CAJ | 학술논문

目的：对芪苈强心胶囊治疗慢性充血性心力衰竭的疗效进行系统评价。方法检索2013年12月31日之前发表的芪苈强心胶囊治疗慢性充血性心力衰竭的随机对照试验文献，按照纳入与排除标准纳入合格文献，采用Cochrane偏倚风险评估工具来对入选的16篇文献进行风险评估。由两位作者（评价员）独立从文本和表格中提取干预组和对照组治疗前后的评价指标及样本量。运用RevMan5.2.7软件分析加权均数差及95%可信区间。结果共纳入16个研究试验，1422例研究对象，其中对照组699例，芪苈强心组723例。Meta分析显示在心力衰竭患者常规治疗的基础上加入芪苈强心胶囊后能够显著改善患者症状、提高临床综合疗效（RR=1.18，95%CI：1.13~1.24）；增加左室射血分数（WMD=4.89，95%CI：3.03~6.75，P＜0.00001）；降低血浆脑钠肽水平（WMD=95.86，95%CI：43.96~147.77，P＜0.00001）；增加左室舒张末期内径（WMD=3.22，95%CI：1.64~4.80，P＜0.00001）；有效增加患者的6分钟步行距离（WMD=41.44，95%CI：33.30~49.59，P＜0.00001）；增加心排血量（WMD=0.22，95%CI：0.00~0.44，P=0.05）；降低明尼苏达生活质量表积分（WMD=7.69，95%CI：4.39~10.99，P＜0.00001）。结论基于目前证据，芪苈强心胶囊治疗慢性充血性心力衰竭疗效良好。但纳入研究可能存在发表偏倚，对于芪苈强心胶囊治疗慢性心力衰竭的远期预后疗效还需更多的临床证据证实。
목적：대기력강심효낭치료만성충혈성심력쇠갈적료효진행계통평개。방법검색2013년12월31일지전발표적기력강심효낭치료만성충혈성심력쇠갈적수궤대조시험문헌，안조납입여배제표준납입합격문헌，채용Cochrane편의풍험평고공구래대입선적16편문헌진행풍험평고。유량위작자（평개원）독립종문본화표격중제취간예조화대조조치료전후적평개지표급양본량。운용RevMan5.2.7연건분석가권균수차급95%가신구간。결과공납입16개연구시험，1422례연구대상，기중대조조699례，기력강심조723례。Meta분석현시재심력쇠갈환자상규치료적기출상가입기력강심효낭후능구현저개선환자증상、제고림상종합료효（RR=1.18，95%CI：1.13~1.24）；증가좌실사혈분수（WMD=4.89，95%CI：3.03~6.75，P＜0.00001）；강저혈장뇌납태수평（WMD=95.86，95%CI：43.96~147.77，P＜0.00001）；증가좌실서장말기내경（WMD=3.22，95%CI：1.64~4.80，P＜0.00001）；유효증가환자적6분종보행거리（WMD=41.44，95%CI：33.30~49.59，P＜0.00001）；증가심배혈량（WMD=0.22，95%CI：0.00~0.44，P=0.05）；강저명니소체생활질량표적분（WMD=7.69，95%CI：4.39~10.99，P＜0.00001）。결론기우목전증거，기력강심효낭치료만성충혈성심력쇠갈료효량호。단납입연구가능존재발표편의，대우기력강심효낭치료만성심력쇠갈적원기예후료효환수경다적림상증거증실。
Objective To review the curative effect of Qili Qiangxin Capsules on chronic congestive heart failure (CHF). Methods The randomized controlled trials (RCT) about Qili Qiangxin Capsules in chronic CHF treatment published before Dec. 31, 2013 were retrieved, and qualified RCT were chosen according to inclusion and exclusion criteria. All included 16 RCT documents were given risk reviewing by using Cochrane bias risk tool, and review index and sample volume were extracted from texts and tables by 2 independent reviewers in intervention group and control group before and after treatment. The weighting average difference and 95%CI were analyzed by using RevMan5.2.7 software. Results There were totally 16 RCT included involved 1422 cases (699 in control group and 723 in intervention group). The results of Meta-analysis showed that Qili Qiangxin Capsules combining routine therapies relieved significantly symptoms, improved clinical efficacy (RR=1.18, 95%CI: 1.13-1.24), increased LVEF (WMD=4.89, 95%CI: 3.03-6.75, P<0.00001), decreased BNP level (WMD=95.86, 95%CI:43.96-147.77, P=0.0003, P<0.00001), increased LVEDd (WMD=3.22, 95%CI:1.64-4.80, P<0.00001), increased effectively 6MWT (WMD=41.44, 95%CI:33.30-49.59, P<0.00001), increased CO (WMD=0.22, 95%CI:0.00-0.44, P=0.05), and decreased the integral of Minnesota Table of Quality of Life (WMD=7.69, 95%CI: 4.39-10.99, P<0.00001). Conclusion The current evidence shows that Qili Qiangxin Capsules has good curative effect on chronic CHF. Because of included RCT with publishing bias, more clinical data are needed to confirm the long-term efficacy of Qiangxin Capsules.