Meta-Analysis of Modified Zhenwu Decoction in Treatment of Diuretic Resistance in Heart Failure
Objective To systematically evaluate the clinical efficacy of modified Zhenwu Decoction combined with conventional western medicine in the treatment of diuretic resistance in heart failure.Methods The randomized con-trolled trials of modified Zhenwu Decoction in the treatment of diuretic resistance in heart failure were searched from CNKI,Wanfang Database,VIP Database,China Biomedical Literature Database,PubMed,Cochrane Library,Embase,Web of Science,Clinical Trials,China Clinical Trial Registry,and other databases from their establishment to November 1,2023.Review Manager 5.4 software was used for the Meta-analysis of the data from the literature.Results A total of 15 pieces of literature were included,involving 1 187 patients.Meta-analysis showed that compared with those in the western medicine control group,the total 24 h urine volume[n=1 058,MD=397.30,95％CI(269.44,525.16),P＜0.01],total clinical effective rate[n=625,RR=1.24,95％CI(1.15,1.34),P＜0.01],left ventricular ejection fractions(LVEF)[n=697,MD=4.32,95％CI(2.51,6.112),P＜0.01],level of N-terminal pro-B-type natriuretic peptide(NT-proBNP)[n=282,MD=734.4,95％CI(828.93,639.87),P＜0.01],IL-6 level in peripheral blood[n=170,MD=-5.70,95％CI(-7.23,-4.16),P＜0.01],and TNF-α level in peripheral blood[n=170,MD=-12.79,95％CI(-15.53,-10.04),P＜0.01]in the modified Zhenwu Decoction combined with conventional western medicine were significantly improved.However,there was no significant improvement in left ventricular end-diastolic diameter[n=266,MD=-4.50,95％CI(-9.36,0.35),P=0.07].The drug had good safety,and the incidence of hypokalemia could be significantly reduced by traditional Chinese medicine(TCM)treatment[n=177,RR=0.32,95％CI(0.18,0.57),P＜0.01].Conclusion On the basis of simple western medicine treatment,modified Zhenwu Decoction can improve 24 h u-rine volume,increase the clinical total effective rate,improve the cardiac function of patients with diuretic resistance in heart failure,reduce the level of inflammatory factors,and have good safety.
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