摘要
目的:评价真武汤加减治疗心力衰竭伴利尿剂抵抗的有效性及安全性。方法:检索PubMed、中国生物医学文献数据库、CNKI中国期刊全文数据库、万方数据库、VIP维普数据库。根据Cochrane评价手册评价所纳入文献的质量。使用RevMan 5.3软件进行统计分析。结果:共纳入10篇文献,共计772例患者。结果显示,真武汤加减方联合常规西药治疗心力衰竭伴利尿剂抵抗相较于单纯西药治疗,试验组24h尿量增加[MD=0.40,95%CI(0.24,0.55),P<0.00001],体重减轻[MD=-2.87,95%CI(-3.55,-2.19),P<0.00001],B型利钠肽(BNP)降低[MD=-0.70,95%CI(-1.25,-0.15),P=0.01],左室射血分数(LVEF)增加[MD=2.86,95%CI(1.64,4.07),P<0.00001],NYHA心功能分级改善[OR=3.73,95%CI(2.42,5.75),P<0.00001],心衰症状疗效(Lee氏评分)改善[OR=3.77,95%CI(1.71,8.28),P=0.001],中医证候积分改善[OR=3.17,95%CI(1.50,6.66),P=0.002],低钾血症发生率低[MD=0.15,95%CI(0.08,0.22),P<0.0001]。结论:基于目前证据,真武汤加减对治疗心力衰竭伴利尿剂抵抗临床疗效良好,且不良反应发生率低。
Objective:To evaluate the effectiveness and safety of Zhenwu Decoction in the treatment of heart failure with diuretic resistance.Methods:We search the following database:PubMed,CBM,CNKI,Wanfang,VIP.The quality of the included literatures were evaluated according to the Cochrane evaluation manual.Revman 5.3 software was used for statistical analysis.Results:A total of 10 literatures including 772 patients were included.The results showed that compared with western medicine alone,Zhenwu Decoction plus conventional western medicine in the treatment of heart failure with diuretic resistance,the 24 hurine volume increased[MD=0.40,95%CI(0.24,0.55),P<0.00001],blody weight decreased[MD=-2.87,95%CI(-3.55,-2.19),P<0.00001],B-type natriuretic peptide(BNP)decreased[MD=-0.70,95%CI(-1.25,-0.15),P=0.01],left ventricular ejection fraction(LVEF)increased[MD=2.86,95%CI(1.64,4.07),P<0.00001],NYHA classification improved[OR=3.73,95%CI(2.42,5.75),P<0.00001],Lee’s score improved[OR=3.77,95%CI(1.71,8.28),P=0.001],TCM syndrome score improved[OR=3.17,95%CI(1.50,6.66),P=0.002],and the incidence of Hypokalemia was low[MD=0.15,95%CI(0.08,0.22),P<0.0001].Conclusion:Based on current evidence,Zhenwu decoction has good clinical efficacy in the treatment of heart failure with diuretic resistance,and the incidence of adverse reactions is low.
作者
邹吉涛
钱舒乐
刘建和
王建国
Zou Jitao;Qian Shule;Liu Jianhe;Wang Jianguo(Hunan University of Chinese Medicine,Changsha 410208,China;The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Tongde Hospital of Zhejiang Province,Hangzhou 310000,China)
出处
《亚太传统医药》
2021年第11期159-165,共7页
Asia-Pacific Traditional Medicine
关键词
心力衰竭
利尿剂抵抗
真武汤
META分析
Heart Failure
Diuretic Resistance
Zhenwu Decoction
Meta Analysis
