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.	中國心血管健康與疾病報告編寫組. 中國心血管健康與疾病報告 2019 概要. 中華老年病研究電子雜志, 2020, 7(4): 4-15.
5.	李倫, 楊克虎, 田金徽, 等. 一種新的證據總結方法——證據圖簡介. 中國循證兒科雜志, 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, 陳日新. 系統評價/Meta 分析方法學質量的評價工具 AMSTAR. 中國循證醫學雜志, 2011, 11(9): 1084-1089.
8.	張曉雨, 鐘長鳴, 關曼柯, 等. 心肌梗死中醫防治臨床研究證據圖. 世界中醫藥, 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.	袁潔, 曹文富, 胡大一, 等. 保留收縮功能心衰的臨床研究及太極拳運動對其血流動力學的影響. 重慶: 重慶醫科大學. 2019.
11.	王連心, 謝雁鳴, 楊薇, 等. 基于HIS真實世界的參麥注射液臨床實效研究. 中國中藥雜志, 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.	羅良濤, 王娟, 趙慧輝, 等. 17 家中醫醫院慢性心力衰竭患者臨床特征及治療情況調查. 中國中西醫結合雜志, 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.	龐穩泰, 王虎城, 楊豐文, 等. 芪藶強心膠囊治療慢性心力衰竭系統評價的再評價. 天津中醫藥, 2019, 36(11): 1088-1093.
16.	周國鋒, 李媛, 林芮, 等. 中藥注射劑治療心力衰竭系統評價再評價. 中華中醫藥學刊, 2019, 37(1): 125-129.
17.	趙馥, 林新鋒, 趙鋒利, 等. 基于 AMSTAR2 的參附注射液治療心力衰竭系統評價再評價. 國際中醫中藥雜志, 2019, 41(6): 625-630.
18.	林勇, 林珍珍, 呂渭輝, 等. 參芪扶正注射液治療慢性心力衰竭隨機對照試驗的 Meta 分析. 中西醫結合心腦血管病雜志, 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.	莫靜蘭. 慢性心力衰竭臨床路徑Delphi(德爾菲)法調查分析. 廣州: 廣州中醫藥大學, 2009.
21.	中華中醫藥學會. 中醫內科常見病診療指南(西醫疾病部分)心力衰竭. 中國中醫藥現代遠程教育, 2011, 9(18): 145-147.
22.	毛靜遠, 朱明軍. 慢性心力衰竭中醫診療專家共識. 中醫雜志, 2014, 55(14): 1258-1260.
23.	陳可冀, 吳宗貴, 朱明軍, 等. 慢性心力衰竭中西醫結合診療專家共識. 心腦血管病防治, 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.	王瑤, 郭彬, 孫露, 等. 八段錦對慢性心力衰竭患者生活質量影響的 Meta 分析. 按摩與康復醫學, 2019, 10(15): 45-49.
29.	王拴虎, 毛靜遠, 侯雅竹, 等. 西藥常規加用芪參益氣滴丸治療慢性心力衰竭隨機對照試驗的系統評價. 中國中西醫結合雜志, 2013, 33(11): 1468-1475.
30.	張長江, 夏豪. 參芪扶正注射液治療心力衰竭有效性及安全性的 Meta 分析. 中國循證心血管醫學雜志, 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. 中國心血管健康與疾病報告編寫組. 中國心血管健康與疾病報告 2019 概要. 中華老年病研究電子雜志, 2020, 7(4): 4-15.
5. 李倫, 楊克虎, 田金徽, 等. 一種新的證據總結方法——證據圖簡介. 中國循證兒科雜志, 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, 陳日新. 系統評價/Meta 分析方法學質量的評價工具 AMSTAR. 中國循證醫學雜志, 2011, 11(9): 1084-1089.
8. 張曉雨, 鐘長鳴, 關曼柯, 等. 心肌梗死中醫防治臨床研究證據圖. 世界中醫藥, 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. 袁潔, 曹文富, 胡大一, 等. 保留收縮功能心衰的臨床研究及太極拳運動對其血流動力學的影響. 重慶: 重慶醫科大學. 2019.
11. 王連心, 謝雁鳴, 楊薇, 等. 基于HIS真實世界的參麥注射液臨床實效研究. 中國中藥雜志, 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. 羅良濤, 王娟, 趙慧輝, 等. 17 家中醫醫院慢性心力衰竭患者臨床特征及治療情況調查. 中國中西醫結合雜志, 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. 龐穩泰, 王虎城, 楊豐文, 等. 芪藶強心膠囊治療慢性心力衰竭系統評價的再評價. 天津中醫藥, 2019, 36(11): 1088-1093.
16. 周國鋒, 李媛, 林芮, 等. 中藥注射劑治療心力衰竭系統評價再評價. 中華中醫藥學刊, 2019, 37(1): 125-129.
17. 趙馥, 林新鋒, 趙鋒利, 等. 基于 AMSTAR2 的參附注射液治療心力衰竭系統評價再評價. 國際中醫中藥雜志, 2019, 41(6): 625-630.
18. 林勇, 林珍珍, 呂渭輝, 等. 參芪扶正注射液治療慢性心力衰竭隨機對照試驗的 Meta 分析. 中西醫結合心腦血管病雜志, 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. 莫靜蘭. 慢性心力衰竭臨床路徑Delphi(德爾菲)法調查分析. 廣州: 廣州中醫藥大學, 2009.
21. 中華中醫藥學會. 中醫內科常見病診療指南(西醫疾病部分)心力衰竭. 中國中醫藥現代遠程教育, 2011, 9(18): 145-147.
22. 毛靜遠, 朱明軍. 慢性心力衰竭中醫診療專家共識. 中醫雜志, 2014, 55(14): 1258-1260.
23. 陳可冀, 吳宗貴, 朱明軍, 等. 慢性心力衰竭中西醫結合診療專家共識. 心腦血管病防治, 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. 王瑤, 郭彬, 孫露, 等. 八段錦對慢性心力衰竭患者生活質量影響的 Meta 分析. 按摩與康復醫學, 2019, 10(15): 45-49.
29. 王拴虎, 毛靜遠, 侯雅竹, 等. 西藥常規加用芪參益氣滴丸治療慢性心力衰竭隨機對照試驗的系統評價. 中國中西醫結合雜志, 2013, 33(11): 1468-1475.
30. 張長江, 夏豪. 參芪扶正注射液治療心力衰竭有效性及安全性的 Meta 分析. 中國循證心血管醫學雜志, 2013, 5(3): 233-236.

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