目的:系统评价补肾和脉方对单纯收缩期高血压患者血压和血管功能的影响及其临床用药安全性.方法:检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science等8个中英文数据库从建库至2022年10月关于补肾和脉方治疗单纯收缩期高血压的临床随机对照试验.首先进行文献筛选和信息提取,进行质量评价后对最终纳入的19篇文献进行Meta分析.结果:19篇文献中共1 612例患者.Meta分析结果显示:相比于对照组,试验组能有效降低偶测收缩压[均数差(MD)=-7.11,95％置信区间(CI)(-9.11,-5.11),P＜0.000 01],且不降低偶测舒张压[MD=0.72,95％CI(-0.75,2.19),P=0.34];相比于对照组,试验组能有效降低24 h动态收缩压[MD=-7.03,95％CI(-10.88,-3.17),P=0.000 4],且不降低 24 h 动态舒张压[MD=0.72,95％CI(-0.40,1.84),P=0.21];相比于对照组,试验组能显著降低脉搏波传导速度[MD=-147.71,95％CI(-195.16,-100.26),P＜0.000 01];相比于对照组,试验组能有效降低尿白蛋白/肌酐值[MD=-0.10,95％CI(-0.11,-0.09),P＜0.000 01];相比于对照组,试验组能有效降低不良反应事件发生率[相对危险度(RR)=0.44,95％CI(0.23,0.83),P=0.01],且差异具有统计学意义(P＜0.05).结论:相比于单纯西医常规治疗,联合治疗有更好的降收缩压效果,且不降低舒张压,可显著改善大血管弹性,还有一定的微血管保护作用,在不良反应方面,单用补肾和脉方显示出良好的临床用药安全性.
A Meta-analysis of the effects of Bushen Hemai formula on blood pressure and vascular function in patients with isolated systolic hypertension
Objective:To systematically evaluate the effects of Bushen Hemai formula(补肾和脉方)on blood pressure and vascular function in patients with simple systolic hypertension and the safety.Methods:Eight Chinese and English databases,including CNKI,VIP Database,Wanfang Database,China Biomedical Literature Database,PubMed,Cochrane Library,Embase,and Web of Science were searched for clinical randomized controlled trials(RCTs)on treation simple systolic hypertension with Bushen Hemai formula from the establishment of database to October 2022.Firstly,literature screening and information extraction were per-formed,and then Meta-analysis was performed.Results:A total of 19 articles were included,involving 1612 patients.The results of Me-ta-analysis showed that compared with the control group,the experimental group could effectively reduce the measured systolic blood pres-sure[MD=-7.11,95％CI(-9.11,-5.11),P＜0.000 01],and did not reduce the measured diastolic blood pressure[MD=0.72,95％CI(-0.75,2.19),P=0.34].Compared with the control group,the experimental group could effectively reduce 24 h dynamic systolic blood pressure[MD=-7.03,95％CI(-10.88,-3.17),P=0.000 4],and did not reduce 24 h dynamic diastolic blood pressure[MD=0.72,95％CI(-0.40,1.84),P=0.21].Compared with the control group,the experimental group could significantly decrease pulse conduction velocity[MD=-147.71,95％CI(-195.16,-100.26),P＜0.000 01];Compared with the control group,UACR value in the experimental group was significantly decreased[MD=-0.10,95％CI(-0.11,-0.09),P＜0.000 01].Compared with the control group,the experimental group could effectively reduce the incidence of adverse reactions[RR=0.44,95％CI(0.23,0.83),P=0.01],and the difference was statistically significant(P＜0.05).Conclusion:Compared with conventional Westem medicine treatment alone,the combination therapy has a better effect of reducing systohing blood pressure without reducing diastolic effect,can significantly improve macrovascular elasticity,with a certain microvascular protective effect;and better safety.
万方数据
维普
