黄芪注射液治疗慢性心力衰竭的系统评价

目的 系统评价黄芪注射液治疗慢性心力衰竭的短期疗效和安全性.方法 采用Cochrane协作网系统评价方法,制定文献纳入标准和排除标准,检索CBMdisc、CNKI、PubMed等电子数据库;评价纳入文献质量,对同质研究进行meta分析.结果 11项研究被纳入meta分析,慢性心力衰竭患者共1 044例,常规药物对照组(对照组)503例,黄芪注射液+常规药物治疗组(治疗组)541例.meta分析显示与常规药物治疗相比,加用黄芪注射液可使总效率提高,差异具有统计学意义[相对危险度(RR)=1.22,95%CI(1.15,1.29)].加用黄芪注射液组左室射血分数明显高于常规药物治疗组,差异具有统计学意义[加权均数差(WMD)=6.32,95%CI(4.69,7.95)].结论 现有临床证据表明,加用黄芪注射液治疗慢性心力衰竭可能有效,且无严重的不良反应.但由于本系统评价所纳入的文献研究用药时间较短,因未能进行较长期疗效与安全性的分析,这还需要大量此类文献的支持.     

黄芪注射液治疗慢性心力衰竭对心输出量的影响

目的探讨黄芪注射液对慢性心力衰竭心输出量的影响。方法110例病人随机分成2组，基础治疗方法相同。治疗组加用黄芪注射液滴注，用超声心动图观察LVEF、CI、SV变化情况及心功能改善情况。结果治疗组心功能较对照组改善明显（P〈0．05）。结论黄芪注射液能显著改善心功能，提高临床疗效。     

生脉注射液联合黄芪注射液治疗慢性心力衰竭疗效观察

目的观察生脉注射液联合黄芪注射液治疗慢性心力衰竭的疗效。方法将58例心力衰竭患者随机分为两组。对照组28例,采用常规治疗;治疗组30例,在常规治疗基础上加用生脉注射液与黄芪注射液。结果治疗组总有效率93．3％,对照组总有效率75．0％,治疗组优于对照组（P〈0．01）。结论生脉注射液联合黄芪注射液治疗慢性心力衰竭优于常规治疗。     

葛根素联合黄芪注射液治疗慢性心力衰竭的疗效观察

目的探讨葛根素联合黄芪注射液治疗慢性心力衰竭的疗效。方法将64例慢性心力衰竭患者随机分为两组,对照组予以常规治疗,治疗组在常规治疗基础上加葛根素和黄芪注射液。结果两组患者病情均得到明显改善,对照组治疗有效率为71.4%,治疗组有效率为88.9%,两组比较差异有统计学意义(P0.05)。结论葛根素联合黄芪注射液对慢性心力衰竭的治疗及预后均有良好作用。     

黄芪注射液治疗慢性心力衰竭临床研究的Meta分析

目的客观评价黄芪注射液治疗慢性心力衰竭(CHF)的临床疗效。方法以"黄芪注射液"和"心功能不全"或"心衰"或"心力衰竭"限定,检索中国生物医学文献数据库,不限制年限。对合格的随机对照试验,进行Meta分析。结果 10个试验进入Meta分析,总样本量为711例。加用黄芪注射液,可以更有效提高左室射血分数和临床总有效率(P<0.05);加用黄芪注射液与加用硝酸甘油对比,病死率和心律失常发生率差异无统计学意义。结论在常规治疗基础上加用黄芪注射液可更好地改善CHF患者心功能。根据目前的Meta分析尚不能得出最终结果,真正评价黄芪注射液治疗CHF的疗效还需要大样本、多中心的严格设计的高质量随机对照试验。     

黄芪注射液联合硝酸甘油治疗重症心力衰竭的临床观察

我院自 1997年 10月至 2 0 0 0年 10月收治重症充血性心力衰竭 (CHF)患者 5 2例 ,其中 2 6例应用黄芪注射液 (中科院成都地奥制药公司生产 )联合硝酸甘油治疗 ,取得了满意临床疗效 ,现报道如下。1　资料与方法1.1　一般资料5 2例均为住院的重症 CHF患者 ,男 38例 ,女 14例 ,年龄 61～ 81(平均 65 )岁。均符合 Framinghanx的 CHF诊断标准 ,按 NYHA心功能分级 , 级 4 3例 , 级 9例。其中冠心病 32例 ,高血压性心脏病10例 ,扩张性心肌病 3例 ,风心病 2例 ,肺心病 4例。1.2　治疗方法全部患者均给予休息、吸氧、限盐、利尿等一般治疗。治…     

西药联合生脉注射液治疗慢性心力衰竭随机对照试验的系统评价

目的系统评价西药联合生脉注射液治疗慢性心力衰竭的有效性和安全性。方法计算机检索中国期刊全文数据库(CNKI,1979.01~2013.12)、中文科技期刊全文数据库(VIP,1989.01~2013.12)、万方期刊数据库(Wan Fang,1978.01~2013.12),Pub Med(1978~2013.12)、Cochrane Library(2013年第4期)。手工检索相关杂志,搜集西药联合生脉注射液治疗慢性心力衰竭的随机对照试验,按照Cochrane Handbook方法评价纳入研究质量和提取有效数据,采用Rev Man5.2.0软件进行系统评价。结果共纳入12个临床随机对照试验,总计939例患者,其研究质量均为C级。Meta分析显示:西药联合生脉注射液可显著改善心衰患者中医临床疗效[RR=1.23,95%CI(1.14~1.33),P0.01],改善慢性心衰患者的心功能分级[RR=1.36,95%CI(1.20~1.55),P0.01]以及生存质量量表积分[WMD=-6.49,95%CI(-12.31~-0.67),P=0.03],增加左心室射血分数[WMD=9.22,95%CI(5.88~12.56),P0.01]和6分钟步行试验距离(P0.05),同时降低心衰患者的血浆脑钠肽(BNP)水平(P0.05)。有1项研究显示生脉注射液可能会降低体循环外周阻力(SVR)及降低血管性血友病因子(v WF)、P-选择素、D-二聚体水平,另外有2项研究显示生脉注射液可能会降低慢性心衰患者N-末端脑钠肽(NT-pro BNP)水平和改善心率变异性(HRV)等。结论西药联合生脉注射液较单纯西药常规治疗心力衰竭可进一步提高临床疗效。     

黄芪注射液治疗慢性充血性心力衰竭49例

心力衰竭是各种心脏病的严重阶段 ,我们对住院的慢性充血性心力衰竭 (CHF)患者应用黄芪注射液治疗 ,并进行临床对比研究 ,旨在观察其治疗效果。现将结果报告如下。1 　 对象与方法按美国纽约心脏病协会 (NYHA) 1 974年心力衰竭诊断标准确诊为CHF的患者 98例 ,年龄 39～ 72(平均 47.6)岁 ,心功能Ⅲ～Ⅳ级 ,心脏超声示左室射血分数 (LVEF) <40 %。其中缺血性心脏病 64例 ,扩张型心肌病 1 0例 ,瓣膜性心脏病 2 4例。分为治疗组 49例 ,对照组 49例。两组患者的性别、原发病、肝肾功能、电解质和心功能分级差异无统计学意义 (P >0 .0 5 )…     

黄芪注射液治疗心力衰竭的研究进展

黄芪为豆科多年生草本植物蒙古黄芪或膜荚黄芪的根,主要功效为补气升阳、益卫固表、利水消肿、托疮生肌,临床应用广泛[1]。黄芪注射液是临床上最常用的黄芪成药制剂,药理学研究证实,黄芪具有强心、扩血管作用[2-4],黄芪对心肌的正性肌力作用以及扩血管的作用主要来自于其中的皂     

Telemonitoring for patients with chronic heart failure: a systematic review

BackgroundTelemonitoring, the use of communication technology to remotely monitor health status, is an appealing strategy for improving disease management.Methods and ResultsWe searched Medline databases, bibliographies, and spoke with experts to review the evidence on telemonitoring in heart failure patients. Interventions included: telephone-based symptom monitoring (n = 5), automated monitoring of signs and symptoms (n = 1), and automated physiologic monitoring (n = 1). Two studies directly compared effectiveness of 2 or more forms of telemonitoring. Study quality and intervention type varied considerably. Six studies suggested reduction in all-cause and heart failure hospitalizations (14% to 55% and 29% to 43%, respectively) or mortality (40% to 56%) with telemonitoring. Of the 3 negative studies, 2 enrolled low-risk patients and patients with access to high quality care, whereas 1 enrolled a very high-risk Hispanic population. Studies comparing forms of telemonitoring demonstrated similar effectiveness. However, intervention costs were higher with more complex programs ($8383 per patient per year) versus less complex programs ($1695 per patient per year).ConclusionThe evidence base for telemonitoring in heart failure is currently quite limited. Based on the available data, telemonitoring may be an effective strategy for disease management in high-risk heart failure patients.     

Efficacy of different telemonitoring strategies on chronic heart failure care: A protocol for systematic review and meta-analysis

Background:Growing interest on the effects of telemonitoring on patients with chronic heart failure (CHF) has led to a rise in the number of trials addressing the same or very similar research questions with a concomitant increase in discordant findings. Therefore, we conducted a protocol for systematic review and meta-analysis to compare the effects of different telemonitoring strategies on clinical outcomes in patients with CHF.Methods:Two individual researchers conducted the platform searches on the PubMed, Cochrane Library, and Embase databases from inception to February 2022. Literature retrieving was carried out through a combined searching of subject terms (“MeSH” on PubMed and “Emtree” on “Embase”) and free terms on the platforms of PubMed and Embase, and through keywords searching on platform of Cochrane Library. Systematic review and meta-analysis of the data will be performed in STATA13.0 software according to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Two authors independently performed the literature searching, data extraction, and quality evaluation. Risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized controlled trials (RCTs).Results:The results will be submitted to a peer-reviewed journal.Conclusion:This meta-analysis will provide a comprehensive analysis and synthesis that can be used as an evidence map to inform practitioners and policy makers about the effectiveness of telemonitoring interventions for patients with CHF.     

Alcohol consumption and heart failure: A systematic review

Heart failure (HF) remains a major public health issue. It is estimated that about 500,000 Americans per year are diagnosed with HF. Despite advanced medical and surgical treatments for HF, mortality after the onset of HF is still high, thereby underscoring the importance of primary prevention. Among modifiable lifestyle factors, alcohol consumption appears to play a role in the development of HF. Although excessive drinking has been known to lead to alcoholic cardiomyopathy and light-to-moderate drinking may confer some cardiovascular benefits, recent studies suggest it is not only the quantity, but also drinking patterns and genetic factors, that may influence the relation between alcohol consumption and cardiovascular disease. This article reviews current evidence on the association between alcohol consumption and HF.     

A systematic review of telemonitoring for the management of heart failure

BACKGROUND: Telemonitoring allows a clinician to monitor, on a daily basis, physiological variables measured by patients at home. This provides a means to keep patients with heart failure under close supervision, which could reduce the rate of admission to hospital and accelerate discharge. OBJECTIVE: To review the literature on the application of telemedicine in the management of heart failure. METHODS: A literature search was conducted on studies involving telemonitoring and heart failure between 1966 and 2002 using Medline, Embase, Cochrane Library and Journal of Telemedicine and Telecare. RESULTS: Eighteen observational studies and six randomised controlled trials involving telemonitoring and heart failure were identified. Observational studies suggest that telemonitoring; used either alone or as part of a multidisciplinary care program, reduce hospital bed-days occupancy. Patient acceptance of and compliance with telemonitoring was high. Two randomised controlled trials suggest that telemonitoring of vital signs and symptoms facilitate early detection of deterioration and reduce readmission rates and length of hospital stay in patients with heart failure. One study also showed a reduction in readmission charges. One substantial randomised controlled study showed a significant reduction in mortality at 6 months by monitoring weight and symptoms in patients with heart failure; however, no difference was observed in readmission rates. Another randomised study comparing video-consultation performed as part of a home health care programme for patients with a variety of diagnoses, suggested a reduction in the costs of hospital care, which offset the cost of video-consultation. Patients with heart failure were not reported separately. One randomised study showed no difference in outcomes between the telemonitoring group and the standard care group. CONCLUSION: Telemonitoring might have an important role as part of a strategy for the delivery of effective health care for patients with heart failure. Adequately powered multicentre, randomised controlled trials are required to further evaluate the potential benefits and cost-effectiveness of this intervention.     

Prevalence of sarcopenia in heart failure: A systematic review

ObjectiveHeart Failure (HF) is emerging as a crucial factor promoting muscle wasting and dysfunction contributing to sarcopenia. This modulates disease severity and reduces exercise capacity and leading to poorer outcomes. Therefore, we aimed to systematically investigate the overall prevalence of sarcopenia in HF.MethodsAn electronic search was carried out in selected databases until 21st January, 2021. Data was pooled from the included articles and represented as pooled prevalence of sarcopenia. Subgroup analysis was undertaken between methods of diagnosis of sarcopenia, gender, ejection fraction, median time point and geographical region.ResultsAmongst 32,643 citations imported from selected databases, 12 articles were included in final analysis. Analysis for prevalence of sarcopenia was 34%, with prevalence rates ranging from 10.1% to 68%. Subgroup analysis revealed strong associations between Dual-energy X-ray Absorptiometry (DXA) and Asian Working Group for Sarcopenia (AWGS) (chi square = 3.24; p < 0.001), with a good level of agreement (kappa = 0.76 [95% CI: 0.70–0.82]; p < 0.001). Gender wise analysis revealed higher prevalence of sarcopenia among males (66%) than females (34%).ConclusionSarcopenia is highly prevalent among those with HF (irrespective of type of HF) and is more commonly seen in males compared to females.