养心氏片治疗心力衰竭临床疗效的Meta分析(1)
摘要 目的：系统评价养心氏片治疗心力衰竭的临床疗效。方法：检索中国知网、VIP、万方数据医药期刊数据网、中国生物医学文献光盘数据库(CBM)、PubMed、Cochrane Library数据库。筛选合格研究，进行文献质量评价，运用异质性检验、Meta分析、敏感性分析等方法统计相关数据。结果：纳入6项研究，共计559例患者，文献质量偏低；Meta分析结果显示，与对照药物比较，养心氏片能提高6分钟步行距离[WMD=49.97，95% CI：33.22～66.71，P<0.00001]，改善心功能[OR=2.50，95% CI：1.43～4.38，P=0.001]，改善中医症状(胸闷[WMD=-0.53，95% CI：-0.76～-0.31，P<0.00001]、心悸[WMD=-0.31，95% CI：-0.53～-0.08，P=0.007]、乏力[WMD=-0.52，95% CI：-0.97～-0.06，P=0.03]、气促[WMD=-0.45，95% CI：-0.88～-0.02，P=0.04])，但在改善左心室射血分数(LVEF)方面与常规治疗药物效果比较，差异无统计学意义(P>0.05)。结论养心氏片较常规治疗心力衰竭可进一步提高临床疗效，上述结论仍需更多高质量、大样本量的论据加以论证。
关键词 养心氏片；心力衰竭；随机对照试验；系统评价
Abstract Objective：To evaluate the clinical curative effect of Yangxinshi Pill in the treatment of chronic heart failure with meta-analysis. Methods：CNKI， VIP， CBM， WanFang， PubMed and Cochrane Library were electronically searched to collect qualified researches for evaluation. The data was analyzed by the heterogeneity test， meta-analysis and sensitivity analysis. Results：Six randomized controlled trials (RCTs) involving 559 patients with poor general quality were included. Results of meta-analyses showed that compared with the control drug group， Yangxinshi Pill could significantly improve the efficacy of 6 minutes′ walk distance[WMD=49.97， 95% CI (33.22～66.71)， P<0.00001]， cardiac function[OR=2.50， 95% CI (1.43～4.38)， P=0.001]， traditional Chinese medicine (TCM) syndrome (chest tightness[WMD=-0.53， 95% CI (-0.76～-0.31)， P<0.00001]， palpitation[WMD=-0.31， 95% CI (-0.53～-0.08)， P=0.007]， hypodynamic[WMD=-0.52， 95% CI (-0.97～-0.06)， P=0.03]， anhelation[WMD=-0.45， 95% CI (-0.88～-0.02)， P=0.04]). There was no significant difference in left ventricular ejection fraction between two groups. Conclusion：Yangxinshi Pill is effective in the treatment of HF. However rigorously designed RCTs with large sample are still needed to support its clinical effectiveness.
Key Words Yangxinshi Pill； Heart failure； Randomized controlled trials； Systematic review
中圖分类号：R289.5；R541文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.08.058
养心氏片由黄芪、灵芝、人参、党参、丹参、葛根、生地黄、当归、淫羊藿、炙延胡索、山楂、炙甘草、黄连等中药组成，具有补气活血，温肾通脉的功能。现代药理研究表明，养心氏片具有增强心肌携氧能力，抗心肌缺血作用，能够降低心肌耗氧量，使心输出量及冠脉血流量增加，提高左心室射血分数，显著改善心力衰竭症状，增强心脏功能[1]。本研究旨在运用Meta分析养心氏片治疗心力衰竭的实际效果以及安全性，为临床科学地运用此药提供可靠的循证依据。
资料与方法
1. 文献检索 系统地搜索中国知网、VIP、万方数据医药期刊数据网、中国生物医学文献光盘数据库(CBM)、PubMed、Cochrane Library等在线数据库。在检索过程中所设置的检索条件为各数据库建库最初建立到2017年12月的研究资料。文献的发布种类以及语种并未设定限制。中文检索词有：养心氏片、心力衰竭、心力衰竭等。英文检索词有：Yangxinshi Pill、heart failure、chronic heart failure、HF等。, http://www.100md.com(郑宇昕 李益萍 王肖龙 高俊杰)
关键词 养心氏片；心力衰竭；随机对照试验；系统评价
Abstract Objective：To evaluate the clinical curative effect of Yangxinshi Pill in the treatment of chronic heart failure with meta-analysis. Methods：CNKI， VIP， CBM， WanFang， PubMed and Cochrane Library were electronically searched to collect qualified researches for evaluation. The data was analyzed by the heterogeneity test， meta-analysis and sensitivity analysis. Results：Six randomized controlled trials (RCTs) involving 559 patients with poor general quality were included. Results of meta-analyses showed that compared with the control drug group， Yangxinshi Pill could significantly improve the efficacy of 6 minutes′ walk distance[WMD=49.97， 95% CI (33.22～66.71)， P<0.00001]， cardiac function[OR=2.50， 95% CI (1.43～4.38)， P=0.001]， traditional Chinese medicine (TCM) syndrome (chest tightness[WMD=-0.53， 95% CI (-0.76～-0.31)， P<0.00001]， palpitation[WMD=-0.31， 95% CI (-0.53～-0.08)， P=0.007]， hypodynamic[WMD=-0.52， 95% CI (-0.97～-0.06)， P=0.03]， anhelation[WMD=-0.45， 95% CI (-0.88～-0.02)， P=0.04]). There was no significant difference in left ventricular ejection fraction between two groups. Conclusion：Yangxinshi Pill is effective in the treatment of HF. However rigorously designed RCTs with large sample are still needed to support its clinical effectiveness.
Key Words Yangxinshi Pill； Heart failure； Randomized controlled trials； Systematic review
中圖分类号：R289.5；R541文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.08.058
养心氏片由黄芪、灵芝、人参、党参、丹参、葛根、生地黄、当归、淫羊藿、炙延胡索、山楂、炙甘草、黄连等中药组成，具有补气活血，温肾通脉的功能。现代药理研究表明，养心氏片具有增强心肌携氧能力，抗心肌缺血作用，能够降低心肌耗氧量，使心输出量及冠脉血流量增加，提高左心室射血分数，显著改善心力衰竭症状，增强心脏功能[1]。本研究旨在运用Meta分析养心氏片治疗心力衰竭的实际效果以及安全性，为临床科学地运用此药提供可靠的循证依据。
资料与方法
1. 文献检索 系统地搜索中国知网、VIP、万方数据医药期刊数据网、中国生物医学文献光盘数据库(CBM)、PubMed、Cochrane Library等在线数据库。在检索过程中所设置的检索条件为各数据库建库最初建立到2017年12月的研究资料。文献的发布种类以及语种并未设定限制。中文检索词有：养心氏片、心力衰竭、心力衰竭等。英文检索词有：Yangxinshi Pill、heart failure、chronic heart failure、HF等。, http://www.100md.com(郑宇昕 李益萍 王肖龙 高俊杰)