Objective To systemically evaluate the clinical therapeutic effect of combined traditional Chinese medicine (TCM) and western medicine for treatment of acute heart failure by Meta analysis. Methods The America National Library PubMed and China Biomedical Literature Data System (SinoMed), China National Knowledge Infrastructure (CNKI), VIP Data Resource, Wanfang Data Resource, Chinese TCM Database Retrieval System were searched from 1990 to May 2014 to identify the formally published randomized controlled trials (RCTs) in which the effects of combined TCM and western medicine (experiment group) or simple western medicine (control group) for treatment of patients with acute heart failure were reported. The Cochrane system 4.2.2 quality evaluation standard in Evaluation Handbook was applied to assess the methodological quality of literature. The Cochrane Collaboration's RevMan 5.2 software was used to seek the literatures consistent to the criteria of enrolling into the study for Meta analysis. Results There were 18 RCTs, and all together 1 374 cases were included in the data. The grade of methodological quality of the enrolled studies was of high migration. Meta analysis showed: compared with the control group, the clinical efficacy in experimental group was significantly higher [odds ratio (OR) = 5.04, 95% confidence interval (95%CI): 3.31 - 7.69, P < 0.000 01]; the level of type B natriuretic peptide (BNP) was significantly reduced [standardized mean difference (SMD) = -1.31, 95%CI: -1.78 to -0.83, P<0.000 01];left ventricular ejection fraction (LVEF) was significantly increased (SMD=0.79, 95%CI:0.52-1.07, P < 0.000 01); the therapeutic effect on TCM syndrome was significantly elevated [categorical variables: relative risk (RR) = 1.30, 95%CI: 1.06 - 1.59, P = 0.01; quantitative variables: mean difference (MD) = -1.67, 95%CI: -2.48 to-0.86, P<0.000 1] and cardiac diastolic function was significantly improved (SMD=0.64, 95%CI:0.05-1.24, P<0.05). Conclusions The clinical therapeutic effects of combined TCM and western medicine are significantly higher than those of simple western medicine for treatment of patients with acute heart failure. However, the low quality of the reports involved in this study limits the reliability of this conclusion.%目的：系统评价中西医结合治疗急性心力衰竭（心衰）的临床疗效。方法全面检索美国国立图书馆PubMed数据库、中国生物医学文献数据系统（SinoMed）、中国知网CNKI数据库、中文科技期刊全文数据库（维普）、万方数据资源系统、中国中医药数据库检索系统，收集1990年至2014年5月正式发表的中西医结合（试验组）与单纯西医治疗（对照组）急性心衰的随机对照临床试验（RCT）的文章，采用Cochrane系统评价员手册4.2.2质量评价标准评价文献方法学质量，运用RevMan 5.2软件对符合纳入标准的文献进行Meta分析。结果共纳入18篇RCT文献、1374例患者。质量评价等级均为高偏移度。Meta分析显示：与对照组比较，试验组临床综合疗效明显提高〔优势比（OR）＝5.04，95%可信区间（95%CI）为3.31～7.69，P＜0.00001〕，B型脑钠肽（BNP）水平明显降低〔标准均数差（SMD）＝-1.31，95%CI为-1.78～-0.83，P＜0.00001〕，左室射血分数（LVEF）明显增加（SMD＝0.79，95%CI为0.52～1.07，P＜0.00001）；中医证候疗效明显提高〔分类变量：相对危险度（RR）＝1.30，95%CI为1.06～1.59，P＝0.01；定量变量：均数差（MD）＝-1.67，95%CI为-2.48~-0.86， P＜0.0001〕；舒张功能明显改善（SMD＝0.64，95%CI为0.05～1.24，P＜0.05）。结论中西医结合治疗急性心衰较单纯西医治疗可明显提高临床疗效，然而研究文献的低质量限制了结论的可信度。
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