芪参益气滴丸改善急性心肌梗死后左心室功能的系统评价

QiShen Yiqi Dropping Pill improve left ventricular cardiac function in convalescent period of acute myocardial infarction:a systematic review

关键词:  芪参益气滴丸  急性心肌梗死恢复期  Meta分析

Key words:  QiShen Yiqi Dropping Pill  recoverable period of acute myocardial infarction  Meta-analysis

摘要:

[目的] 系统评价芪参益气滴丸对急性心肌梗死（AMI）恢复期内左心室功能的改善及收益。[方法] 在中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、EMbase和Cochrane Library数据库中检索自建库至今已发表的芪参益气滴丸与常规西药联合治疗心肌梗死恢复期的临床随机对照试验（RCT）研究。对文献进行质量评价并提取有效资料后，运用RevMan5.3软件进行统计学分析。[结果] 共纳入15个RCT，受试者1 569例，其中试验组794例，对照组775例，纳入文献质量普遍偏低。与单纯常规西药治疗比较，加用芪参益气滴丸可进一步改善AMI血运重建术后患者左心室射血分数（LVEF）[短期治疗（＜6个月）：P＜0.05，MD＝5.94，95%CI（3.75，8.14）；长期治疗（≥6个月）：P＜0.05，MD＝5.35，95%CI（4.16，6.54）]；短期治疗患者左心室收缩末期内径[P＜0.05，MD= -5.56，95%CI（-6.82，-4.30）]或容积[P＜0.05，MD=-10.11，95%CI（-11.73，-8.49）]更小；左心室舒张末期内径或容积更小[P＜0.05，MD＝-9.28，95%CI（-11.43，-7.14）]。[结论] 与常规西药治疗相比，加用芪参益气滴丸可增强血运重建术后患者心功能，延缓左心室重构进程。鉴于纳入临床研究在数量及质量上存在局限性，结果仅作为临床诊疗循证参考，还需更多高质量RCT进一步证实其疗效。

Abstract:

[Objective] To evaluate the efficacy of QiShen Yiqi Dropping Pills combined with conventional Western medicine in improving left ventricular cardiac function in the convalescence of acute myocardial infarction (AMI).[Methods] Randomized controlled trials (RCTs) of Qishen Yiqi Dropping Pills combined with conventional Western medicine in the treatment of myocardial infarction in convalescent stage were searched in CNKI,Wan Fang,Wei Pu (VIP),Chinese biomedical literature database (CBMdisc),PubMed,EMbase database and the Cochrane Library. After quality evaluation and effective data extraction,Revman 5.3 software was used for statistical analysis.[Result] A total of 15 qualified RCTs were included,including 1 569 subjects,including 794 in the experimental group and 775 in the control group. The quality of the included literature was generally low. Compared with conventional western medicine treatment,QiShen Yiqi Dropping Pills could improve left ventricular ejection fraction (LVEF) in AMI patients after revascularization[short term treatment (<6 months) P<0.05,MD=5.94,95%CI(3.75, 8.14);long term treatment (≥ 6 months) P<0.05,MD=5.35,95%CI (4.16,6.54)]. In short-term treatment,left ventricular end systolic diameter (LVESD)[P<0.05,MD=-5.56,95%CI (-6.82,-4.30)] or volume(LVESV)[P<0.05,MD=-10.11, 95%CI(-11.73,-8.49)] were smaller. Left ventricular end diastolic diameter (LVEDD) or volume (LVEDV) were smaller[P<0.05,MD=-9.28,95%CI (-11.43,-7.14)].[Conclusion] Compared with conventional western medicine in the treatment of AMI convalescence,QiShen Yiqi Dropping Pills can enhance the cardiac function of patients after revascularization and delay the process of left ventricular remodeling. However,the limitation in quantity and quality of included clinical studies,the results are only used as evidence-based reference for clinical diagnosis and treatment,and more high-quality RCTs are needed to further confirm the curative effect.