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[近两年中医治疗原发性高血压的随机对照试验结局指标分析]

[Analysis of RCT outcome indicators of traditional Chinese medicine for essential hypertension in recent two years].

作者信息

Hu Rui-Xue, Xiong Xing-Jiang, Chen Ren-Bo, Yang Wei, Zhao Hui, Wang Yong-Yan, Liao Xing

机构信息

Office of Basic Research in Evidence-based Medicine,Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences Beijing 100700,China.

Guang'anmen Hospital,China Academy of Chinese Medical Sciences Beijing 100053,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2021 Mar;46(6):1547-1557. doi: 10.19540/j.cnki.cjcmm.20200730.502.

Abstract

To find the status of outcome indicators reported in published randomized controlled trial(RCT) of traditional Chinese medicine(TCM) for essential hypertension in the past two years, we searched for relevant information from four Chinese databases, three English databases and two clinical trial registries in this study, from January 2018 to September 2019. The outcome indicators of RCT were extracted and categorized from trials and the risk of bias was assessed by ROB tools from the Cochrane Collaboration. A total of 125 RCTs and 15 RCT protocols were finally included after study screening. The results showed that the RCT outcomes mainly included efficacy and safety outcomes. Efficacy indicators mainly included blood pressure measurement, quality of life assessment, blood biochemical indicators, urine analysis, arterial ultrasound, vascular endothelial function indicators, hematocrit, hemorheology indicators and other indicators. The safety indicators mainly included general physical examination items, heart, liver and kidney function tests, blood, urine, and stool routine examinations as well as adverse drug reactions/events. The current RCTs cannot distinguish primary and secondary outcomes, and the RCT protocols didn't report efficacy criteria clearly. They both didn't report health economic indicators and the methodological qualities were relatively low. In view of the current status on outcome indicators reported in TCM RCTs, constructing a core outcome set of TCM for essential hypertension and improving the methodology quality of RCTs will help to accurately reflect the actual efficacy of TCM intervention.

摘要

为了了解过去两年发表的中医药治疗原发性高血压随机对照试验(RCT)中所报告的结局指标状况,本研究于2018年1月至2019年9月期间,从四个中文数据库、三个英文数据库和两个临床试验注册库中检索了相关信息。从试验中提取并分类RCT的结局指标,并用Cochrane协作网的ROB工具评估偏倚风险。经过研究筛选,最终共纳入125项RCT和15项RCT方案。结果显示,RCT的结局主要包括疗效和安全性结局。疗效指标主要包括血压测量、生活质量评估、血液生化指标、尿液分析、动脉超声、血管内皮功能指标、血细胞比容、血液流变学指标等。安全性指标主要包括一般体格检查项目、心、肝、肾功能检查、血、尿、便常规检查以及药物不良反应/事件。目前的RCT无法区分主要和次要结局,RCT方案也未明确报告疗效标准。两者均未报告卫生经济学指标,且方法学质量相对较低。鉴于目前中医药RCT中结局指标的报告现状,构建原发性高血压中医药核心结局集并提高RCT的方法学质量,将有助于准确反映中医药干预的实际疗效。

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