Efficacy of Qiliqiangxin capsule for heart failure with preserved ejection fraction on cardiac function: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

CAO Yawen ^1,2 , BI Yingfei ¹ , WANG Xianliang ¹ , ZHAO Zhiqiang ¹ , YANG Ying ^1,2 ,  MAO Jingyuan ¹

1. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, P.R.China;
2. Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P.R.China;

Corresponding author：

MAO Jingyuan, Email: jymao@126.com

Keywords：

Qiliqiangxin capsule; Ejection fraction preserved heart failure; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202009079

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives To systematically review the efficacy of Qiliqiangxin capsule on cardiac function in patients with heart failure with preserved ejection fraction (HFpEF).Methods CNKI, VIP, WanFang Data, CBM, EMbase, PubMed and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) of Qiliqiangxin capsule for HFpEF from inception to August 1^st, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was performed by RevMan5.3 software.Results A total of 24 RCTs involving 2 021 patients were included. The results of meta-analysis showed that Qiliqiangxin capsule combined with conventional western medicine could improve E/A wave ratio (MD=0.17, 95%CI 0.13 to 0.21, P<0.000 01), reduce E/e' wave ratio (MD=−2.16, 95%CI −3.23 to −1.08, P<0.000 1), BNP (MD=−240.43, 95%CI −357.66 to −123.20, P<0.000 1), and NT-proBNP (MD=−200.64, 95%CI −290.02 to −111.27, P<0.000 1). However, there were no statistically significant differences between two groups in re-hospitalization rate (RR=0.57, 95%CI 0.27 to 1.19, P=0.13), mortality (RR=0.33, 95%CI 0.04 to 3.05, P=0.33), and incidence of adverse events (RR=0.59, 95%CI 0.26 to 1.34, P=0.20).Conclusions The present evidence shows that Qiliqiangxin capsule combined with conventional western medicine can improve neuroendocrine disorders and cardiac structure in patients with HFpEF, and further improve cardiac diastolic function. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

Citation： CAO Yawen, BI Yingfei, WANG Xianliang, ZHAO Zhiqiang, YANG Ying, MAO Jingyuan. Efficacy of Qiliqiangxin capsule for heart failure with preserved ejection fraction on cardiac function: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(12): 1427-1433. doi: 10.7507/1672-2531.202009079 Copy

1.	中华医学会心血管病学分会心力衰竭学组, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南 2018. 中华心血管病杂志, 2018, 46(10): 760-789.
2.	Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol, 2017, 70(20): 2476-2486.
3.	毛静远, 朱明军. 慢性心力衰竭中医诊疗专家共识. 中医杂志, 2014, 55(14): 1258-1260.
4.	Li X, Zhang J, Huang J, et al. A multicenter, randomized, double-blind, parallel-group, placebo-controlled study of the effects of qili qiangxin capsules in patients with chronic heart failure. J Am Coll Cardiol, 2013, 62(12): 1065-1072.
5.	许强, 刘宏军, 刘学会. 芪苈强心胶囊治疗射血分数保留的心力衰竭疗效的 Meta 分析. 疑难病杂志, 2015, 14(9): 898-901.
6.	冯英, 蒋玙姝, 何倩雯, 等. 芪苈强心胶囊治疗舒张性心力衰竭的疗效及安全性的 Meta 分析. 武汉大学学报(医学版), 2015, 36(6): 992-999.
7.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南 2014. 中华心血管病杂志, 2014, 42(2): 98-122.
8.	陈可冀, 吴宗贵, 朱明军, 等. 慢性心力衰竭中西医结合诊疗专家共识. 中国中西医结合杂志, 2016, 36(2): 133-141.
9.	简航宇, 李强, 曾丽云. 常规疗法联合芪苈强心胶囊治疗慢性舒张性心功能不全的临床疗效及其对心率变异性的影响. 实用心脑肺血管病杂志, 2015, 23(10): 115-117.
10.	陈统. 地尔硫卓联合芪苈强心胶囊治疗射血分数保留性心衰的临床疗效分析. 延安: 延安大学, 2014.
11.	冯文伟, 熊斌, 李玉凤. 芪苈强心胶囊对射血分数保留的心力衰竭患者多普勒 E/E’比值及 NT-pro-BNP 的影响. 新中医, 2014, 46(10): 39-41.
12.	强玉娜. 芪苈强心胶囊对舒张性心衰患者 NT-proBNP 和 6min 步行试验的影响. 中国现代药物应用, 2016, 10(2): 198-199.
13.	李彦霞, 袁国强, 贾振华. 芪苈强心胶囊对舒张性心衰患者生活质量及血浆 NT-proBNP 水平的影响. 中国中医基础医学杂志, 2012, 18(3): 289-291.
14.	甄利波, 田祥. 芪苈强心胶囊辅治冠心病舒张性心力衰竭效果观察. 临床合理用药杂志, 2013, 6(25): 82-83.
15.	关思虞, 杨玲. 芪苈强心胶囊辅治射血分数正常心力衰竭的临床研究. 疑难病杂志, 2012, 11(7): 500-502.
16.	宋建广, 韩玉. 芪苈强心胶囊辅治舒张性心力衰竭的疗效观察. 临床合理用药杂志, 2017, 10(25): 48-49.
17.	王晓宁, 沃金善, 郭洁. 芪苈强心胶囊辅助治疗冠心病合并左心舒张功能不全的临床效果. 疑难病杂志, 2016, 15(2): 183-185, 194.
18.	杨海燕, 索云锡. 芪苈强心胶囊辅助治疗舒张性心衰患者的疗效对照研究. 医药, 2015, (29): 287.
19.	陈伟, 侯湘岭, 王伟红, 等. 芪苈强心胶囊联合卡托普利对老年高血压合并左室舒张功能不全患者房室重构及血清 D-二聚体、hs-CRP、BNP 水平的影响. 现代中西医结合杂志, 2018, 27(20): 2182-2185.
20.	李瑜贤. 芪苈强心胶囊联合美托洛尔治疗高血压并舒张性心力衰竭的效果观察. 中国民康医学, 2018, 30(21): 84-85, 89.
21.	池豪, 杨东伟, 刘新叶. 芪苈强心胶囊联合美托洛尔治疗舒张性心功能不全的疗效观察. 中国实用医药, 2014, (10): 187-188.
22.	董梅, 孙旭杜, 贾相科, 等. 芪苈强心胶囊联合曲美他嗪治疗射血分数保留心力衰竭的临床研究. 中国误诊学杂志, 2018, 13(1): 9-11.
23.	罗平, 万凤福. 芪苈强心胶囊联合西药治疗射血分数保留的心衰临床观察. 江西医药, 2016, 51(10): 1069-1071.
24.	余智云. 芪苈强心胶囊治疗 45 例舒张性心衰的临床疗效观察. 中国民族民间医药, 2013, 22(21): 28.
25.	高彩, 金连珍, 文磊, 等. 芪苈强心胶囊治疗射血分数保留慢性心力衰竭的临床研究. 中西医结合心脑血管病杂志, 2019, 17(17): 2621-2623.
26.	刘宏军, 许强, 夏晓鹏, 等. 芪苈强心胶囊治疗射血分数保留心力衰竭的疗效观察. 中西医结合心脑血管病杂志, 2017, 15(14): 1730-1733.
27.	高艳霞, 李小虎. 芪苈强心胶囊治疗舒张性心力衰竭的临床观察. 中国现代医生, 2016, 54(7): 107-109.
28.	杜亚康. 芪苈强心胶囊治疗舒张性心力衰竭疗效观察. 山西中医, 2014, 30(2): 14-15, 42.
29.	洪恩. 芪苈强心胶囊治疗舒张性心衰 40 例临床疗效观察. 中国民族民间医药, 2013, 22(24): 70.
30.	田野, 李彦霞, 任君霞, 等. 芪苈强心胶囊治疗舒张性心衰的疗效观察. 中国临床药理学杂志, 2011, 27(9): 666-668.
31.	于建华. 舒张性心力衰竭患者血 hs-CRP 水平变化及芪苈强心胶囊干预的研究. 济南: 山东中医药大学, 2008.
32.	胡鹏, 朱定君, 曹学敏, 等. 舒张性心衰患者应用芪苈强心胶囊治疗的效果分析. 中国临床研究, 2016, 29(7): 957-958, 961.
33.	李娅, 宋优, 程翔, 等. 芪苈强心胶囊对大鼠心肌梗死后心肌重构及心功能的影响. 中国分子心脏病学杂志, 2007, 7(4): 201-204.
34.	Zhang J, Huang M, Shen S, et al. Qiliqiangxin attenuates isoproterenol-induced cardiac remodeling in mice. Am J Transl Res, 2017, 9(12): 5585-5593.
35.	Han A, Lu Y, Zheng Q, et al. Qiliqiangxin Attenuates Cardiac Remodeling via Inhibition of TGF-β1/Smad3 and NF-κB Signaling Pathways in a Rat Model of Myocardial Infarction. Cell Physiol Biochem, 2018, 45(5): 1797-1806.
36.	Lin S, Wu X, Tao L, et al. The metabolic effects of traditional Chinese medication Qiliqiangxin on H9C2 cardiomyocytes. Cell Physiol Biochem, 2015, 37(6): 2246-2256.
37.	Wang J, Zhou J, Wang Y, et al. Qiliqiangxin protects against anoxic injury in cardiac microvascular endothelial cells via NRG-1/ErbB-PI3K/Akt/mTOR pathway. J Cell Mol Med, 2017, 21(9): 1905-1914.
38.	吴相君, 赵保礼, 韩硕龙, 等. 芪苈强心胶囊对扩张型心肌病患者心功能及血管内皮功能影响的临床研究. 疑难病杂志, 2018, 17(4): 329-333.
39.	马柳一, 尹玉洁, 张军芳, 等. 芪苈强心胶囊对慢性心衰大鼠下丘脑室旁核 RAS 系统及交感神经系统的影响. 中国药理学通报, 2016, 32(4): 575-580.
40.	Steinberg BA, Zhao X, Heidenreich PA, et al. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation, 2012, 126(1): 65-75.
41.	Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2015, 16(3): 233-270.
42.	Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2013, 62(16): e147-239.

1. 中华医学会心血管病学分会心力衰竭学组, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南 2018. 中华心血管病杂志, 2018, 46(10): 760-789.
2. Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol, 2017, 70(20): 2476-2486.
3. 毛静远, 朱明军. 慢性心力衰竭中医诊疗专家共识. 中医杂志, 2014, 55(14): 1258-1260.
4. Li X, Zhang J, Huang J, et al. A multicenter, randomized, double-blind, parallel-group, placebo-controlled study of the effects of qili qiangxin capsules in patients with chronic heart failure. J Am Coll Cardiol, 2013, 62(12): 1065-1072.
5. 许强, 刘宏军, 刘学会. 芪苈强心胶囊治疗射血分数保留的心力衰竭疗效的 Meta 分析. 疑难病杂志, 2015, 14(9): 898-901.
6. 冯英, 蒋玙姝, 何倩雯, 等. 芪苈强心胶囊治疗舒张性心力衰竭的疗效及安全性的 Meta 分析. 武汉大学学报(医学版), 2015, 36(6): 992-999.
7. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南 2014. 中华心血管病杂志, 2014, 42(2): 98-122.
8. 陈可冀, 吴宗贵, 朱明军, 等. 慢性心力衰竭中西医结合诊疗专家共识. 中国中西医结合杂志, 2016, 36(2): 133-141.
9. 简航宇, 李强, 曾丽云. 常规疗法联合芪苈强心胶囊治疗慢性舒张性心功能不全的临床疗效及其对心率变异性的影响. 实用心脑肺血管病杂志, 2015, 23(10): 115-117.
10. 陈统. 地尔硫卓联合芪苈强心胶囊治疗射血分数保留性心衰的临床疗效分析. 延安: 延安大学, 2014.
11. 冯文伟, 熊斌, 李玉凤. 芪苈强心胶囊对射血分数保留的心力衰竭患者多普勒 E/E’比值及 NT-pro-BNP 的影响. 新中医, 2014, 46(10): 39-41.
12. 强玉娜. 芪苈强心胶囊对舒张性心衰患者 NT-proBNP 和 6min 步行试验的影响. 中国现代药物应用, 2016, 10(2): 198-199.
13. 李彦霞, 袁国强, 贾振华. 芪苈强心胶囊对舒张性心衰患者生活质量及血浆 NT-proBNP 水平的影响. 中国中医基础医学杂志, 2012, 18(3): 289-291.
14. 甄利波, 田祥. 芪苈强心胶囊辅治冠心病舒张性心力衰竭效果观察. 临床合理用药杂志, 2013, 6(25): 82-83.
15. 关思虞, 杨玲. 芪苈强心胶囊辅治射血分数正常心力衰竭的临床研究. 疑难病杂志, 2012, 11(7): 500-502.
16. 宋建广, 韩玉. 芪苈强心胶囊辅治舒张性心力衰竭的疗效观察. 临床合理用药杂志, 2017, 10(25): 48-49.
17. 王晓宁, 沃金善, 郭洁. 芪苈强心胶囊辅助治疗冠心病合并左心舒张功能不全的临床效果. 疑难病杂志, 2016, 15(2): 183-185, 194.
18. 杨海燕, 索云锡. 芪苈强心胶囊辅助治疗舒张性心衰患者的疗效对照研究. 医药, 2015, (29): 287.
19. 陈伟, 侯湘岭, 王伟红, 等. 芪苈强心胶囊联合卡托普利对老年高血压合并左室舒张功能不全患者房室重构及血清 D-二聚体、hs-CRP、BNP 水平的影响. 现代中西医结合杂志, 2018, 27(20): 2182-2185.
20. 李瑜贤. 芪苈强心胶囊联合美托洛尔治疗高血压并舒张性心力衰竭的效果观察. 中国民康医学, 2018, 30(21): 84-85, 89.
21. 池豪, 杨东伟, 刘新叶. 芪苈强心胶囊联合美托洛尔治疗舒张性心功能不全的疗效观察. 中国实用医药, 2014, (10): 187-188.
22. 董梅, 孙旭杜, 贾相科, 等. 芪苈强心胶囊联合曲美他嗪治疗射血分数保留心力衰竭的临床研究. 中国误诊学杂志, 2018, 13(1): 9-11.
23. 罗平, 万凤福. 芪苈强心胶囊联合西药治疗射血分数保留的心衰临床观察. 江西医药, 2016, 51(10): 1069-1071.
24. 余智云. 芪苈强心胶囊治疗 45 例舒张性心衰的临床疗效观察. 中国民族民间医药, 2013, 22(21): 28.
25. 高彩, 金连珍, 文磊, 等. 芪苈强心胶囊治疗射血分数保留慢性心力衰竭的临床研究. 中西医结合心脑血管病杂志, 2019, 17(17): 2621-2623.
26. 刘宏军, 许强, 夏晓鹏, 等. 芪苈强心胶囊治疗射血分数保留心力衰竭的疗效观察. 中西医结合心脑血管病杂志, 2017, 15(14): 1730-1733.
27. 高艳霞, 李小虎. 芪苈强心胶囊治疗舒张性心力衰竭的临床观察. 中国现代医生, 2016, 54(7): 107-109.
28. 杜亚康. 芪苈强心胶囊治疗舒张性心力衰竭疗效观察. 山西中医, 2014, 30(2): 14-15, 42.
29. 洪恩. 芪苈强心胶囊治疗舒张性心衰 40 例临床疗效观察. 中国民族民间医药, 2013, 22(24): 70.
30. 田野, 李彦霞, 任君霞, 等. 芪苈强心胶囊治疗舒张性心衰的疗效观察. 中国临床药理学杂志, 2011, 27(9): 666-668.
31. 于建华. 舒张性心力衰竭患者血 hs-CRP 水平变化及芪苈强心胶囊干预的研究. 济南: 山东中医药大学, 2008.
32. 胡鹏, 朱定君, 曹学敏, 等. 舒张性心衰患者应用芪苈强心胶囊治疗的效果分析. 中国临床研究, 2016, 29(7): 957-958, 961.
33. 李娅, 宋优, 程翔, 等. 芪苈强心胶囊对大鼠心肌梗死后心肌重构及心功能的影响. 中国分子心脏病学杂志, 2007, 7(4): 201-204.
34. Zhang J, Huang M, Shen S, et al. Qiliqiangxin attenuates isoproterenol-induced cardiac remodeling in mice. Am J Transl Res, 2017, 9(12): 5585-5593.
35. Han A, Lu Y, Zheng Q, et al. Qiliqiangxin Attenuates Cardiac Remodeling via Inhibition of TGF-β1/Smad3 and NF-κB Signaling Pathways in a Rat Model of Myocardial Infarction. Cell Physiol Biochem, 2018, 45(5): 1797-1806.
36. Lin S, Wu X, Tao L, et al. The metabolic effects of traditional Chinese medication Qiliqiangxin on H9C2 cardiomyocytes. Cell Physiol Biochem, 2015, 37(6): 2246-2256.
37. Wang J, Zhou J, Wang Y, et al. Qiliqiangxin protects against anoxic injury in cardiac microvascular endothelial cells via NRG-1/ErbB-PI3K/Akt/mTOR pathway. J Cell Mol Med, 2017, 21(9): 1905-1914.
38. 吴相君, 赵保礼, 韩硕龙, 等. 芪苈强心胶囊对扩张型心肌病患者心功能及血管内皮功能影响的临床研究. 疑难病杂志, 2018, 17(4): 329-333.
39. 马柳一, 尹玉洁, 张军芳, 等. 芪苈强心胶囊对慢性心衰大鼠下丘脑室旁核 RAS 系统及交感神经系统的影响. 中国药理学通报, 2016, 32(4): 575-580.
40. Steinberg BA, Zhao X, Heidenreich PA, et al. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation, 2012, 126(1): 65-75.
41. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2015, 16(3): 233-270.
42. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2013, 62(16): e147-239.

Chinese Journal of Evidence-Based Medicine

Efficacy of Qiliqiangxin capsule for heart failure with preserved ejection fraction on cardiac function: a systematic review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content