| 引用本文:韩美子.强心宁煎剂治疗慢性心力衰竭（非保留型）的有效性及安全性系统评价与Meta分析[J].世界中医药,2019,(10):. |
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| 强心宁煎剂治疗慢性心力衰竭（非保留型）的有效性及安全性系统评价与Meta分析 |
| Efficacy and Safety of Qiangxinning Decoction in the Treatment of Chronic Heart Failure(Non Reserved)：A Systematic Review and Meta-Analysis |
| 投稿时间：2018-09-27 |
| DOI：10.3969/j.issn.1673-7202.2019.10.020 |
| 中文关键词: 强心宁 慢性心力衰竭 系统评价 疗效 meta分析 射血分数减低 射血分数中等 安全性。 |
| English Keywords:Qiangxinning Chronic heart failure Systematic review Efficacy Meta-analysis Decreased ejection fraction Moderate ejection fraction Safety. |
| 基金项目:省部共建心肌缺血重点实验室开放课题(KF201207)——益气温阳活血利水方药物血清对乳鼠心肌细胞凋亡激活途径及相关蛋白表达的影响 |
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| 中文摘要: |
| 目的：通过循证医学方法评价中药复方强心宁煎剂治疗慢性心力衰竭（非保留型）的有效性及安全性。方法：系统检索中文数据库cnki数据库、万方数据库、维普数据库、sinomed数据库，英文数据库pubmed、medline数据库及corchrane library。文献检索年限起始为不限至2018年3月，分别以“强心宁”及qiangxinning作为关键词全文检索中英文数据库。纳入强心宁煎剂加标准治疗对照标准治疗治疗慢性心力衰竭的RCT文献。采用corchrane handbook评价偏倚，并采用review manage 5.3对计量资料进行Meta分析；对异质性采用敏感性分析，并做合理解释；发表偏倚采用倒漏斗图进行评估。结果：共纳入10项RCT研究752例患者，文章质量风险评估普遍为Unclear risk of bias，观察组比较对照组，疗效结果显示：有效率RD（95%CI）:2.5[0.82-8.39]，heterogeneity:P=0.95；左室射血分数（LVEF）：MD（95%CI）:0.60[0.35-0.85]，heterogeneity:P=0.19；左心室舒张末期内径（LVEDD）：MD（95%CI）:-0.48[-0.78至-0.17]，heterogeneity:P=021。结论：强心宁煎剂对射血分数减低型心力衰竭的能够减轻心力衰竭患者的临床症状，且能在一定程度上提升射血分数，减低左室舒张期末径，出现的不良较少，疗效性及安全性仍需强证据等级研究进一步证实。 |
| English Summary: |
| To evaluate the efficacy and safety of Chinese herbal compound-Qiangxinning Decoction in the treatment of chronic heart failure(CRF, non reserved)by evidence-based medicine.Methods:Chinese databases CNKI database, Wanfang database, VIP database and Sinomed database, as well as English databases PubMed, Medline databases and Corchrane Library were systematically retrieved.The period of literature retrieval was “not limited to March 2018”.“强心宁” and “Qiangxing” were used as keywords in full-text retrieval of Chinese and English databases.RCT literatures of Qiangxinning Decoction plus standard treatment control and standard treatment for CRF were included.The bias was evaluated with Corchrane Handbook, and Review Manage 5.3 was used to perform Meta-analysis on the measurement data.Sensitivity analysis was used to analyze the heterogeneity, and a reasonable explanation was made.The publication bias was evaluated by the inverted funnel plot.Results:A total of 752 patients were included in 10 RCT studies.The quality risk assessment was generally “unclear risk of bias”.The experimental group was compared with the control group, and the efficacy results showed that the effective rate：RD(95% CI)was 2.5 [0.82-8.39], and the heterogeneity was “P=0.95”; the left ventricular ejection fraction(LVEF)：MD(95% CI)was 0.60 [0.35-0.85], and the heterogeneity was “P=0.19”; the left ventricular end-diastolic diameter(LVEDD)：MD(95% CI)was-0.48 [-0.78 to-0.17], and the heterogeneity was “P=0.21”.Conclusion:Qiangxinning Decoction can relieve the clinical symptoms of heart failure patients with decreased ejection fraction, improve the ejection fraction to a certain extent, and reduce the left ventricular end-diastolic diameter, with less adverse reactions.However, the efficacy and safety still need strong evidence-based study to be further confirmed. |
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