Wang Kaihuan, Wu Jiarui, Duan Xiaojiao, Wu Jiatao, Zhang Dan, Zhang Xiaomeng, Zhang Bing
Department of Clinical Pharmacology of Traditional Chinese Medicine, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China.
Medicine (Baltimore). 2017 Sep;96(39):e8167. doi: 10.1097/MD.0000000000008167.
To evaluate the clinical effectiveness and safety of Huangqi injection (HI) in treating chronic heart failure (CHF) systematically.
A literature search was conducted for retrieving randomized controlled trials (RCTs) on CHF treated by HI in the Cochrane Library, PubMed, Embase, China Biology Medicine disc, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang Database up to June, 6, 2017, and then the included RCTs were assessed by the Cochrane Risk of Bias Assessment Tool. The clinical total effective rate, left ventricular ejection fraction (LVEF), and others outcomes were analyzed by Review Manager 5.3 in random-effect model, the funnel plot were depicted as well. Meanwhile, the sensitivity analysis was carried out by STATA 12.0.
Sixteen RCTs involved 1864 patients were included. The result of HI group was more efficient in the clinical total effective rate (RR = 1.19, 95% confidence intervals (95% CI) [1.14-1.26], P < .00001). In addition, HI plus western medicine (WM) could improve LVEF (MD = 4.64, 95% CI [3.52-5.75], P < .00001), and others cardiac indexes. Meanwhile, a combination of HI and WM also can perfect 6 minutes walk test (6MWT). Three RCTs reported no serious adverse drug events/adverse drug reactions occurred.
Compared with WM, a combination of HI and WM was more efficacious in improving the clinical total effective rate, and perfect patients' condition, but more evidence-based medicine researches needed to support this study further.
系统评价黄芪注射液（HI）治疗慢性心力衰竭（CHF）的临床有效性和安全性。
检索Cochrane图书馆、PubMed、Embase、中国生物医学文献数据库、中国知网、维普数据库、万方数据库中截至2017年6月6日关于HI治疗CHF的随机对照试验（RCT），采用Cochrane偏倚风险评估工具对纳入的RCT进行评估。采用RevMan 5.3软件对临床总有效率、左心室射血分数（LVEF）等结局指标进行随机效应模型分析，并绘制漏斗图。同时，采用STATA 12.0软件进行敏感性分析。
纳入16项RCT，共1864例患者。HI组临床总有效率更高（RR = 1.19，95%置信区间[95%CI][1.14 - 1.26]，P <.00001）。此外，HI联合西药（WM）可提高LVEF（MD = 4.64，95%CI[3.52 - 5.75]，P <.00001）及其他心脏指标。同时，HI与WM联合还可改善6分钟步行试验（6MWT）。3项RCT报告未发生严重不良药物事件/药物不良反应。
与WM相比，HI联合WM在提高临床总有效率、改善患者病情方面更有效，但需要更多循证医学研究进一步支持本研究。
