Lu Sheng-Hua, Yu Yun-Feng, Dai Si-Si, Hu Ya-Qi, Liu Jian-He
The First Clinical College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China.
Branch of National Clinical Research Center for Chinese Medicine Cardiology, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China.
World J Clin Cases. 2024 May 6;12(13):2218-2230. doi: 10.12998/wjcc.v12.i13.2218.
The specific benefits of Yangxinshi tablet (YXST) in the treating chronic heart failure (CHF) remain uncertain.
To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.
Randomized controlled trials (RCTs) investigating YXST for CHF treatment were retrieved from eight public databases up to November 2023. Meta-analyses of the included clinical studies were conducted using Review Manager 5.3.
Twenty RCTs and 1845 patients were included. The meta-analysis results showed that the YXST combination group, compared to the conventional drug group, significantly increased the clinical efficacy rate by 23% [relative risk (RR) = 1.23, 95%CI: 1.17-1.29], < 0.00001), left ventricular ejection fraction by 6.69% [mean difference (MD) = 6.69, 95%CI: 4.42-8.95, < 0.00001] and 6-min walk test by 49.82 m (MD = 49.82, 95%C: 38.84-60.80, < 0.00001), and reduced N-terminal pro-B-type natriuretic peptide by 1.03 ng/L [standardized MD (SMD) = -1.03, 95%CI: -1.32 to -0.74, < 0.00001], brain natriuretic peptide by 80.95 ng/L (MD = -80.95, 95%CI: -143.31 to -18.59, = 0.01), left ventricular end-diastolic diameter by 3.92 mm (MD = -3.92, 95%CI: -5.06 to -2.78, < 0.00001), and left ventricular end-systolic diameter by 4.34 mm (MD = -4.34, 95%CI: -6.22 to -2.47, < 0.00001). Regarding safety, neither group reported any serious adverse events during treatment (RR = 0.54, 95%CI: 0.15-1.90, = 0.33). In addition, Egger's test results indicated no significant publication bias ( = 0.557).
YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile, suggesting its potential as a therapeutic strategy for CHF.
养心氏片(YXST)治疗慢性心力衰竭(CHF)的具体益处仍不明确。
系统评价养心氏片治疗CHF的有效性和安全性。
检索截至2023年11月的八个公共数据库中关于养心氏片治疗CHF的随机对照试验(RCT)。使用Review Manager 5.3对纳入的临床研究进行荟萃分析。
纳入20项RCT,共1845例患者。荟萃分析结果显示,与传统药物组相比,养心氏片联合组临床有效率显著提高23%[相对危险度(RR)=1.23,95%置信区间(CI):1.17-1.29,P<0.00001],左心室射血分数提高6.69%[平均差值(MD)=6.69,95%CI:4.42-8.95,P<0.00001],6分钟步行试验距离增加49.82米(MD=49.82,95%CI:38.84-60.80,P<0.00001),N末端B型利钠肽前体降低1.03纳克/升[标准化MD(SMD)=-1.03,95%CI:-1.32至-0.74,P<0.00001],脑钠肽降低80.95纳克/升(MD=-80.95,95%CI:-143.31至-18.59,P=0.01),左心室舒张末期内径减小3.92毫米(MD=-3.92,95%CI:-5.06至-2.78,P<0.00001)以及左心室收缩末期内径减小4.34毫米(MD=-4.34,95%CI:-6.22至-2.47,P<0.00001)。关于安全性,两组在治疗期间均未报告任何严重不良事件(RR=0.54,95%CI:0.15-1.90,P=0.33)。此外,Egger检验结果表明无显著发表偏倚(P=0.557)。
养心氏片可有效改善CHF患者的临床症状和心功能,同时保持良好的安全性,提示其作为CHF治疗策略的潜力。