Zhang Yan, Wang Biqing, Ju Chunxiao, Liu Lu, Zhu Ying, Mei Jun, Liu Yue, Xu Fengqin
Graduate School of China Academy of Chinese Medical Sciences, Beijing 100700, China.
Center of Geriatrics Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.
Evid Based Complement Alternat Med. 2020 Dec 18;2020:5471931. doi: 10.1155/2020/5471931. eCollection 2020.
We systematically retrieved and summarised clinical studies on traditional Chinese medicine (TCM) for the prevention and treatment of essential hypertension (EH) using the evidence map. We aimed to explore the evidence distribution, identify gaps in evidence, and inform on future research priorities. Clinical studies, systematic reviews, guidelines, and pathway studies related to TCM for the prevention and treatment of EH, published between January 2000 and December 2019, were included from databases CNKI, WanFang Data, VIP, PubMed, Embase, and Web of Science. The distribution of evidence was analysed using text descriptions, tables, and graphs. A total of 9,403 articles were included, including 5,920 randomised controlled studies (RCTs), 16 guidelines, expert consensus and path studies, and 139 systematic reviews (SRs). The articles publishing trend increased over time. This study showed that the intervention time of TCM was concentrated at 4-8 weeks, mainly through Chinese herbal medicine (CHM) for the prevention and treatment of elderly hypertension and the complications. A Measurement Tool to Assess Systematic Reviews (AMSTAR) scores of the included reviews ranged from 2 to 10. Most of the SRs had a potentially positive effect ( = 120), mainly in 5-8 score. Primary studies and SRs show potential benefits of TCM in lowering blood pressure, lowering the TCM syndrome and symptom differentiation scores (TCM-SSD scores), improving the total effective rate, and reducing the adverse events. The adjunctive effect of TCM on improving the total effective rate, lowering the blood pressure, lowering the TCM-SSD scores, and lowering the adverse effects was only supported by low-quality evidence in this research. The evidence map was used to show the overall research on TCM for the treatment of EH; however, due to the existing problems of the primary studies, the current research conclusion needs further research with higher quality and standardisation.
我们使用证据图谱系统检索并总结了关于中医预防和治疗原发性高血压（EH）的临床研究。我们旨在探索证据分布，找出证据空白，并为未来的研究重点提供信息。纳入了2000年1月至2019年12月期间发表的与中医预防和治疗EH相关的临床研究、系统评价、指南和路径研究，这些研究来自中国知网、万方数据、维普、PubMed、Embase和Web of Science数据库。使用文本描述、表格和图表分析证据分布。共纳入9403篇文章，其中包括5920项随机对照试验（RCT）、16项指南、专家共识和路径研究以及139项系统评价（SR）。文章发表趋势随时间增加。本研究表明，中医干预时间集中在4至8周，主要通过中药预防和治疗老年高血压及其并发症。纳入评价的《评估系统评价的测量工具》（AMSTAR）评分范围为2至10分。大多数SR具有潜在的积极作用（n = 120），主要在5至8分。原始研究和SR显示中医在降低血压、降低中医证候和症状分化评分（中医-SSD评分）、提高总有效率以及减少不良事件方面具有潜在益处。本研究中，中医在提高总有效率、降低血压、降低中医-SSD评分和降低不良反应方面的辅助作用仅得到低质量证据的支持。证据图谱用于展示中医治疗EH的总体研究情况；然而，由于原始研究存在的问题，目前的研究结论需要进一步高质量和标准化的研究。
