特点，严重影响患者生活质量，给社会和家庭带来巨大的经济负担。目前慢性心力衰竭的治疗是以血管紧张素转化酶抑制剂(ACEI)、β受体阻滞剂、醛固酮受体拮抗剂、利尿剂、洋地黄类等为基础的西药治疗[1]。尽管这些药物的使用明显降低了慢性心衰病人的死亡率、致残率，改善了生活质量，但由于慢性心力衰竭是一个不断进展且不可逆的过程，所以慢性心力衰竭的死亡率仍然很高。近年来很多试验证明中医药在辅助治疗慢性心力衰竭具有独特的优势，可以明显改善患者心衰症状、精神状态及生活质量[2]。, http://www.100md.com(曹野 王伟琼 卢力 郭小梅)