陶诗怡，于林童，杨德爽，张瑾，张兰鑫，王子涵，黄力

引用本文： 陶诗怡，于林童，杨德爽，张瑾，张兰鑫，王子涵，黄力.中医药治疗正常高值血压有效性和安全性的Meta分析[J].中西医结合心脑血管病杂志,2022,20(3):385-393

摘要： 目的系统评价中医药治疗正常高值血压的有效性和安全性。方法计算机检索中国知网全文数据库（CNKI）、中国学术期刊数据库（WanFang数据库）、维普中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）、PubMed、Web of Science、the Cochrane Library、EMbase数据库，同时通过手工检索等其他途径补充文献，筛选中医药治疗正常高值血压的随机对照试验。采用修改后的Jadad量表和Cochrane Reviewers Handbook 5.1.0偏倚风险评估工具对文献进行质量评价，借助Review Manager 5.3软件进行Meta分析。结果最终纳入22篇文献，包含2 041例病人。文献方法学质量总体较差，仅有3篇高质量文献。Meta分析结果显示，中医药疗法能进一步降低正常高值血压病人的收缩压［MD＝－5.87，95%CI（－7.20，－4.53），P＜0.000 01］、舒张压［MD＝－3.91，95%CI（－5.00，－2.81），P＜0.000 01］、中医证候积分［MD＝－4.88，95%CI（－7.92，－1.85），P＜0.000 01］，提高临床症状有效率［RR＝1.59，95%CI（1.44，1.75），P＜0.000 01］，降低体质指数［MD＝－0.87，95%CI（－1.33，－0.41），P＝0.000 2］，安全性与西药比较，差异无统计学意义［RR＝0.78，95%CI（0.04，15.50），P＝0.87］。结论现有证据表明，在生活方式干预的基础上联用中医药疗法可进一步改善正常高值血压病人的临床症状，疗效优于单纯生活方式干预或西药治疗，但由于纳入研究质量普遍偏低，结论仍需更多高质量的临床研究加以证实。

关键词： 正常高值血压；中医药；高血压前期；临界高血压；Meta分析

TAO Shiyi,YU Lintong,YANG Deshuang,ZHANG Jin,ZHANG Lanxin,WANG Zihan,HUANG Li

Abstract ObjectiveTo evaluate the efficacy and safety of traditional Chinese medicine in the treatment of high-normal blood pressure.Methods China National Knowledge Infrastructure(CNKI),WanFang Database,VIP Database,China Biology Medicine disc(CBM),PubMed,Web of Science,the Cochrane Library,and EMbase were retrieved by computers to screen out the randomized controlled trials(RCT) of traditional Chinese medicines in treating high-normal blood pressure,manual retrieval was used for supplement of the literature.The modified Jadad scale and Cochrane Reviewers Handbook 5.1.0 were used to evaluate the quality of the included literature.Review Manager 5.3 software was used for Meta-analysis.ResultsA total of 2 041 patients in 22 RCTs were collected in which the methodological quality was generally poor and there are 3 with high qualified standard.The results of Meta-analysis showed that traditional Chinese medicine(TCM) could reduce systolic blood pressure in patients with high-normal blood pressure［MD＝－5.87,95%CI(－7.20,－4.53),P＜0.000 01］,reduce diastolic blood pressure［MD＝－3.91,95%CI(－5.00,－2.81),P＜0.000 01］,reduce traditional Chinese medicine score［MD＝－4.88,95%CI(－7.92,－1.85),P＜0.000 01］,improve effective rate of clinical symptoms［RR＝1.59,95%CI(1.44,1.75),P＜0.000 01］,reduce body mass index［MD＝－0.87,95%CI(－1.33,－0.41),P＝0.000 2］,without significant difference in safety compared to western medicine［RR＝0.78,95%CI(0.04,15.50),P＝0.87］.ConclusionThe results indicated that the efficacy of traditional Chinese medicine combined therapy of lifestyle intervention in treating high-normal blood pressure was better than that of lifestyle intervention or western medicine alone,which could further improve the clinical symptoms.However,due to the poor quality of the included studies,the conclusion needs to be confirmed by more high-quality clinical studies.

Keywords high-normal blood pressure;traditional Chinese medicine;prehypertension;borderline hypertension;Meta-analysis

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