Traditional Chinese Medicine for Essential Hypertension: An Overview of Systematic Reviews_Chinese Journal of Evidence-Based Medicine

Authors：

 YANGYan-tao ¹ ,  MALi ¹ , YANGXiao-xia ¹ , ZHAOChun-xiang ²

1. First People's Hospital of Lanzhou, Lanzhou 730050, China;
2. People's Hospital of Gaolan of Lanzhou, Lanzhou 730050, China;

Corresponding?author：

MALi, Email: flykikimary@163.com

Keywords：

Traditional Chinese medicine; Essential hypertension; Overview of systematic review; GRADE system

DOI：

10.7507/1672-2531.20140175

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the methodological bias and the reliability of the conclusions of systematic reviews (SRs) about traditional Chinese medicine for essential hypertension. Methods We comprehensively searched PubMed, EMbase, The Cochrane library (Issue 4, 2014), CBM, CNKI and WanFang Data to collect SRs of traditional Chinese medicine for essential hypertension from the establishment time of databases to April 30th, 2014. The AMSTAR tool was applied for methodological quality assessment of included studies, and the GRADE system was applied for evidence quality assessment of included outcomes of SRs. Results A total of 12 SRs involving 31 outcomes were included, of which 11 SRs focused on the comparison of therapeutic effects between traditional Chinese medicine combined with western medicine and western medicine alone. Nine SRs adopted Jadad tool to assess methodological quality of included original studies. The results of assessment using AMSTAR showed that, among 11 items, there were the most problems concerning Item 1 "Was an 'a prior' design provided?" (none of the 12 SRs provided it); followed by Item 11 "Were potential conflict of interest included?" (nine SRs didn't described it), and Item 6 "Were the characteristics of included studies provided" (six SRs didn't provided it). The results of grading showed that, 29 outcomes were graded as "low" or "very low" quality. The main factors contributed to downgrading evidence quality were limitations (31 outcomes), followed by imprecision (12 outcomes), and inconsistency (13 outcomes). Conclusion Currently, the methodological quality of SRs about traditional Chinese medicine for essential hypertension was poor on the whole, with low quality of evidence as well as lack of enough attention to the end outcomes of patients with essential hypertension. Thus, physicians should apply the evidence to make decision about traditional Chinese medicine for essential hypertension with caution in clinical practice.

Citation： YANGYan-tao, MALi, YANGXiao-xia, ZHAOChun-xiang. Traditional Chinese Medicine for Essential Hypertension: An Overview of Systematic Reviews. Chinese Journal of Evidence-Based Medicine, 2014, 14(9): 1070-1076. doi: 10.7507/1672-2531.20140175 Copy

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2.	陸再英, 鐘南山.內科學.北京:人民衛生出版社, 2008:251.
3.	Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension:analysis of worldwide data. Lancet, 2005, 365(9455):217-223.
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5.	中國高血壓防治指南修訂委員會.中國高血壓防治指南2010.中華心血管病雜志, 2011, 39(7):579-616.
6.	王寧.原發性高血壓的發病機制與臨床治療.中國醫藥指南, 2013, (33):570-571.
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8.	楊克虎, 劉雅莉, 袁金秋, 等.發展和完善中的系統評價再評價.中國循證兒科雜志, 2011, 6(1):54-57.
9.	劉雅莉, 袁金秋, 楊克虎, 等.系統評價再評價的制作方法簡介及相關資料分析.中國循證兒科雜志, 2011, 6(1):58-64.
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13.	曾憲濤, 冷衛東, 李勝, 等.如何正確理解及使用GRADE系統.中國循證醫學雜志, 2011, 11(9):985-990.
14.	陳新宇, 尹玲瓏, 劉紫軒, 等.半夏白術天麻湯治療原發性高血壓臨床療效Meta分析.遼寧中醫雜志, 2014, 41(2):196-199.
15.	王瓊.丹參注射液治療高血壓腦出血療效與安全性的Meta分析.浙江大學, 2012.
16.	郭意欣, 陳新林, 丘振文, 等.六味地黃丸聯合西藥治療高血壓病的Meta分析和系統評價.中國中醫急癥, 2013, 22(2):189-191.
17.	周倩儀, 馬楷奇, 郭意欣, 等.天麻鉤藤飲聯合卡托普利治療原發性高血壓的系統評價和Meta分析.安徽中醫學院學報, 2013, 32(4):12-17.
18.	董大幸, 姚松林, 余男, 等.天麻鉤藤飲聯合依那普利治療原發性高血壓系統評價和Meta分析.中國中醫急癥, 2011, 20(5):762-764.
19.	任毅, 歐愛華, 林曉忠.中醫藥治療原發性高血壓隨機對照試驗的Meta分析.陜西中醫, 2006, 27(7):794-796.
20.	戴娟.中醫藥治療原發性高血壓的系統評價.中國中醫藥咨訊, 2010, 2(36):22-24.
21.	杜浩, 戴小華.養血清腦顆粒治療高血壓伴隨癥狀的Meta分析.安徽中醫藥大學學報, 2014, 33(1):8-11.
22.	李東娜, 楊傳華.中醫藥治療老年單純收縮期高血壓臨床療效的Meta分析.遼寧中醫雜志, 2012, 39(5):812-815.
23.	Xiong X, Yang X, Liu W, et al. Banxia Baizhu Tianma Decoction for Essential Hypertension:A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med, 2012, 2012:271462.
24.	Wang J, Feng B, Yang X, et al. Tianma gouteng yin as adjunctive treatment for essential hypertension:systematic review of randomizedcontrolled trials. Evid Based Complement Alternat Med, 2013, 2013:706125.
25.	Wu X, Jiang X. Systematic review and meta-analysis of randomized controlled trials on Tianmagouteng decoction in treatment of primary hypertension with liver Yang hyperactivity syndrome. J Tradit Chin Med, 2013, 33(1):15-18.
26.	Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011.
27.	Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR:a measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology, 2007, 7(1):10.
28.	郭新峰, 賴世隆.對中醫藥領域開展循證醫學研究的幾點看法.中國循證醫學雜志, 2008, 8(1):10-12.
29.	王俊文, 崔蒙, 趙英凱, 等.中醫藥領域循證醫學發展建議.世界中醫藥, 2010, 05(5):305-307.
30.	李靜, 李幼平.不斷完善與發展的Cochrane系統評價.中國循證醫學雜志, 2008, 8(9):742-743.
31.	Jadad AR, Cook DJ, Jones A. Methodology and reports of systematic reviews and meta-analysis:a comparison of Cochrane paper-based journals. JAMA, 1998, 280(3):278-280.
32.	郭新峰, 朱泉, 賴世隆.替代指標和中間指標及其在中醫藥療效評價研究中應用價值的思考.中國中西醫結合雜志, 2005, 25(7):585-590.
33.	Oliver MF, Heady JA, Morris JN, et al. For the Committeeof Principal Investigators. WHO cooperative trial of primary prevention of ischemic heart disease with clofibrate to lower serum cholesterol:final mortality follow-up. Lancet, 1984, 2:600-604.

1. 易秋, 艷張, 林潮.原發性高血壓流行病學研究進展.中華高血壓雜志, 2010, 18(9):823-826.
2. 陸再英, 鐘南山.內科學.北京:人民衛生出版社, 2008:251.
3. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension:analysis of worldwide data. Lancet, 2005, 365(9455):217-223.
4. 中華人民共和國衛生部.中國居民營養與健康狀況.中國心血管病研究雜, 2004, 2(12):919-922.
5. 中國高血壓防治指南修訂委員會.中國高血壓防治指南2010.中華心血管病雜志, 2011, 39(7):579-616.
6. 王寧.原發性高血壓的發病機制與臨床治療.中國醫藥指南, 2013, (33):570-571.
7. 于匯民, 王兵, 劉國仗, 等.原發性高血壓的病因及發病機制.新醫學, 2003, 34(3):135-136.
8. 楊克虎, 劉雅莉, 袁金秋, 等.發展和完善中的系統評價再評價.中國循證兒科雜志, 2011, 6(1):54-57.
9. 劉雅莉, 袁金秋, 楊克虎, 等.系統評價再評價的制作方法簡介及相關資料分析.中國循證兒科雜志, 2011, 6(1):58-64.
10. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure:the JNC 7 report. JAMA, 2003, 289(19):2560-2571.
11. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR:a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7:10.
12. GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454):1490.
13. 曾憲濤, 冷衛東, 李勝, 等.如何正確理解及使用GRADE系統.中國循證醫學雜志, 2011, 11(9):985-990.
14. 陳新宇, 尹玲瓏, 劉紫軒, 等.半夏白術天麻湯治療原發性高血壓臨床療效Meta分析.遼寧中醫雜志, 2014, 41(2):196-199.
15. 王瓊.丹參注射液治療高血壓腦出血療效與安全性的Meta分析.浙江大學, 2012.
16. 郭意欣, 陳新林, 丘振文, 等.六味地黃丸聯合西藥治療高血壓病的Meta分析和系統評價.中國中醫急癥, 2013, 22(2):189-191.
17. 周倩儀, 馬楷奇, 郭意欣, 等.天麻鉤藤飲聯合卡托普利治療原發性高血壓的系統評價和Meta分析.安徽中醫學院學報, 2013, 32(4):12-17.
18. 董大幸, 姚松林, 余男, 等.天麻鉤藤飲聯合依那普利治療原發性高血壓系統評價和Meta分析.中國中醫急癥, 2011, 20(5):762-764.
19. 任毅, 歐愛華, 林曉忠.中醫藥治療原發性高血壓隨機對照試驗的Meta分析.陜西中醫, 2006, 27(7):794-796.
20. 戴娟.中醫藥治療原發性高血壓的系統評價.中國中醫藥咨訊, 2010, 2(36):22-24.
21. 杜浩, 戴小華.養血清腦顆粒治療高血壓伴隨癥狀的Meta分析.安徽中醫藥大學學報, 2014, 33(1):8-11.
22. 李東娜, 楊傳華.中醫藥治療老年單純收縮期高血壓臨床療效的Meta分析.遼寧中醫雜志, 2012, 39(5):812-815.
23. Xiong X, Yang X, Liu W, et al. Banxia Baizhu Tianma Decoction for Essential Hypertension:A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med, 2012, 2012:271462.
24. Wang J, Feng B, Yang X, et al. Tianma gouteng yin as adjunctive treatment for essential hypertension:systematic review of randomizedcontrolled trials. Evid Based Complement Alternat Med, 2013, 2013:706125.
25. Wu X, Jiang X. Systematic review and meta-analysis of randomized controlled trials on Tianmagouteng decoction in treatment of primary hypertension with liver Yang hyperactivity syndrome. J Tradit Chin Med, 2013, 33(1):15-18.
26. Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011.
27. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR:a measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology, 2007, 7(1):10.
28. 郭新峰, 賴世隆.對中醫藥領域開展循證醫學研究的幾點看法.中國循證醫學雜志, 2008, 8(1):10-12.
29. 王俊文, 崔蒙, 趙英凱, 等.中醫藥領域循證醫學發展建議.世界中醫藥, 2010, 05(5):305-307.
30. 李靜, 李幼平.不斷完善與發展的Cochrane系統評價.中國循證醫學雜志, 2008, 8(9):742-743.
31. Jadad AR, Cook DJ, Jones A. Methodology and reports of systematic reviews and meta-analysis:a comparison of Cochrane paper-based journals. JAMA, 1998, 280(3):278-280.
32. 郭新峰, 朱泉, 賴世隆.替代指標和中間指標及其在中醫藥療效評價研究中應用價值的思考.中國中西醫結合雜志, 2005, 25(7):585-590.
33. Oliver MF, Heady JA, Morris JN, et al. For the Committeeof Principal Investigators. WHO cooperative trial of primary prevention of ischemic heart disease with clofibrate to lower serum cholesterol:final mortality follow-up. Lancet, 1984, 2:600-604.

Chinese Journal of Evidence-Based Medicine

Traditional Chinese Medicine for Essential Hypertension: An Overview of Systematic Reviews

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