Wang Meng-Xi, Wu Chen-Jie, Cao Pei-Hua, Chen Xiao-Hu
Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine) Nanjing 210029, China.
Zhongguo Zhong Yao Za Zhi. 2021 Feb;46(3):685-693. doi: 10.19540/j.cnki.cjcmm.20200521.501.
To systematically evaluate the efficacy and safety of traditional Chinese medicine in treating patients with resistant hypertension. CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Cochrane Library, EMbase and other databases were retrieved by computers to screen out the randomized controlled trial of traditional Chinese medicine in treating resistant hypertension. Cochrane Handbook was used to evaluate the quality of the included literature, RevMan 5.3 and Stata 12.0 was used for Meta-analysis. Finally, 11 literatures meeting the criteria were included, involving 1 023 patients. The results of Meta-analysis showed that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further reduce systolic blood pressure of patients with resistant hypertension(MD=-16.69, 95%CI[-22.21,-11.16], P<0.000 01), reduce diastolic blood pressure(MD=-7.51, 95%CI[-8.26,-6.76], P<0.000 01), improve the effective rate of anti-hypertension(OR=5.16, 95%CI[3.01, 8.84], P<0.000 01), improve the up-to-standard rate of blood pressure(OR=3.01, 95%CI[1.49, 6.09], P=0.002), and improve the effectiveness of clinical symptoms(OR=4.48, 95%CI[2.31, 8.68], P<0.000 01), with no significant effect on creatinine level(MD=-2.51, 95%CI[-6.91, 1.89], P=0.26). The results of this study indicated that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further improve the clinical efficacy in patients with resistant hypertension with a good safety, but more high-quality clinical studies are still needed to verify this conclusion.
为系统评价中医药治疗顽固性高血压患者的疗效和安全性。通过计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、Cochrane图书馆、EMbase等数据库，筛选出中医药治疗顽固性高血压的随机对照试验。采用Cochrane手册评估纳入文献的质量，使用RevMan 5.3和Stata 12.0进行Meta分析。最终纳入11篇符合标准的文献，涉及1023例患者。Meta分析结果显示，标准三联降压方案联合中医药治疗可进一步降低顽固性高血压患者的收缩压（MD=-16.69，95%CI[-22.21，-11.16]，P<0.000 01），降低舒张压（MD=-7.51，95%CI[-8.26，-6.76]，P<0.000 01），提高降压有效率（OR=5.16，95%CI[3.01，8.84]，P<0.000 01），提高血压达标率（OR=3.01，95%CI[1.49，6.09]，P=0.002），改善临床症状有效率（OR=4.48，95%CI[2.31，8.68]，P<0.000 01），对肌酐水平无显著影响（MD=-2.51，95%CI[-6.91，1.89]，P=0.26）。本研究结果表明，标准三联降压方案联合中医药治疗可进一步提高顽固性高血压患者的临床疗效，安全性良好，但仍需更多高质量的临床研究验证该结论。
