Meta-analysis of the efficacy of Qili Qiangxin capsule combined with western medicine to treat chronic heart failure
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摘要: 目的:应用Meta分析系统评价芪苈强心胶囊联合西药治疗慢性心力衰竭(心衰)的有效性。方法:检索2010-01-2014-04在国内外公开发表的关于芪苈强心胶囊联合西药治疗慢性心衰的随机对照试验,按照Cochrane Handbook提供的方法评价纳入文献质量并提取有效数据,应用RevMan5.2软件进行统计分析。结果:共纳入17个研究,包括1 964例患者,其中治疗组986例,对照组978例。Meta分析结果显示,在西药基础上应用芪苈强心胶囊和单纯应用西药相比较:可改善心衰患者的NYHA心功能分级(OR=3.83,95%CI:2.78~5.28,P<0.01);增加左室射血分数(WMD=6.32,95%CI:3.92~8.73,P<0.01);增加心输出量(WMD=0.48,95%CI:0.03~0.93,P=0.04);降低血浆脑利钠肽水平(WMD=71.69,95%CI:45.16~98.21,P<0.01);增加6 min步行试验的距离(WMD=34.10,95%CI:25.88~42.32,P<0.01)。结论:芪苈强心胶囊联合西药较单纯西药治疗慢性心衰可进一步提高临床疗效,但上述结论仍需要更多大样本高质量的临床试验加以验证。Abstract: Objective: To systematically review the efficacy of Qili Qiangxin capsule combined with western medicine to treat patients with chronic heart failure.Method: We searched through domestic and foreign literatures that were published between January 2010 and April 2014 with the purpose of finding randomized control trials which use Qili Qiangxin capsule combined with western medicine to treat chronic heart failure. The quality of the inclusive literatures was assessed by the methods provided from the Cochrane Handbook. Valid data were extracted and analyzed with Meta-analysis using the Software RevMan 5.2.Result: Total 17 trials and 1964 patients were included. Results of Meta-analysis showed that in comparison with the simple western medicine treatment group, the added use of Qili Qiangxin capsule could improve NYHA function class(RR=3.83, 95%CI:2.78~5.28, P<0.01); increase left ventricular ejection fraction(WMD=6.32, 95%CI:3.92~8.73, P<0.01);increase in cardiac output(WMD=0.48, 95%CI:0.03~0.93, P=0.04);reduce plasma brain natriuretic peptide levels(WMD=71.69, 95%CI:45.16~98.21, P<0.01);increase the distance of 6-minute walk test(WMD=34.10, 95%CI:25.88~42.32, P<0.01).Conclusion: Compared to simple western medicine treatment, the added use of Qili Qiangxin capsule can further improve clinical outcomes; however, the implementation of larger and higher quality clinical trials is necessary to verify the conclusion.
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Key words:
- chronic heart failure /
- Qili Qiangxin capsule /
- meta-analysis
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