摘要
目的:系统评价祛痰化瘀法治疗原发性高血压的有效性及安全性。方法:计算机检索中国知网、万方数据库、维普期刊数据库、PubMed等6个数据库,检索时间为建库至2021年9月。纳入运用祛痰化瘀法治疗原发性高血压的随机对照试验(RCT),以降压疗效、血压(收缩压及舒张压)变化、症状疗效、中医证候积分改善情况、不良反应发生情况为结局指标。采用Cochrane协作网系统评价员手册5.1.0版偏倚风险评估工具评价文献质量,使用RevMan 5.4.1和StataSE16.0软件进行Meta分析。结果:共纳入17项研究,涉及1542例病人,其中,治疗组770例,对照组772例。Meta分析结果显示:与对照组相比,应用祛痰化瘀类中药的治疗组降压疗效更好[OR=3.21,95%CI(2.29,4.51),P<0.00001],收缩压和舒张压明显降低[MD=-5.78,95%CI(-7.48,-4.08),P<0.00001;MD=-3.61,95%CI(-4.74,-2.49),P<0.00001],症状疗效更高[OR=4.32,95%CI(2.90,6.43),P<0.00001],中医证候积分明显改善[MD=-2.51,95%CI(-2.82,-2.21),P<0.00001]。两组不良事件发生情况比较差异无统计学意义[OR=0.84,95%CI(0.36,1.93),P=0.68]。结论:现有证据表明,祛痰化瘀法治疗原发性高血压有较好的临床疗效,并且不会增加不良反应,有较好的安全性。
Objective:To evaluate the efficacy and safety of the method of removing phlegm and removing blood stasis in the treatment of essential hypertension.Methods:CNKI,WanFang Database,VIP Database,and PubMed were searched from the establishment of the database to September 2021.Randomized controlled trials(RCTs)with method of removing phlegm and removing blood stasis in the treatment of essential hypertension were included.The efficacy of antihypertensive,blood pressure level(systolic and diastolic blood pressure)changes,symptom efficacy,improvement of traditional Chinese medicine(TCM)syndrome scores,and occurrence of adverse reactions were collected.The Cochrane Collaboration System Evaluator Manual Version 5.1.0 Deviation Risk Assessment Tool was used to evaluate the quality of the literature,and the RevMan 5.4.1 and StataSE 16.0 were used for Meta-analysis.Results:A total of 17 studies were included,with 1542 patients,770 in the treatment group and 772 in the control group.Meta-analysis results showed that compared with control group,the antihypertensive effect of treatment group with removing phlegm and blood stasis was better[OR=3.21,95%CI(2.29,4.51),P<0.00001],systolic blood pressure and diastolic blood pressure of treatment group were reduced significantly[MD=-5.78,95%CI(-7.48,-4.08),P<0.00001;MD=-3.61,95%CI(-4.74,-2.49),P<0.00001],the symptom curative effect of treatment group was better[OR=4.32,95%CI(2.90,6.43),P<0.00001],TCM syndrome scores of treatment group were significantly improved[MD=-2.51,95%CI(-2.82,-2.21),P<0.00001].There was no statistically significant difference in the occurrence of adverse events between two groups[OR=0.84,95%CI(0.36,1.93),P=0.68].Conclusion:Existing evidence shows that the method of removing phlegm and removing blood stasis is effective and safety in the treatment of essential hypertension,without increase of adverse reactions.
作者
尹彤
韩学杰
王丽颖
刘大胜
YIN Tong;HAN Xuejie;WANG Liying;LIU Dasheng(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中西医结合心脑血管病杂志》
2023年第2期222-233,238,共13页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
国家自然科学青年科学基金项目(No.81904325)
中国中医科学院科技创新工程(No.CI2021A00105)。
关键词
原发性高血压
祛痰化瘀
有效性
安全性
META分析
essential hypertension
removing phlegm and removing blood stasis
efficacy
safety
Meta-analysis
