Clinical study on traditional Chinese medicine for heart failure prevention and treatment: an evidence map_Chinese Journal of Evidence-Based Medicine

Authors：

JU Chunxiao ^1,2 , ZHANG Yao ^1,2 , SHI Yue ^1,2 , CHENG Bairu ¹ , JIA Zijun ^1,2 , WANG Biqing ^1,2 , ZHANG Yan ^2,3 , LIU Lu ^1,2 , ZHAO Junnan ^2,4 , MEI Jun ^2,4 ,  LIU Yue ^2,5 ,  XU Fengqin ^2,4

1. Graduate School, Beijing University of Chinese Medicine, Beijing 100029, P.R.China;
2. Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R.China;
3. Graduate School, China Academy of Chinese Medical Sciences, Beijing 100700, P.R.China;
4. Institute of Gerontology, China Academy of Chinese Medical Sciences, Beijing 100091, P.R.China;
5. National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091, P.R.China;

Corresponding author：

LIU Yue, Email: liuyue@188.com; XU Fengqin, Email: 18800021979@163.com

Keywords：

Heart failure; Traditional Chinese medicine; Evidence map; Clinical study; Overview of systematic review

DOI：

10.7507/1672-2531.202103100

Video：

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Objective To retrieve and summarize the clinical studies on traditional Chinese medicine for heart failure prevention and treatment and to observe the distribution of evidence in the field of heart failure by using the method of evidence map.Methods PubMed, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were searched from January 2000 to January 2020. Clinical studies, systematic reviews, guidelines, and clinical pathways related to traditional Chinese medicine for heart failure prevention and treatment were included, and the distribution characteristics of evidence were analyzed by using charts and text descriptions.Results A total of 8 580 papers were included, including 8 398 clinical studies (6 821 randomized controlled trials, 1 109 non-randomized controlled trials and 468 observational studies), 160 systematic reviews, and 22 guidelines, expert consensus and pathway studies. The number of clinical studies domestically and abroad showed an overall growth trend. The sample size was concentrated in 60- 100 cases. Coronary atherosclerotic heart disease was the most common comorbidity of heart failure. AMSTAR scores of systematic reviews were primarily 4 to 8. The results of high-quality randomized controlled trials and systematic reviews showed that traditional Chinese medicine combined with conventional Western medicine in the treatment of heart failure had certain advantages in improving heart function, quality of life and prognosis.Conclusions High-quality clinical studies show that traditional Chinese medicine has certain advantages in the efficacy and safety of heart failure prevention and treatment; however, few studies have high methodological quality. In the future, multi-center, large sample size, and high methodological quality clinical studies are needed to further explore the efficacy and safety of traditional Chinese medicine therapy in the field of heart failure.

Citation： JU Chunxiao, ZHANG Yao, SHI Yue, CHENG Bairu, JIA Zijun, WANG Biqing, ZHANG Yan, LIU Lu, ZHAO Junnan, MEI Jun, LIU Yue, XU Fengqin. Clinical study on traditional Chinese medicine for heart failure prevention and treatment: an evidence map. Chinese Journal of Evidence-Based Medicine, 2021, 21(8): 964-972. doi: 10.7507/1672-2531.202103100 Copy

1.	Metra M, Teerlink JR. Heart failure. Lancet, 2017, 390(10106): 1981-1995.
2.	Groenewegen A, Rutten FH, Mosterd A, et al. Epidemiology of heart failure. Eur J Heart Fail, 2020, 22(8): 1342-1356.
3.	Hao G, Wang X, Chen Z, et al. Prevalence of heart failure and left ventricular dysfunction in China: the China hypertension survey, 2012-2015. Eur J Heart Fail, 2019, 21(11): 1329-1337.
4.	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告 2019 概要. 中华老年病研究电子杂志, 2020, 7(4): 4-15.
5.	李伦, 杨克虎, 田金徽, 等. 一种新的证据总结方法——证据图简介. 中国循证儿科杂志, 2011, 6(3): 230-232.
6.	Miake-Lye IM, Hempel S, Shanman R, et al. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Syst Rev, 2016, 5: 28.
7.	熊俊, 陈日新. 系统评价/Meta 分析方法学质量的评价工具 AMSTAR. 中国循证医学杂志, 2011, 11(9): 1084-1089.
8.	张晓雨, 钟长鸣, 关曼柯, 等. 心肌梗死中医防治临床研究证据图. 世界中医药, 2019, 14(10): 2537-2544, 2551.
9.	Hempel S, Taylor S L, Solloway M R, et al. Evidence map of acupuncture. Washington (DC): Department of Veterans Affairs (US), 2014.
10.	袁洁, 曹文富, 胡大一, 等. 保留收缩功能心衰的临床研究及太极拳运动对其血流动力学的影响. 重庆: 重庆医科大学. 2019.
11.	王连心, 谢雁鸣, 杨薇, 等. 基于HIS真实世界的参麦注射液临床实效研究. 中国中药杂志, 2012, 37(18): 2710-2713.
12.	Yu Y, Spatz ES, Tan Q, et al. Traditional Chinese medicine use in the treatment of acute heart failure in Western medicine hospitals in China: analysis from the China PEACE retrospective heart failure study. J Am Heart Assoc, 2019, 8(15): e012776.
13.	罗良涛, 王娟, 赵慧辉, 等. 17 家中医医院慢性心力衰竭患者临床特征及治疗情况调查. 中国中西医结合杂志, 2014, 34(6): 754-757.
14.	Tsai MY, Hu WL, Lin CC, et al. Prescription pattern of Chinese herbal products for heart failure in Taiwan: a population-based study. Int J Cardiol, 2017, 228: 90-96.
15.	庞稳泰, 王虎城, 杨丰文, 等. 芪苈强心胶囊治疗慢性心力衰竭系统评价的再评价. 天津中医药, 2019, 36(11): 1088-1093.
16.	周国锋, 李媛, 林芮, 等. 中药注射剂治疗心力衰竭系统评价再评价. 中华中医药学刊, 2019, 37(1): 125-129.
17.	赵馥, 林新锋, 赵锋利, 等. 基于 AMSTAR2 的参附注射液治疗心力衰竭系统评价再评价. 国际中医中药杂志, 2019, 41(6): 625-630.
18.	林勇, 林珍珍, 吕渭辉, 等. 参芪扶正注射液治疗慢性心力衰竭随机对照试验的 Meta 分析. 中西医结合心脑血管病杂志, 2016, 14(16): 1836-1840.
19.	Sun J, Zhang K, Xiong WJ, et al. Clinical effects of a standardized Chinese herbal remedy, Qili Qiangxin, as an adjuvant treatment in heart failure: systematic review and meta-analysis. BMC Complement Altern Med, 2016, 16: 201.
20.	莫静兰. 慢性心力衰竭临床路径Delphi(德尔菲)法调查分析. 广州: 广州中医药大学, 2009.
21.	中华中医药学会. 中医内科常见病诊疗指南(西医疾病部分)心力衰竭. 中国中医药现代远程教育, 2011, 9(18): 145-147.
22.	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.
23.	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. 心脑血管病防治, 2016, 16(5): 340-347.
24.	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.
25.	Zhou Q, Qin WZ, Liu SB, et al. Shengmai (a traditional Chinese herbal medicine) for heart failure. Cochrane Database Syst Rev, 2014, (4): CD005052.
26.	Hao T, Zhibin C, Yanbing L, et al. Effect of Shenmai injection on cardiac function in gerontal patients with chronic heart failure. Heart, 2012, 98: E242.
27.	Backs J, Schneider A, Strych K, et al. Effects of acupuncture compared with placebo-acupuncture on autonomic function, exercise tolerance, and quality of life in patients with heart failure: a randomized controlled single-blind pilot study. J Am Coll Cardiol, 2004, 43(5): A192.
28.	王瑶, 郭彬, 孙露, 等. 八段锦对慢性心力衰竭患者生活质量影响的 Meta 分析. 按摩与康复医学, 2019, 10(15): 45-49.
29.	王拴虎, 毛静远, 侯雅竹, 等. 西药常规加用芪参益气滴丸治疗慢性心力衰竭随机对照试验的系统评价. 中国中西医结合杂志, 2013, 33(11): 1468-1475.
30.	张长江, 夏豪. 参芪扶正注射液治疗心力衰竭有效性及安全性的 Meta 分析. 中国循证心血管医学杂志, 2013, 5(3): 233-236.

1. Metra M, Teerlink JR. Heart failure. Lancet, 2017, 390(10106): 1981-1995.
2. Groenewegen A, Rutten FH, Mosterd A, et al. Epidemiology of heart failure. Eur J Heart Fail, 2020, 22(8): 1342-1356.
3. Hao G, Wang X, Chen Z, et al. Prevalence of heart failure and left ventricular dysfunction in China: the China hypertension survey, 2012-2015. Eur J Heart Fail, 2019, 21(11): 1329-1337.
4. 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告 2019 概要. 中华老年病研究电子杂志, 2020, 7(4): 4-15.
5. 李伦, 杨克虎, 田金徽, 等. 一种新的证据总结方法——证据图简介. 中国循证儿科杂志, 2011, 6(3): 230-232.
6. Miake-Lye IM, Hempel S, Shanman R, et al. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Syst Rev, 2016, 5: 28.
7. 熊俊, 陈日新. 系统评价/Meta 分析方法学质量的评价工具 AMSTAR. 中国循证医学杂志, 2011, 11(9): 1084-1089.
8. 张晓雨, 钟长鸣, 关曼柯, 等. 心肌梗死中医防治临床研究证据图. 世界中医药, 2019, 14(10): 2537-2544, 2551.
9. Hempel S, Taylor S L, Solloway M R, et al. Evidence map of acupuncture. Washington (DC): Department of Veterans Affairs (US), 2014.
10. 袁洁, 曹文富, 胡大一, 等. 保留收缩功能心衰的临床研究及太极拳运动对其血流动力学的影响. 重庆: 重庆医科大学. 2019.
11. 王连心, 谢雁鸣, 杨薇, 等. 基于HIS真实世界的参麦注射液临床实效研究. 中国中药杂志, 2012, 37(18): 2710-2713.
12. Yu Y, Spatz ES, Tan Q, et al. Traditional Chinese medicine use in the treatment of acute heart failure in Western medicine hospitals in China: analysis from the China PEACE retrospective heart failure study. J Am Heart Assoc, 2019, 8(15): e012776.
13. 罗良涛, 王娟, 赵慧辉, 等. 17 家中医医院慢性心力衰竭患者临床特征及治疗情况调查. 中国中西医结合杂志, 2014, 34(6): 754-757.
14. Tsai MY, Hu WL, Lin CC, et al. Prescription pattern of Chinese herbal products for heart failure in Taiwan: a population-based study. Int J Cardiol, 2017, 228: 90-96.
15. 庞稳泰, 王虎城, 杨丰文, 等. 芪苈强心胶囊治疗慢性心力衰竭系统评价的再评价. 天津中医药, 2019, 36(11): 1088-1093.
16. 周国锋, 李媛, 林芮, 等. 中药注射剂治疗心力衰竭系统评价再评价. 中华中医药学刊, 2019, 37(1): 125-129.
17. 赵馥, 林新锋, 赵锋利, 等. 基于 AMSTAR2 的参附注射液治疗心力衰竭系统评价再评价. 国际中医中药杂志, 2019, 41(6): 625-630.
18. 林勇, 林珍珍, 吕渭辉, 等. 参芪扶正注射液治疗慢性心力衰竭随机对照试验的 Meta 分析. 中西医结合心脑血管病杂志, 2016, 14(16): 1836-1840.
19. Sun J, Zhang K, Xiong WJ, et al. Clinical effects of a standardized Chinese herbal remedy, Qili Qiangxin, as an adjuvant treatment in heart failure: systematic review and meta-analysis. BMC Complement Altern Med, 2016, 16: 201.
20. 莫静兰. 慢性心力衰竭临床路径Delphi(德尔菲)法调查分析. 广州: 广州中医药大学, 2009.
21. 中华中医药学会. 中医内科常见病诊疗指南(西医疾病部分)心力衰竭. 中国中医药现代远程教育, 2011, 9(18): 145-147.
22. 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.
23. 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. 心脑血管病防治, 2016, 16(5): 340-347.
24. 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.
25. Zhou Q, Qin WZ, Liu SB, et al. Shengmai (a traditional Chinese herbal medicine) for heart failure. Cochrane Database Syst Rev, 2014, (4): CD005052.
26. Hao T, Zhibin C, Yanbing L, et al. Effect of Shenmai injection on cardiac function in gerontal patients with chronic heart failure. Heart, 2012, 98: E242.
27. Backs J, Schneider A, Strych K, et al. Effects of acupuncture compared with placebo-acupuncture on autonomic function, exercise tolerance, and quality of life in patients with heart failure: a randomized controlled single-blind pilot study. J Am Coll Cardiol, 2004, 43(5): A192.
28. 王瑶, 郭彬, 孙露, 等. 八段锦对慢性心力衰竭患者生活质量影响的 Meta 分析. 按摩与康复医学, 2019, 10(15): 45-49.
29. 王拴虎, 毛静远, 侯雅竹, 等. 西药常规加用芪参益气滴丸治疗慢性心力衰竭随机对照试验的系统评价. 中国中西医结合杂志, 2013, 33(11): 1468-1475.
30. 张长江, 夏豪. 参芪扶正注射液治疗心力衰竭有效性及安全性的 Meta 分析. 中国循证心血管医学杂志, 2013, 5(3): 233-236.

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