振源胶囊辅助治疗慢性心力衰竭有效性比较的Meta分析

计算机检索Pub Med,EMbase,the Cochrane Library,CBM,CNKI,VIP,Wanfang Data数据库,收集振源胶囊辅助治疗慢性心力衰竭的相关随机对照试验(RCT),检索时间限制从建库至2016年10月。由2位评价者独立筛选文献、提取资料和评价纳入文献的偏倚风险后,采用Rev Man 5.3软件进行Meta分析,系统评价振源胶囊对慢性心力衰竭病人疗效。最终纳入14个RCT,共1 204例慢性心力衰竭患者。Meta分析结果显示,振源胶囊组的心功能疗效RR=1.27,95%CI(1.20,1.35),P0.000 01],每搏输出量WMD=7.62,95%CI(6.39,8.84),P0.000 01],HAMA评分WMD=-4.16,95%CI(-5.59,-2.72),P0.000 01],HAMA心理疗效RR=1.47,95%CI(1.15,1.89),P=0.002],中医症候疗效RR=1.46,95%CI(1.25,1.72),P0.000 01]均显著优于对照组,且差异具有统计学意义。现有证据表明,在常规西药治疗基础上联用振源胶囊可以改善慢性心力衰竭患者心功能、心理状态,提高生活质量,且安全性好。受纳入研究质量和数量的限制,仍需大规模高质量RCT予以验证。

Adjuvant effects of Zhenyuan capsule on chronic heart failure: Meta-analysis

To systematically review the adjuvant effects of Zhenyuan capsule on improving the cardiac function of patients with chronic heart failure. Databases including PubMed, EMbase, the Cochrane Library, CBM, CNKI, VIP and Wanfang Data were searched electronically from inception to October 2016 to collect randomized controlled trials (RCTs) about Zhenyuan capsule for adjuvant treatment of chronic heart failure. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, Meta-analysis was performed by using RevMan 5.3 software. A total of 14 RCTs involving 1 204 patients were included. The results of Meta-analysis showed that the Zhenyuan capsule group had significantly better effectiveness in cardiac function (RR=1.27, 95%CI 1.20 to 1.35, P<0.000 01), stroke volume (WMD=7.62, 95%CI 6.39 to 8.84,P<0.000 01), scores of HAMA (WMD=-4.16, 95%CI -5.59 to -2.72, P<0.000 01), psychological effect of HAMA (RR=1.47, 95%CI 1.15 to 1.89, P=0.002), and traditional Chinese medical syndrome (RR=1.46, 95%CI 1.25 to 1.72, P<0.000 01) than those of the control group, with statistically significant differences. Current evidence showed that Zhenyuan capsule combined with routine treatment could improve the cardiac function and quality of life of patients with chronic heart failure, and with high safety. Due to the limited quantity and quality of the included studies, the above conclusion still needs to be verified by carrying out more high-quality RCTs.