世界中医药

作者	单位
郑宇昕，李益萍，王肖龙，高俊杰	1 上海中医药大学附属曙光医院心血管科，上海，201203； 2 上海中医药大学附属曙光医院心血管病研究所，上海，201203

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中文摘要:

目的：系统评价养心氏片治疗心力衰竭的临床疗效。方法：检索中国知网、VIP、万方数据医药期刊数据网、中国生物医学文献光盘数据库(CBM)、PubMed、Cochrane Library数据库。筛选合格研究，进行文献质量评价，运用异质性检验、Meta分析、敏感性分析等方法统计相关数据。结果：纳入6项研究，共计559例患者，文献质量偏低；Meta分析结果显示，与对照药物比较，养心氏片能提高6分钟步行距离［WMD=49.97，95% CI：33.22~66.71，P<0.00001］，改善心功能［OR=2.50，95% CI：1.43~4.38，P=0.001］，改善中医症状（胸闷［WMD=-0.53，95% CI：-0.76~-0.31，P<0.00001］、心悸［WMD=-0.31，95% CI：-0.53~-0.08，P=0.007］、乏力［WMD=-0.52，95% CI：-0.97~-0.06，P=0.03］、气促［WMD=-0.45，95% CI：-0.88~-0.02，P=0.04］），但在改善左心室射血分数（LVEF）方面与常规治疗药物效果比较，差异无统计学意义（P>0.05）。结论养心氏片较常规治疗心力衰竭可进一步提高临床疗效，上述结论仍需更多高质量、大样本量的论据加以论证。

English Summary:

To evaluate the clinical curative effect of Yangxinshi Pill in the treatment of chronic heart failure with meta-analysis. Methods:CNKI, VIP, CBM, WanFang, PubMed and Cochrane Library were electronically searched to collect qualified researches for evaluation. The data was analyzed by the heterogeneity test, meta-analysis and sensitivity analysis. Results:Six randomized controlled trials (RCTs) involving 559 patients with poor general quality were included. Results of meta-analyses showed that compared with the control drug group, Yangxinshi Pill could significantly improve the efficacy of 6 minutes' walk distance［WMD=49.97, 95% CI (33.22~66.71), P<0.00001］, cardiac function［OR=2.50, 95% CI (1.43~4.38), P=0.001］, traditional Chinese medicine (TCM) syndrome (chest tightness［WMD=-0.53, 95% CI (-0.76~-0.31), P<0.00001］, palpitation［WMD=-0.31, 95% CI (-0.53~-0.08), P=0.007］, hypodynamic［WMD=-0.52, 95% CI (-0.97~-0.06), P=0.03］, anhelation［WMD=-0.45, 95% CI (-0.88~-0.02), P=0.04］). There was no significant difference in left ventricular ejection fraction between two groups. Conclusion:Yangxinshi Pill is effective in the treatment of HF. However rigorously designed RCTs with large sample are still needed to support its clinical effectiveness.

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