中西医结合治疗高血压(肝阳上亢证) Meta分析

Meta-Analysis of Integrated Traditional Chinese and Western Medicine in the Treatment of Hypertension with Hyperactivity of the Liver-Yang

摘要: 目的：分析中西医结合治疗高血压(肝阳上亢证)的临床效果及安全性。方法：检索中国知网(CNKI)、万方数据库、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、Embase和Web of science数据库，搜集有关于中西医结合治疗高血压(肝阳上亢证)的随机对照试验，检索的时限为2012年1月至2022年1月，使用Cochrane评价手册5.1.0对纳入文献进行质量评估，并应用Revman 5.3进行数据分析。结果：最终研究共纳入16篇文献，总计纳入1497例患者，Meta分析显示：中西医结合治疗肝阳上亢型高血压在提高降压疗效[OR=4.31, 95% CI (3.01, 6.17), P < 0.00001]、提高中医症候疗效[OR = 5.62, 95% CI (2.42, 13.06), P < 0.0001]、降低收缩压[MD = −11.07, 95% CI (−14.58, −7.55), P < 0.00001]、降低舒张压[MD = −6.89, 95% CI (−9.03, −4.74), P < 0.00001]，降低不良反应发生率[OR = 0.38, 95% CI (0.17, 0.85), P = 0.02]等方面的效果优于常规西医治疗，具有统计学意义。结论：与单纯西医常规治疗相比较，中西医结合治疗高血压(肝阳上亢证)，可提高降压疗效，改善患者中医临床症状，降低收缩压及舒张压且具有较好的安全性。

Abstract: Objective: To analyze the clinical effect and safety of integrated traditional Chinese and Western medicine in the treatment of hypertension (hyperactivity of the liver-yang). Methods: Databases Chinese Knowledge Infrastructure Engineering (CNKI), WanFang Data Knowledge Service Platform, Chinese Journal Service Platform (VIP), Chinese Biomedical Literature Database (CBM), PubMed, Cochrane Library, Embase and Web of science were searched. The randomized controlled trials of integrated traditional Chinese and Western medicine in the treatment of hypertension (hyperactiv-ity of the liver-yang Syndrome) were collected from January 2012 to January 2022, Cochrane Re-viewers Handbook 5.1.0 were used to evaluate the quality of the included literatures and Revman 5.3 was used for data analysis. Results: A total of 16 literatures were included in the final study, in-cluding 1497 patients. Compared with conventional Western medicine treatment ,the treatment of hypertension with hyperactivity of the liver-yang with integrated traditional Chinese and Western medicine had better effects in improving the antihypertensive effect [OR = 4.31, 95% CI (3.01, 6.17), P < 0.00001], improving the curative effect of TCM symptoms [OR = 5.62, 95% CI (2.42, 13.06), P < 0.0001], reducing systolic blood pressure [MD = −11.07, 95% CI (−14.58, −7.55), P < 0.00001], reducing diastolic blood pressure [MD = −6.89, 95% CI (−9.03, −4.74), P < 0.00001] and reducing the incidence of adverse reactions [OR = 0.38, 95% CI (0.17, 0.85), P = 0.02], which was statistically significant. Conclusion: Compared with the conventional treatment of Western medi-cine, the treatment of hypertension (hyperactivity of the liver-yang Syndrome) with integrated tra-ditional Chinese and Western medicine can improve the antihypertensive effect, improve the clini-cal symptoms of patients, reduce systolic and diastolic blood pressure, and has good safety.