CAJ | 학술논문

目的：分析中成药联用西药治疗高血压病左心室肥厚（LVH）疗效与安全性。方法计算机检索PubMed、EMbase、Cochrane图书馆、中国期刊全文数据库、万方数据库、维普数据库关于口服中成药联用西药对LVH疗效的临床随机对照试验（RCT），检索时间截止至2013年10月。采用RevMan5.2软件进行Meta分析。结果最终纳入14个随机对照实验（RCT），共计1055例患者。Meta分析显示：①中成药联用逆转LVH的作用优于单用西药，左室舒张末期内径（WMD=-1.38，95%CI：-2.36～-0.71， P＜0.0001）；舒张末期室间隔厚度（WMD=-1.08，95%CI：-1.67～-0.49，P=0.0002）、舒张末期左室后壁厚度（WMD=-0.99，95%CI：-1.54～-0.45，P=0.0003）、左室重量指数（WMD=-8.55，95%CI：-11.67～-5.43，P＜0.00001），各指标组间比较差异具有统计学意义；②两组SBP比较差异无统计学意义（WMD=-5.31，95%CI：-11.23～0.60，P=0.08）；两组DBP比较差异有统计学意义（WMD=-3.42，95%CI：-5.53～-1.31，P=0.001）；降压有效率组间比较差异无统计学意义（OR=1.68，95%CI：0.59～4.74，P=0.33）；③两组临床症状改善情况比较差异具有统计学意义（OR=5.74，95%CI：2.70～12.21，P＜0.00001）。结论提示与单纯西药相比，联合使用中成药具有更好的逆转LVH的疗效，能更明显的降低DBP，改善临床症状。
목적：분석중성약련용서약치료고혈압병좌심실비후（LVH）료효여안전성。방법계산궤검색PubMed、EMbase、Cochrane도서관、중국기간전문수거고、만방수거고、유보수거고관우구복중성약련용서약대LVH료효적림상수궤대조시험（RCT），검색시간절지지2013년10월。채용RevMan5.2연건진행Meta분석。결과최종납입14개수궤대조실험（RCT），공계1055례환자。Meta분석현시：①중성약련용역전LVH적작용우우단용서약，좌실서장말기내경（WMD=-1.38，95%CI：-2.36～-0.71， P＜0.0001）；서장말기실간격후도（WMD=-1.08，95%CI：-1.67～-0.49，P=0.0002）、서장말기좌실후벽후도（WMD=-0.99，95%CI：-1.54～-0.45，P=0.0003）、좌실중량지수（WMD=-8.55，95%CI：-11.67～-5.43，P＜0.00001），각지표조간비교차이구유통계학의의；②량조SBP비교차이무통계학의의（WMD=-5.31，95%CI：-11.23～0.60，P=0.08）；량조DBP비교차이유통계학의의（WMD=-3.42，95%CI：-5.53～-1.31，P=0.001）；강압유효솔조간비교차이무통계학의의（OR=1.68，95%CI：0.59～4.74，P=0.33）；③량조림상증상개선정황비교차이구유통계학의의（OR=5.74，95%CI：2.70～12.21，P＜0.00001）。결론제시여단순서약상비，연합사용중성약구유경호적역전LVH적료효，능경명현적강저DBP，개선림상증상。
Objective To analyze the curative effect and safety of Chinese patent medicine combining Western drugs on hypertensive left ventricular hypertrophy (LVH). Methods The databases of PubMed, EMbase, Cochrone Library, CNKI, WangFang Database and VIP Database were retrieved with computers for collecting randomized controlled trials (RCT) about the curative effect of Chinese patent medicine combining Western drugs on LVH up to Oct. 2013. A Meta-analysis was conducted by using RevMan5.2 software. Results There were totally 14 RCT included involving 1055 patients. The results of Meta-analysis showed that①Chinese patent medicine combining Western drugs had better effect than only Western drugs, and the comparison in LVDd [WMD=-1.38, 95%CI (-2.36--0.71), P<0.0001], IVST [WMD=-1.08, 95%CI (-1.67--0.49), P=0.0002], LVPWT [WMD=-0.99, 95%CI (-1.54- -0.45), P=0.000 3], and LVMI [WMD=-8.55, 95%CI (-11.67- -5.43), P<0.00001] showed statistical significance between two groups. ②The comparison in SBP [WMD=-5.31, 95%CI (-11.23- 0.60), P=0.08] had no significant difference, in DBP [WMD=-3.42, 95%CI (-5.53--1.31), P=0.001]) had significant difference, and in antihypertensive efficiency [OR=1.68, 95%CI (0.59-4.74), P=0.33] had no significant difference between two groups. ③The comparison in relief of clinical symptoms [OR=5.74, 95%CI (2.70-12.21), P<0.00001] had statistical significance between two groups. Conclusion Chinese patent medicine combining Western drugs has better effect in adversing LVH, reduces significantly DPB and relieves clinical symptoms compared with only Western drugs. However, more with multiple-center, large-sample and adequate randomized RCT, and allocation concealment, blinding design and long-term follow-up are required.