学术论文

      中成药联用西药治疗高血压病左心室肥厚疗效与安全性的Meta分析

      Curative effect and safety of Chinese patent medicine combining Western drugs on hypertensive left ventricular hypertrophy:a Meta-analysis

      摘要:
      目的:分析中成药联用西药治疗高血压病左心室肥厚(LVH)疗效与安全性。方法计算机检索PubMed、EMbase、Cochrane图书馆、中国期刊全文数据库、万方数据库、维普数据库关于口服中成药联用西药对LVH疗效的临床随机对照试验(RCT),检索时间截止至2013年10月。采用RevMan5.2软件进行Meta分析。结果最终纳入14个随机对照实验(RCT),共计1055例患者。Meta分析显示:①中成药联用逆转LVH的作用优于单用西药,左室舒张末期内径(WMD=-1.38,95%CI:-2.36~-0.71, P<0.0001);舒张末期室间隔厚度(WMD=-1.08,95%CI:-1.67~-0.49,P=0.0002)、舒张末期左室后壁厚度(WMD=-0.99,95%CI:-1.54~-0.45,P=0.0003)、左室重量指数(WMD=-8.55,95%CI:-11.67~-5.43,P<0.00001),各指标组间比较差异具有统计学意义;②两组SBP比较差异无统计学意义(WMD=-5.31,95%CI:-11.23~0.60,P=0.08);两组DBP比较差异有统计学意义(WMD=-3.42,95%CI:-5.53~-1.31,P=0.001);降压有效率组间比较差异无统计学意义(OR=1.68,95%CI:0.59~4.74,P=0.33);③两组临床症状改善情况比较差异具有统计学意义(OR=5.74,95%CI:2.70~12.21,P<0.00001)。结论提示与单纯西药相比,联合使用中成药具有更好的逆转LVH的疗效,能更明显的降低DBP,改善临床症状。
      Abstract:
      Objective To analyze the curative effect and safety of Chinese patent medicine combining Western drugs on hypertensive left ventricular hypertrophy (LVH). Methods The databases of PubMed, EMbase, Cochrone Library, CNKI, WangFang Database and VIP Database were retrieved with computers for collecting randomized controlled trials (RCT) about the curative effect of Chinese patent medicine combining Western drugs on LVH up to Oct. 2013. A Meta-analysis was conducted by using RevMan5.2 software. Results There were totally 14 RCT included involving 1055 patients. The results of Meta-analysis showed that①Chinese patent medicine combining Western drugs had better effect than only Western drugs, and the comparison in LVDd [WMD=-1.38, 95%CI (-2.36--0.71), P<0.0001], IVST [WMD=-1.08, 95%CI (-1.67--0.49), P=0.0002], LVPWT [WMD=-0.99, 95%CI (-1.54- -0.45), P=0.000 3], and LVMI [WMD=-8.55, 95%CI (-11.67- -5.43), P<0.00001] showed statistical significance between two groups. ②The comparison in SBP [WMD=-5.31, 95%CI (-11.23- 0.60), P=0.08] had no significant difference, in DBP [WMD=-3.42, 95%CI (-5.53--1.31), P=0.001]) had significant difference, and in antihypertensive efficiency [OR=1.68, 95%CI (0.59-4.74), P=0.33] had no significant difference between two groups. ③The comparison in relief of clinical symptoms [OR=5.74, 95%CI (2.70-12.21), P<0.00001] had statistical significance between two groups. Conclusion Chinese patent medicine combining Western drugs has better effect in adversing LVH, reduces significantly DPB and relieves clinical symptoms compared with only Western drugs. However, more with multiple-center, large-sample and adequate randomized RCT, and allocation concealment, blinding design and long-term follow-up are required.
      Author: ZENG Yong ZHANG Wen WANG Shun-min LIU Dan LI Xia TAN Yuan-sheng
      作者单位: 湖南中医药大学第一附属医院, 长沙,410000
      年,卷(期): 2014, (3)
      分类号: R544.1
      机标分类号: R56 R54
      在线出版日期: 2014年8月23日
      基金项目: 湖南省科学技术厅科技计划重点项目(2013SK2025);湖南省财政厅项目