| 摘要: |
| [目的] 采用频率学网状Meta分析方法，对不同剂型的血府逐瘀汤制剂治疗心系病的有效性与安全性进行系统评价。[方法] 运用计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网（CNKI）、维普数据库（VIP）、万方数据库（Wanfang Database）、中国生物医学文献数据库（CBM）以及多个国内外主流临床试验注册网站的相关随机对照临床试验（RCT），时限为从建库至2024年12月31日。不同研究者独立对文献进行多层筛选，并根据Cochrane系统评价手册内容进行质量控制，采用Stata 16的Network命令包进行网状Meta分析。[结果] 共纳入53项RCT研究，涉及4 817例患有冠心病、心力衰竭以及肺源性心脏病等心血管疾病的患者，试验组干预措施为血府逐瘀片、血府逐瘀口服液、血府逐瘀颗粒、血府逐瘀丸、血府逐瘀胶囊、血府逐瘀汤分别联合常规西药治疗，对照组为常规西药治疗。网状Meta分析结果提示：1）临床有效率方面，汤剂效果最佳。2）颗粒剂在降低C-反应蛋白（CRP）、脑钠肽（BNP）水平以及心绞痛发作频率方面效果最佳。3）胶囊剂在降低心绞痛持续时间和左室射血分数（LVEF）水平方面效果最佳。4）在药物安全性方面，血府逐瘀汤制剂的不良反应和远期再发心血管事件次数均低于常规西药。[结论] 在心血管疾病的诊治中，常规西药搭配血府逐瘀汤的中西医结合疗效要优于单纯西药。其中推荐优先使用血府逐瘀汤汤剂以获得最佳的临床疗效，此外颗粒剂在降低CRP、BNP和心绞痛发作频率方面效果最佳，而胶囊剂在降低心绞痛持续时间以及改善LVEF方面更具优势。医者应根据患者的临床指征灵活选择疗效更优的剂型，以期在提高疗效的同时减少患者不良反应，使患者获得长期获益。 |
| 关键词: 心系病 网状Meta分析 中成药 剂型 血府逐瘀 |
| DOI：10.11656/j.issn.1672-1519.2026.07.07 |
| 分类号:R256.2 |
| 基金项目:湖南省自然科学基金青年项目（2025JJ60521）；湖南省教育厅一般项目（23C0169）；湖南省研究生科研创新项目（CX20251195）；湖南中医药大学科研项目（2024XJZC016）；湖南中医药大学本科生科研创新基金项目（2023BKS050）。 |
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| Effectiveness and safety of different dosage forms of Xuefu Zhuyu Decoction in the treatment of heart system diseases based on network Meta-analysis |
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YU Zixuan, KONG Beibei, CHEN Xing, WU Zizheng, MAO Yan
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Hunan University of Chinese Medicine, Changsha 410208, China
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| Abstract: |
| [Objective] Frequency network Meta-analysis method was used to conduct a systematic evaluation of the effectiveness and safety of different dosage forms of Xuefu Zhuyu Decoction in the treatment of Heart system diseases. [Methods] Use computers to search PubMed，Web of Science，Embase，Cochrane Library，China National Knowledge Infrastructure（CNKI），VIP Chinese Science and Technology Journal Database（VIP），Wanfang Database，Chinese Biomedical Literature Database（CBM），and multiple domestic and foreign mainstream clinical trials.The time limit for registering relevant randomized controlled clinical trials（RCTs）on the website is from the establishment of the database to December 31st，2024. Different researchers independently conducted multi-level screening of the literature，conducted quality control according to the contents of the Cochrane Systematic Review Manual，and used the Network package of Stata16 to perform network Meta analysis. [Results] A total of 53 RCT studies were included，involving 4 817 patients with cardiovascular diseases such as coronary heart disease，heart failure，and pulmonary heart disease. The intervention measures in the experimental group were Xuefu Zhuyu Tablets，Xuefu Zhuyu Oral Liquid，Xuefu Zhuyu Granules，Xuefu Zhuyu Pills，Xuefu Zhuyu Capsules，and Xuefu Zhuyu Decoction combined with conventional western medicine. The control group was treated with conventional western medicine. Network Meta-analysis results suggest that：1）In terms of clinical effectiveness，decoction has the best effect. 2）Granules have the best effect in reducing C-reactive protein（CRP），brain natriuretic peptide（BNP）levels and the frequency of angina attacks. 3）Capsules The agent has the best effect in reducing the duration of angina pectoris and the level of left ventricular ejection fraction（LVEF）.4）The adverse reactions and the number of long-term cardiovascular events of the Xuefu Zhuyu Decoction preparation are lower than those of conventional Western medicine，which means it is mach more safer. [Conclusion] In the treatment of cardiovascular diseases，the efficacy of conventional Western medicine combined with Xuefu Zhuyu Decoction is better than the former.Among them，in order to obtain the best clinical effect，decoction should be recommended first.In addition，granules have the best effect in reducing CRP，BNP and the frequency of angina pectoris attacks，while capsules are more effective in reducing the duration of angina pectoris and improving LVEF. Physicians should flexibly choose dosage forms with better efficacy based on the patient’s clinical indications，in order to improve the efficacy while reducing adverse reactions and allowing patients to obtain long-term benefits. |
| Key words: heart system diseases network Meta-analysis Chinese patent medicine dosage form Xuefu Zhuyu |
