中成药改善慢性心衰患者左室射血分数与脑钠肽水平的系统评价和Meta分析

系统评价已上市中成药对慢性心衰患者左室射血分数与脑钠肽(brain natriuretic peptide, BNP)的有效性和安全性. 检索世界医学文献数据库(PubMed)、循证医学图书馆(The Cochrane Library)、中国期刊全文专题数据库(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(WanFang Data), 时间截至2016 年3 月. 纳入的随机对照试验使用Cochrane 手册进行质量评估, 并用Rev Man 5.3软件进行Meta 分析. 共纳入16项随机对照研究, Meta分析结果显示, 中成药在改善左室射血分数(MD=5.80, 95%置信区间: 0.236.73, P < 0.01)、降低BNP 含量(MD=–366.99, 95%置信区间: ?412.00  ?321.97, P < 0.01)方面的效果优于对照组, 纳入的临床试验质量较低. 基于低质量研究及有限数据, 中成药在改善慢性心衰患者左室射血分数与血浆BNP水平方面有一定疗效. 但仍亟需高质量的临床研究进一步验证中医药治疗心力衰竭的有效性和安全性.

Effects of Chinese patent medicines on left ventricular ejection fraction and brain natriuretic peptide in patients with chronic heart failure: systematic review#br# and Meta-analysis

To evaluate efficacy and security of Chinese patent medicines on left ventricular ejection fraction (LVEF) and plasma brain natriuretic peptide (BNP) in the treatment of heart failure (HF). Five databases including PubMed, The Cochrane Library, CNKI, VIP and WanFang Data have been searched to identify relevant randomized controlled trials (RCTs) up till March 2016. Methodological quality of the included studies was assessed using criteria from Cochrane Reviewer’s Handbook 5.3, and analyzed using Rev Man 5.3 software. Sixteen RCTs of Chinese patent medicines were included. Results of the Meta-analysis showed that Chinese patent medicines were more effective on LVEF (MD=5.80, 95%CI (confidence interval): 0.236.73, P < 0.01) and BNP (MD= ?366.99, 95%CI: ?412.00  ?321.97, P < 0.01). In addition, assessed quality of the included randomized controlled trials were low. Based on low quality and limited data, Chinese patent medicines were more significant at the LVEF and BNP level. Therefore, sufficient high quality experiments need to be conducted to confirm efficacy and security of Chinese patent medicines.