Qishen Yiqi dropping pill in the treatment of chronic heart failure: an overview of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

FAN Maoxia ¹ ,  DAI Guohua ² , GAO Wulin ² , GUAN Hui ² , LI Runmin ¹ , REN Lili ²

1. The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan 250014, P. R. China;
2. Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, P. R. China;

Corresponding author：

DAI Guohua, Email: daiguohua202208@163.com

Keywords：

Qishen Yiqi dropping pill; Chronic heart failure; Overview of systematic reviews; AMSTAR-2; ROBIS; PRISMA; GRADE

DOI：

10.7507/1672-2531.202301078

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically summarize and evaluate the existing evidence of Qishen Yiqi dropping pill (QSYQ) in the treatment of chronic heart failure (CHF), and to evaluate its quality. Methods The PubMed, Cochrane Library, EMbase, Web of Science, CNKI, CBM, WanFang Data databases were electronically searched to collect systematic reviews/meta-analyses(SRs/MAs) related to objectives from inception to December 31, 2022. Two researchers independently screened the literature and extracted data, and assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of included SRs/MAs by using Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic(ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results This overview included 17 SRs/MAs. The methodological quality, reporting quality, risk of bias, and quality of evidence for outcome measures of SRs/MAs were all unsatisfactory. All SRs/MAs were of low quality according to the results of the AMSTAR-2 assessment. And only a small number of SRs/MAs were assessed as low risk of bias based on the results of the ROBIS assessment. The evaluation results of the PRISMA checklist showed that the report quality of the 24 studies included was relatively complete. According to the GRADE system evaluation results, 94% of the 84 outcome indicators were low-quality and very low-quality evidence. Limitations were the main factors leading to their degradation, followed by publication bias, inconsistency, imprecision and indirectness. Conclusion At present, QSYQ has good clinical efficacy in the treatment of CHF, but the standardization and scientificity of clinical research and secondary research reports are insufficient, resulting in low quality of clinical recommendations evidence. In the future, it is necessary to further standardize and improve the quality of clinical and secondary research.

Citation： FAN Maoxia, DAI Guohua, GAO Wulin, GUAN Hui, LI Runmin, REN Lili. Qishen Yiqi dropping pill in the treatment of chronic heart failure: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2023, 23(9): 1060-1065. doi: 10.7507/1672-2531.202301078 Copy

1.	中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 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2018. 中华心血管病杂志, 2018, 46(10): 760-789.
2.	邱伯雍. 慢性心力衰竭流行病学及防治研究进展. 中华实用诊断与治疗杂志, 2017, 31(6): 619-621.
3.	中国中西医结合学会心血管疾病专业委员会, 中国医师协会中西医结合医师分会心血管疾病专业委员会. 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.
4.	赵林丹, 王汉卿, 赵志强, 等. 射血分数正常心力衰竭的中医诊疗进展. 中华中医药杂志, 2022, 37(6): 3343-3345.
5.	陈家显, 刘先霞, 陈跃武, 等. 芪参益气滴丸对慢性心力衰竭大鼠心肌细胞凋亡的抑制作用及其机制. 吉林大学学报(医学版), 2020, 46(5): 972-978, 1113.
6.	许祖建, 戴小华, 汤丽芬, 等. 芪参益气滴丸对冠心病PCI术后患者心功能及心绞痛疗效的影响. 时珍国医国药, 2019, 30(9): 2208-2209.
7.	马莉, 刘志超, 高晟玮, 等. 芪参益气滴丸治疗心血管疾病药理作用与临床应用研究进展. 药物评价研究, 2022, 45(4): 780-787.
8.	谢东霞, 黄显章, 毛秉像. 芪参益气滴丸改善心梗模型大鼠心室重构的相关机制. 中国实验方剂学杂志, 2011, 17(6): 180-183.
9.	陈慧, 李春, 石天娇, 等. 芪参益气滴丸对心衰大鼠RAAS系统的实验研究. 北京中医药大学学报, 2014, 37(8): 538-542.
10.	Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 2021, 372: n160.
11.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
12.	Whiting P, Savović J, Higgins JP, et al. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol, 2016, 69: 225-234.
13.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
14.	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.
15.	裴英豪, 朱翠玲, 朱明军, 等. 芪参益气滴丸治疗慢性心力衰竭的疗效及安全性系统评价. 中国中医急症, 2013, 22(9): 1472-1475.
16.	曲凤, 邢冬梅, 郑文科, 等. 芪参益气滴丸治疗缺血性心力衰竭的系统评价. 中国实验方剂学杂志, 2014, 20(3): 213-218.
17.	刘军刚, 顾万红, 刘效栓, 等. 芪参益气滴丸治疗慢性心力衰竭的Meta分析. 中国新药与临床杂志, 2014, 33(3): 189-195.
18.	高长春, 徐国良, 秦玲. 芪参益气滴丸治疗慢性充血性心力衰竭有效性及安全性的Meta分析. 中国中医急症, 2014, 23(2): 232-234.
19.	田野, 顾健霞. 芪参益气滴丸治疗冠心病心力衰竭的Meta分析. 中国中医急症, 2016, 25(9): 1725-1727, 1742.
20.	单秋月, 张闻, 吕露, 等. 用芪参益气滴丸抑制慢性心力衰竭患者心室重构效果的Meta分析. 当代医药论丛, 2017, 15(11): 71-73.
21.	章轶立, 王娟, 李园, 等. 芪参益气滴丸治疗慢性心力衰竭(气虚血瘀证)的Meta分析. 中国实验方剂学杂志, 2019, 25(21): 162-169.
22.	郭娇, 刘新灿, 孙天福. 芪参益气滴丸联合西药治疗慢性心力衰竭的临床疗效和安全性分析. 中国循证心血管医学杂志, 2020, 12(5): 519-524.
23.	李雪靖, 张慧玲, 王晓丽, 等. 芪参益气滴丸治疗慢性心力衰竭的循证药物经济学评价. 中国医院用药评价与分析, 2020, 20(12): 1472-1477, 1482.
24.	牛振超, 林文勇, 李益萍, 等. 芪参益气滴丸辨证施治对慢性心力衰竭疗效影响的Meta分析. 药物评价研究, 2021, 44(5): 1076-1087.
25.	谢锋, 段广靖, 王斌, 等. 芪参益气滴丸联合曲美他嗪治疗慢性心力衰竭的Meta分析. 海南医学院学报, 2021, 27(9): 689-694, 700.
26.	张秀文, 戴雁彦, 王宗亮, 等. 芪参益气滴丸联合曲美他嗪治疗慢性心力衰竭的Meta分析. 世界中西医结合杂志, 2021, 16(1): 23-28, 33.
27.	葛昭, 刘春香, 林姗姗, 等. 芪参益气滴丸治疗射血分数降低心力衰竭疗效及安全性的系统评价. 湖南中医杂志, 2022, 38(1): 115-123.
28.	Wang H, Li L, Qing X, et al. Efficacy of Qishen Yiqi drop pill for chronic heart failure: an updated meta-analysis of 85 studies. Cardiovasc Ther, 2020, 2020: 8138764.
29.	Wang M, Shan Y, Wu C, et al. Efficacy and safety of Qishen Yiqi dripping pill for heart failure with preserved ejection fraction: a systematic review and meta-analysis. Front Pharmacol, 2021, 11: 626375.
30.	Chen L, Wang R, Liu H, et al. Clinical efficacy and safety of Qishen Yiqi dropping pill combined with conventional western medicine in the treatment of chronic heart failure: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6612653.
31.	陈炜坚, 陈慕镟, 林挺, 等. 中药注射剂治疗心律失常的系统评价再评价. 中国医院药学杂志, 2020, 40(23): 2445-2452.
32.	黄帆, 赵思怡, 戴琳, 等. 运用雷达图对针灸治疗原发性骨质疏松症的系统评价再评价. 中国循证医学杂志, 2019, 19(5): 602-608.
33.	杨继, 张垚, 高晟玮, 等. 麝香保心丸治疗冠心病心绞痛系统评价的再评价. 中国中医急症, 2021, 30(5): 785-789.
34.	刘亦琳, 徐桂兴, 黄柳杨, 等. 针灸治疗支气管哮喘的系统评价再评价. 中国循证医学杂志, 2022, 22(8): 955-963.
35.	Yang K, Liu Y, Yuan J. Re-evaluation of systematic reviews in development and improvement. CJEBP, 2011, 6(1): 54-57.

1. 中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 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2018. 中华心血管病杂志, 2018, 46(10): 760-789.
2. 邱伯雍. 慢性心力衰竭流行病学及防治研究进展. 中华实用诊断与治疗杂志, 2017, 31(6): 619-621.
3. 中国中西医结合学会心血管疾病专业委员会, 中国医师协会中西医结合医师分会心血管疾病专业委员会. 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.
4. 赵林丹, 王汉卿, 赵志强, 等. 射血分数正常心力衰竭的中医诊疗进展. 中华中医药杂志, 2022, 37(6): 3343-3345.
5. 陈家显, 刘先霞, 陈跃武, 等. 芪参益气滴丸对慢性心力衰竭大鼠心肌细胞凋亡的抑制作用及其机制. 吉林大学学报(医学版), 2020, 46(5): 972-978, 1113.
6. 许祖建, 戴小华, 汤丽芬, 等. 芪参益气滴丸对冠心病PCI术后患者心功能及心绞痛疗效的影响. 时珍国医国药, 2019, 30(9): 2208-2209.
7. 马莉, 刘志超, 高晟玮, 等. 芪参益气滴丸治疗心血管疾病药理作用与临床应用研究进展. 药物评价研究, 2022, 45(4): 780-787.
8. 谢东霞, 黄显章, 毛秉像. 芪参益气滴丸改善心梗模型大鼠心室重构的相关机制. 中国实验方剂学杂志, 2011, 17(6): 180-183.
9. 陈慧, 李春, 石天娇, 等. 芪参益气滴丸对心衰大鼠RAAS系统的实验研究. 北京中医药大学学报, 2014, 37(8): 538-542.
10. Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 2021, 372: n160.
11. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
12. Whiting P, Savović J, Higgins JP, et al. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol, 2016, 69: 225-234.
13. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
14. 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.
15. 裴英豪, 朱翠玲, 朱明军, 等. 芪参益气滴丸治疗慢性心力衰竭的疗效及安全性系统评价. 中国中医急症, 2013, 22(9): 1472-1475.
16. 曲凤, 邢冬梅, 郑文科, 等. 芪参益气滴丸治疗缺血性心力衰竭的系统评价. 中国实验方剂学杂志, 2014, 20(3): 213-218.
17. 刘军刚, 顾万红, 刘效栓, 等. 芪参益气滴丸治疗慢性心力衰竭的Meta分析. 中国新药与临床杂志, 2014, 33(3): 189-195.
18. 高长春, 徐国良, 秦玲. 芪参益气滴丸治疗慢性充血性心力衰竭有效性及安全性的Meta分析. 中国中医急症, 2014, 23(2): 232-234.
19. 田野, 顾健霞. 芪参益气滴丸治疗冠心病心力衰竭的Meta分析. 中国中医急症, 2016, 25(9): 1725-1727, 1742.
20. 单秋月, 张闻, 吕露, 等. 用芪参益气滴丸抑制慢性心力衰竭患者心室重构效果的Meta分析. 当代医药论丛, 2017, 15(11): 71-73.
21. 章轶立, 王娟, 李园, 等. 芪参益气滴丸治疗慢性心力衰竭(气虚血瘀证)的Meta分析. 中国实验方剂学杂志, 2019, 25(21): 162-169.
22. 郭娇, 刘新灿, 孙天福. 芪参益气滴丸联合西药治疗慢性心力衰竭的临床疗效和安全性分析. 中国循证心血管医学杂志, 2020, 12(5): 519-524.
23. 李雪靖, 张慧玲, 王晓丽, 等. 芪参益气滴丸治疗慢性心力衰竭的循证药物经济学评价. 中国医院用药评价与分析, 2020, 20(12): 1472-1477, 1482.
24. 牛振超, 林文勇, 李益萍, 等. 芪参益气滴丸辨证施治对慢性心力衰竭疗效影响的Meta分析. 药物评价研究, 2021, 44(5): 1076-1087.
25. 谢锋, 段广靖, 王斌, 等. 芪参益气滴丸联合曲美他嗪治疗慢性心力衰竭的Meta分析. 海南医学院学报, 2021, 27(9): 689-694, 700.
26. 张秀文, 戴雁彦, 王宗亮, 等. 芪参益气滴丸联合曲美他嗪治疗慢性心力衰竭的Meta分析. 世界中西医结合杂志, 2021, 16(1): 23-28, 33.
27. 葛昭, 刘春香, 林姗姗, 等. 芪参益气滴丸治疗射血分数降低心力衰竭疗效及安全性的系统评价. 湖南中医杂志, 2022, 38(1): 115-123.
28. Wang H, Li L, Qing X, et al. Efficacy of Qishen Yiqi drop pill for chronic heart failure: an updated meta-analysis of 85 studies. Cardiovasc Ther, 2020, 2020: 8138764.
29. Wang M, Shan Y, Wu C, et al. Efficacy and safety of Qishen Yiqi dripping pill for heart failure with preserved ejection fraction: a systematic review and meta-analysis. Front Pharmacol, 2021, 11: 626375.
30. Chen L, Wang R, Liu H, et al. Clinical efficacy and safety of Qishen Yiqi dropping pill combined with conventional western medicine in the treatment of chronic heart failure: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6612653.
31. 陈炜坚, 陈慕镟, 林挺, 等. 中药注射剂治疗心律失常的系统评价再评价. 中国医院药学杂志, 2020, 40(23): 2445-2452.
32. 黄帆, 赵思怡, 戴琳, 等. 运用雷达图对针灸治疗原发性骨质疏松症的系统评价再评价. 中国循证医学杂志, 2019, 19(5): 602-608.
33. 杨继, 张垚, 高晟玮, 等. 麝香保心丸治疗冠心病心绞痛系统评价的再评价. 中国中医急症, 2021, 30(5): 785-789.
34. 刘亦琳, 徐桂兴, 黄柳杨, 等. 针灸治疗支气管哮喘的系统评价再评价. 中国循证医学杂志, 2022, 22(8): 955-963.
35. Yang K, Liu Y, Yuan J. Re-evaluation of systematic reviews in development and improvement. CJEBP, 2011, 6(1): 54-57.

Chinese Journal of Evidence-Based Medicine

Qishen Yiqi dropping pill in the treatment of chronic heart failure: an overview of systematic reviews

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