血府逐瘀方治疗原发性高血压有效性与安全性的系统评价与Meta分析

Xuefu Zhuyu Recipe for the treatment of essential hypertension: a systematic review and Meta-analysis

关键词:  血府逐瘀方  高血压  系统评价  Meta分析

Key words:  Xuefu Zhuyu Recipe  hypertension  systematic review  Meta-analysis

摘要:

[目的]评估血府逐瘀方（包括汤剂、胶囊、丸剂、片剂、颗粒剂）治疗原发性高血压的当前临床证据。[方法]系统检索Cochrane图书馆、PubMed、EMBASE、中国知网（CNKI）、中国科技期刊数据库（重庆维普）、万方数据库、中国生物医学文献服务系统（CBM）7个电子数据库，检索日期截至2018年12月，纳入血府逐瘀方单用或联合降压药与降压药对照的随机临床试验，评估文献的方法学质量，提取有效数据并根据Cochrane系统评价方法进行系统评价，结局指标包括降压疗效、收缩压及舒张压水平、中医证候疗效和不良反应。[结果]降压疗效Meta分析显示，OR=3.32，95% CI[2.00，5.50]，P<0.000 01，差异比较有统计学意义。收缩压水平Meta分析显示，MD=-5.64，95% CI[-8.10，-3.17]，P<0.000 01，两组差异有统计学意义。舒张压Meta分析显示，MD=-3.42，95% CI[-4.61，-2.24]，P<0.000 01，两组差异有统计学意义。中医证候疗效Meta分析显示，OR=3.57，95% CI[2.09，6.11]，P<0.000 01，差异有统计学意义。不良反应Meta分析显示，OR=1.34，95% CI[0.44，4.09]，P=0.6，差异无统计学意义。[结论]血府逐瘀方联合降压药在降低血压水平、提高疗效和改善中医证候方面优于单纯降压药治疗，不增加不良反应，但由于目前纳入的文献质量参差不齐，干预措施不完全一致，仍需要进一步深入研究。

Abstract:

[Objective] To evaluate the current clinical evidence for Xuefu Zhuyu Recipe (including decoction,capsules,pills,tablets,granules) in the treatment of essential hypertension.[Methods] Seven electronic databases including Cochrane Library,PubMed,EMBASE,CNKI,Weipu,Wanfang Database and CBM were searched. The search date was until December 2018,and all RCTs should be included in the Xuefu Zhuyu Recipe alone or in combination with antihypertensive drugs versus antihypertensive drugs in control. Assessing the methodological quality of the literature,extracting valid data and systematically evaluating it according to the Cochrane systematic review method. Outcome measures include antihypertensive effect,systolic blood pressure and diastolic blood pressure,TCM syndrome efficacy and adverse reactions.[Results] Meta-analysis of antihypertensive efficacy showed that OR=3.32,95%CI[2.00,5.50],P<0.000 01,the difference was statistically significant. Meta-analysis of systolic blood pressure showed that MD=-5.64,95% CI[-8.10, -3.17],P<0.000 01,and the difference between the two groups was statistically significant. Metastatic pressure Meta-analysis showed that MD=-3.42,95%CI[-4.61,-2.24],P<0.00001,and the difference between the two groups was statistically significant. Meta-analysis of TCM syndrome efficacy showed that OR=3.57,95%CI[2.09,6.11],P<0.000 01,and the difference was statistically significant;Meta-analysis of adverse reactions showed OR=1.34,95%CI[0.44,4.09],P=0.6,the difference was not statistically significant.[Conclusion] Xuefu Zhuyu Recipe combined with antihypertensive drugs is superior to simple antihypertensive drugs in reducing blood pressure,improving curative effect and improving TCM syndromes. There is no obvious adverse reaction. But the quality of the literatures currently included is uneven,and the interventions are not completely consistent,and further research is needed.