芪苈强心胶囊治疗扩张型心肌病疗效和安全性的Meta分析

摘要

目的 评价芪苈强心胶囊治疗扩张型心肌病的疗效和安全性.方法 通过计算机和手工检索芪苈强心胶囊治疗扩张型心肌病的随机对照实验文献,采用RevMan5.3软件进行Meta分析.结果 纳入12个研究,总共736例扩张型心肌病患者.Meta分析结果显示:常规西药组联合芪苈强心胶囊总有效率优于单纯西药组(RR=1.36,95%CI:1.16~1.59),提高左室射血分数(MD=5.35,95%CI:3.74~6.95),缩小左室舒张末期内径(MD=3.97,95%CI:2.23~5.70)和左室收缩末期内径(MD=2.88, 95%CI: 1.72~4.03),增加6 min步行距离(MD=43.86,95%CI:28.02~59.56),降低血浆脑钠肽BNP水平(MD=43.86,95%CI:28.02~66.88),降低肿瘤坏死因子水平(MD=43.86,95%CI:28.02~66.88)和高迁移率族蛋白B1水平(MD=4.36,95%CI:2.73~5.98),两组不良反应无明显差别(RR=0.99,95%CI:0.35~2.80).结论 芪苈强心胶囊能够改善扩张型心肌病患者心脏功能,改善临床症状,安全性好,但对疾病的远期疗效仍需要更多临床研究.%Objective To review the curative effect and safety of Qili Qiangxin Capsules in treatment of dilated cardiomyopathy (DCM). Methods The literature of randomized controlled trials (RCT) about treatment of DCM with Qili Qiangxin Capsules were retrieved with computer and handwork, and all data was given a Meta-analysis by using RevMan5.3 software. Results There were 12 RCT included and totally 736 cases of DCM involved in. The results of Meta-analysis showed that the total effective rate was higher in routine Western drugs+Qili Qiangxin Capsules group and Western drug group (RR=1.36, 95%CI: 1.16~1.59). The left ventricular ejection fraction (LVEF, MD=5.35, 95%CI: 3.74~6.95) was improved, left ventricular end-diastolic inner diameter (LVEDD, MD=3.97, 95%CI: 2.23~5.70) and left ventricular end-systolic diameter (LVESD, MD=2.88, 95%CI: 1.72~4.03) were reduced, and 6-minute walk test (6MWT, MD=43.86, 95%CI: 28.02~59.56) was increased. The levels of brain natriuretic peptide (BNP, MD=43.86, 95%CI: 28.02~66.88), tumor necrosis factor (TNF, MD=43.86, 95%CI: 28.02~66.88) and high mobility group protein-B1 (HMG-B1, MD=4.36, 95%CI: 2.73~5.98) were decreased. There was no significant difference in incidence of adverse reactions between 2 groups (RR=0.99, 95%CI: 0.35~2.80). Conclusion Qili Qiangxin Capsules can improve the heart function and relieve clinical symptoms with higher safety in DCM patients, while its long-term curative effect is needed more clinical studies.