中药汤剂联合沙库巴曲缬沙坦治疗慢性心力衰竭疗效及安全性的Meta分析
Efficacy and Safety of Traditional Chinese Herbal Decoction Combined with Sacubitril/Valsartan in the Treatment of Chronic Heart Failure:a Meta-analysis
蒋鹭莲 1温伟 2刘明旺 2张洋芳 2闫宇新 1李浩浩 1郜梦杰 1赵福海1
作者信息
- 1. 北京中医药大学(北京 100029)
- 2. 中国中医科学院西苑医院
- 折叠
摘要
目的:系统评价中药汤剂联合沙库巴曲缬沙坦(LCZ696)治疗慢性心力衰竭(CHF)的有效性和安全性.方法:检索 PubMed、the Cochrane Library、EMbase、中国学术期刊全文数据库、万方数据库、维普数据库和中国生物医学文献数据库中关于中药汤剂联合 LCZ696治疗 CHF的随机对照试验,检索时限为建库至 2022年 9月 1日.采用 Cochrane偏倚风险评估工具对纳入文献进行质量评价,应用 Rev Man 5.3软件进行 Meta分析.结果:共纳入 14项研究,涉及 1 121例病人.Meta分析显示:与常规治疗基础上加用 LCZ696比较,中药汤剂联合 LCZ696治疗 CHF的有效率更高[RR=1.23,95%CI(1.15,1.31),P<0.000 01],治疗后 6 min步行距离[MD=46.41,95%CI(29.57,63.25),P<0.000 01]及左室射血分数[MD=5.07,95%CI(3.14,7.01),P<0.00001]明显增加,治疗后左心室舒张末期内径[MD=-2.76,95%CI(-3.96,-1.55),P<0.00001]及血清N末端脑利钠肽前体[SMD=-2.11,95%CI(-3.13,-1.10),P<0.000 1]水平明显降低,两组不良反应发生率比较差异无统计学意义[RR=0.68,95%CI(0.33,1.38),P =0.28].结论:现有证据表明,中药汤剂联合 LCZ696治疗 CHF可显著提高临床疗效且安全性较好.
Abstract
Objective:To evaluate the efficacy and safety of traditional Chinese herbal decoction combined with sacubitril/valsartan(LCZ696)for the treatment of chronic heart failure(CHF).Methods:Randomized controlled trials of traditional Chinese herbal decoction combined with LCZ696 in the treatment of CHF were searched from PubMed,the Cochrane Library,EMbase,Wanfang Data,Chinese Science and Technology Journal Database(VIP),and Chinese Biomedical Literature Database.The search period was from the establishment of data to September 1,2022.Cochrane bias risk assessment tool was used to evaluate the quality of the included literature.Meta-analysis was performed by RevMan 5.3 software.Results:A total of 14 studies were included,involving 1 121 patients.Meta-analysis showed that compared with LCZ696 alone,traditional Chinese herbal decoction combined with LCZ696 showed higher clinical effective rate for the treatment of CHF(RR=1.23,95%CI 1.15-1.31,P<0.000 01),and 6 min walking distance(MD=46.41,95%CI 29.57-63.25,P<0.000 01)and left ventricular ejection fraction(MD=5.07,95%CI 3.14-7.01,P<0.000 01)significantly increased,and left ventricular end-diastolic diameter(MD=-2.76,95%CI-3.96--1.55,P<0.000 01)and serum N-terminal brain natriuretic peptide precursors(SMD=-2.11,95%CI-3.13--1.10),P<0.000 1)significantly decreased.There was no significant difference in the incidence of adverse reactions between two groups(RR=0.68,95%CI 0.33-1.38,P =0.28).Conclusion:Available evidence shows that traditional Chinese herbal decoction combined with LCZ696 can significantly improve clinical efficacy with safety for the treatment of CHF.
关键词
慢性心力衰竭/中药汤剂/沙库巴曲缬沙坦/左室射血分数/N末端脑利钠肽前体/Meta分析Key words
chronic heart failure/traditional Chinese herbal decoction/sacubitril/valsartan/left ventricular ejection fraction/N-terminal brain natriuretic peptide precursors/Meta-analysis引用本文复制引用
基金项目
国家重点研发计划项目(2019YFC1708501)
出版年
2024
NETL
NSTL
万方数据