Park Yong-Seok, Wang Wei, Li Ying-Dong, Liu Kai
Gansu University of Chinese Medicine Lanzhou 730000, China Gansu Provincial Laboratory of Traditional Chinese Medicine for Prevention and Control of Chronic Diseases Lanzhou 730000, China.
Gansu University of Chinese Medicine Lanzhou 730000, China.
Zhongguo Zhong Yao Za Zhi. 2022 Aug;47(15):4221-4237. doi: 10.19540/j.cnki.cjcmm.20220510.502.
The efficacy of six commonly used Chinese patent medicines for replenishing Qi and activating blood in the treatment of chronic heart failure was evaluated systematically by network Meta-analysis. Randomized controlled trials(RCTs) about the treatment of chronic heart failure were searched against CNKI, Wanfang, SinoMed, PubMed, and Cochrane library. Network Meta-analysis was performed in Stata 16. A total of 154 RCTs involving 15 620 patients were eventually included. The network Meta-analysis showed that Qili Qiangxin Capsules+conventional western medicine had the highest total effective rate, followed by Tongxinluo Capsules+conventional western medicine, Qishen Yiqi Drop Pills+conventional western medicine, Naoxintong Capsules+conventional western medicine, Shexiang Tongxin Drop Pills+conventional western medicine, Yangxinshi Tablets+conventional western medicine, and conventional western medicine. As for left ventricular ejection fraction(LVEF), Yangxinshi Tablets+conventional western medicine had the highest value, followed by Shexiang Tongxin Drop Pills+conventional western medicine, Qili Qiangxin Capsules+conventional western medicine, Tongxinluo Capsules+conventional western medicine, Qishen Yiqi Drop Pills+conventional western medicine, Naoxintong Capsules+conventional western medicine, and conventional western treatments. As for N-terminal pro-B type natriuretic peptide(NT-proBNP), Qishen Yiqi Drop Pills+conventional western medicine was the most effective treatment, followed by Yangxinshi Tablets+conventional western medicine, Shexiang Tongxin Drop Pills+conventional western medicine, Qili Qiangxin Capsules+conventional western medicine, Tongxinluo Capsules+conventional western medicine, and conventional the most effective treatment was. As for left ventricular end-diastolic diameter(LVEDD), Naoxintong Capsules+conventional western medicine was the best therapy, followed by Tongxinluo Capsules+conventional western medicine, Shexiang Tongxin Drop Pills+conventional western medicine, Yangxinshi Tablets+conventional western medicine, Qili Qiangxin Capsules+conventional western medicine, Qishen Yiqi Drop Pills+conventional western medicine, and conventional western medicine. In summary, the combination of Chinese patent medicines for replenishing Qi and activating blood with western medicines is superior to conventional western medicine alone in the treatment of chronic heart failure. It effectively improves cardiac function indicators such as LVEF, NT-proBNP, and LVEDD, and thus is worthy of popularization in clinical practice. The results of this study provide evidence-based options for the clinical treatment of chronic cardiac failure by combining the Chinese patent medicines for replenishing Qi and activating blood with western medicine.
通过网状Meta分析系统评价6种常用益气活血类中成药治疗慢性心力衰竭的疗效。检索中国知网、万方、中国生物医学文献数据库、PubMed及Cochrane图书馆中关于慢性心力衰竭治疗的随机对照试验（RCT）。使用Stata 16进行网状Meta分析。最终纳入154项RCT，涉及15620例患者。网状Meta分析结果显示，芪苈强心胶囊+常规西药的总有效率最高，其次为通心络胶囊+常规西药、参芪益气滴丸+常规西药、脑心通胶囊+常规西药、麝香通心滴丸+常规西药、养心氏片+常规西药、常规西药。在左心室射血分数（LVEF）方面，养心氏片+常规西药的值最高，其次为麝香通心滴丸+常规西药、芪苈强心胶囊+常规西药、通心络胶囊+常规西药、参芪益气滴丸+常规西药、脑心通胶囊+常规西药、常规西药治疗。在N末端B型脑钠肽前体（NT-proBNP）方面，参芪益气滴丸+常规西药的治疗效果最佳，其次为养心氏片+常规西药、麝香通心滴丸+常规西药、芪苈强心胶囊+常规西药、通心络胶囊+常规西药、常规西药。在左心室舒张末期内径（LVEDD）方面，脑心通胶囊+常规西药的治疗效果最佳，其次为通心络胶囊+常规西药、麝香通心滴丸+常规西药、养心氏片+常规西药、芪苈强心胶囊+常规西药、参芪益气滴丸+常规西药、常规西药。综上所述，益气活血类中成药联合西药治疗慢性心力衰竭优于单纯常规西药治疗。其能有效改善LVEF、NT-proBNP及LVEDD等心功能指标，因此值得在临床实践中推广。本研究结果为益气活血类中成药联合西药治疗慢性心力衰竭的临床治疗提供了循证选择。
