Efficacy of Qiliqiangxin capsule for heart failure with preserved ejection fraction on cardiac function: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

CAO Yawen ^1,2 , BI Yingfei ¹ , WANG Xianliang ¹ , ZHAO Zhiqiang ¹ , YANG Ying ^1,2 ,  MAO Jingyuan ¹

1. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, P.R.China;
2. Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P.R.China;

Corresponding?author：

MAO Jingyuan, Email: jymao@126.com

Keywords：

Qiliqiangxin capsule; Ejection fraction preserved heart failure; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202009079

Video：

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Objectives To systematically review the efficacy of Qiliqiangxin capsule on cardiac function in patients with heart failure with preserved ejection fraction (HFpEF).Methods CNKI, VIP, WanFang Data, CBM, EMbase, PubMed and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) of Qiliqiangxin capsule for HFpEF from inception to August 1^st, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was performed by RevMan5.3 software.Results A total of 24 RCTs involving 2 021 patients were included. The results of meta-analysis showed that Qiliqiangxin capsule combined with conventional western medicine could improve E/A wave ratio (MD=0.17, 95%CI 0.13 to 0.21, P<0.000 01), reduce E/e' wave ratio (MD=?2.16, 95%CI ?3.23 to ?1.08, P<0.000 1), BNP (MD=?240.43, 95%CI ?357.66 to ?123.20, P<0.000 1), and NT-proBNP (MD=?200.64, 95%CI ?290.02 to ?111.27, P<0.000 1). However, there were no statistically significant differences between two groups in re-hospitalization rate (RR=0.57, 95%CI 0.27 to 1.19, P=0.13), mortality (RR=0.33, 95%CI 0.04 to 3.05, P=0.33), and incidence of adverse events (RR=0.59, 95%CI 0.26 to 1.34, P=0.20).Conclusions The present evidence shows that Qiliqiangxin capsule combined with conventional western medicine can improve neuroendocrine disorders and cardiac structure in patients with HFpEF, and further improve cardiac diastolic function. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

Citation： CAO Yawen, BI Yingfei, WANG Xianliang, ZHAO Zhiqiang, YANG Ying, MAO Jingyuan. Efficacy of Qiliqiangxin capsule for heart failure with preserved ejection fraction on cardiac function: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(12): 1427-1433. doi: 10.7507/1672-2531.202009079 Copy

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28.	杜亞康. 芪藶強心膠囊治療舒張性心力衰竭療效觀察. 山西中醫, 2014, 30(2): 14-15, 42.
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34.	Zhang J, Huang M, Shen S, et al. Qiliqiangxin attenuates isoproterenol-induced cardiac remodeling in mice. Am J Transl Res, 2017, 9(12): 5585-5593.
35.	Han A, Lu Y, Zheng Q, et al. Qiliqiangxin Attenuates Cardiac Remodeling via Inhibition of TGF-β1/Smad3 and NF-κB Signaling Pathways in a Rat Model of Myocardial Infarction. Cell Physiol Biochem, 2018, 45(5): 1797-1806.
36.	Lin S, Wu X, Tao L, et al. The metabolic effects of traditional Chinese medication Qiliqiangxin on H9C2 cardiomyocytes. Cell Physiol Biochem, 2015, 37(6): 2246-2256.
37.	Wang J, Zhou J, Wang Y, et al. Qiliqiangxin protects against anoxic injury in cardiac microvascular endothelial cells via NRG-1/ErbB-PI3K/Akt/mTOR pathway. J Cell Mol Med, 2017, 21(9): 1905-1914.
38.	吳相君, 趙保禮, 韓碩龍, 等. 芪藶強心膠囊對擴張型心肌病患者心功能及血管內皮功能影響的臨床研究. 疑難病雜志, 2018, 17(4): 329-333.
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1. 中華醫學會心血管病學分會心力衰竭學組, 中華心血管病雜志編輯委員會. 中國心力衰竭診斷和治療指南 2018. 中華心血管病雜志, 2018, 46(10): 760-789.
2. Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol, 2017, 70(20): 2476-2486.
3. 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.
4. 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.
5. 許強, 劉宏軍, 劉學會. 芪藶強心膠囊治療射血分數保留的心力衰竭療效的 Meta 分析. 疑難病雜志, 2015, 14(9): 898-901.
6. 馮英, 蔣玙姝, 何倩雯, 等. 芪藶強心膠囊治療舒張性心力衰竭的療效及安全性的 Meta 分析. 武漢大學學報(醫學版), 2015, 36(6): 992-999.
7. 中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 中國心力衰竭診斷和治療指南 2014. 中華心血管病雜志, 2014, 42(2): 98-122.
8. 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. 中國中西醫結合雜志, 2016, 36(2): 133-141.
9. 簡航宇, 李強, 曾麗云. 常規療法聯合芪藶強心膠囊治療慢性舒張性心功能不全的臨床療效及其對心率變異性的影響. 實用心腦肺血管病雜志, 2015, 23(10): 115-117.
10. 陳統. 地爾硫卓聯合芪藶強心膠囊治療射血分數保留性心衰的臨床療效分析. 延安: 延安大學, 2014.
11. 馮文偉, 熊斌, 李玉鳳. 芪藶強心膠囊對射血分數保留的心力衰竭患者多普勒 E/E’比值及 NT-pro-BNP 的影響. 新中醫, 2014, 46(10): 39-41.
12. 強玉娜. 芪藶強心膠囊對舒張性心衰患者 NT-proBNP 和 6min 步行試驗的影響. 中國現代藥物應用, 2016, 10(2): 198-199.
13. 李彥霞, 袁國強, 賈振華. 芪藶強心膠囊對舒張性心衰患者生活質量及血漿 NT-proBNP 水平的影響. 中國中醫基礎醫學雜志, 2012, 18(3): 289-291.
14. 甄利波, 田祥. 芪藶強心膠囊輔治冠心病舒張性心力衰竭效果觀察. 臨床合理用藥雜志, 2013, 6(25): 82-83.
15. 關思虞, 楊玲. 芪藶強心膠囊輔治射血分數正常心力衰竭的臨床研究. 疑難病雜志, 2012, 11(7): 500-502.
16. 宋建廣, 韓玉. 芪藶強心膠囊輔治舒張性心力衰竭的療效觀察. 臨床合理用藥雜志, 2017, 10(25): 48-49.
17. 王曉寧, 沃金善, 郭潔. 芪藶強心膠囊輔助治療冠心病合并左心舒張功能不全的臨床效果. 疑難病雜志, 2016, 15(2): 183-185, 194.
18. 楊海燕, 索云錫. 芪藶強心膠囊輔助治療舒張性心衰患者的療效對照研究. 醫藥, 2015, (29): 287.
19. 陳偉, 侯湘嶺, 王偉紅, 等. 芪藶強心膠囊聯合卡托普利對老年高血壓合并左室舒張功能不全患者房室重構及血清 D-二聚體、hs-CRP、BNP 水平的影響. 現代中西醫結合雜志, 2018, 27(20): 2182-2185.
20. 李瑜賢. 芪藶強心膠囊聯合美托洛爾治療高血壓并舒張性心力衰竭的效果觀察. 中國民康醫學, 2018, 30(21): 84-85, 89.
21. 池豪, 楊東偉, 劉新葉. 芪藶強心膠囊聯合美托洛爾治療舒張性心功能不全的療效觀察. 中國實用醫藥, 2014, (10): 187-188.
22. 董梅, 孫旭杜, 賈相科, 等. 芪藶強心膠囊聯合曲美他嗪治療射血分數保留心力衰竭的臨床研究. 中國誤診學雜志, 2018, 13(1): 9-11.
23. 羅平, 萬鳳福. 芪藶強心膠囊聯合西藥治療射血分數保留的心衰臨床觀察. 江西醫藥, 2016, 51(10): 1069-1071.
24. 余智云. 芪藶強心膠囊治療 45 例舒張性心衰的臨床療效觀察. 中國民族民間醫藥, 2013, 22(21): 28.
25. 高彩, 金連珍, 文磊, 等. 芪藶強心膠囊治療射血分數保留慢性心力衰竭的臨床研究. 中西醫結合心腦血管病雜志, 2019, 17(17): 2621-2623.
26. 劉宏軍, 許強, 夏曉鵬, 等. 芪藶強心膠囊治療射血分數保留心力衰竭的療效觀察. 中西醫結合心腦血管病雜志, 2017, 15(14): 1730-1733.
27. 高艷霞, 李小虎. 芪藶強心膠囊治療舒張性心力衰竭的臨床觀察. 中國現代醫生, 2016, 54(7): 107-109.
28. 杜亞康. 芪藶強心膠囊治療舒張性心力衰竭療效觀察. 山西中醫, 2014, 30(2): 14-15, 42.
29. 洪恩. 芪藶強心膠囊治療舒張性心衰 40 例臨床療效觀察. 中國民族民間醫藥, 2013, 22(24): 70.
30. 田野, 李彥霞, 任君霞, 等. 芪藶強心膠囊治療舒張性心衰的療效觀察. 中國臨床藥理學雜志, 2011, 27(9): 666-668.
31. 于建華. 舒張性心力衰竭患者血 hs-CRP 水平變化及芪藶強心膠囊干預的研究. 濟南: 山東中醫藥大學, 2008.
32. 胡鵬, 朱定君, 曹學敏, 等. 舒張性心衰患者應用芪藶強心膠囊治療的效果分析. 中國臨床研究, 2016, 29(7): 957-958, 961.
33. 李婭, 宋優, 程翔, 等. 芪藶強心膠囊對大鼠心肌梗死后心肌重構及心功能的影響. 中國分子心臟病學雜志, 2007, 7(4): 201-204.
34. Zhang J, Huang M, Shen S, et al. Qiliqiangxin attenuates isoproterenol-induced cardiac remodeling in mice. Am J Transl Res, 2017, 9(12): 5585-5593.
35. Han A, Lu Y, Zheng Q, et al. Qiliqiangxin Attenuates Cardiac Remodeling via Inhibition of TGF-β1/Smad3 and NF-κB Signaling Pathways in a Rat Model of Myocardial Infarction. Cell Physiol Biochem, 2018, 45(5): 1797-1806.
36. Lin S, Wu X, Tao L, et al. The metabolic effects of traditional Chinese medication Qiliqiangxin on H9C2 cardiomyocytes. Cell Physiol Biochem, 2015, 37(6): 2246-2256.
37. Wang J, Zhou J, Wang Y, et al. Qiliqiangxin protects against anoxic injury in cardiac microvascular endothelial cells via NRG-1/ErbB-PI3K/Akt/mTOR pathway. J Cell Mol Med, 2017, 21(9): 1905-1914.
38. 吳相君, 趙保禮, 韓碩龍, 等. 芪藶強心膠囊對擴張型心肌病患者心功能及血管內皮功能影響的臨床研究. 疑難病雜志, 2018, 17(4): 329-333.
39. 馬柳一, 尹玉潔, 張軍芳, 等. 芪藶強心膠囊對慢性心衰大鼠下丘腦室旁核 RAS 系統及交感神經系統的影響. 中國藥理學通報, 2016, 32(4): 575-580.
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Chinese Journal of Evidence-Based Medicine

Efficacy of Qiliqiangxin capsule for heart failure with preserved ejection fraction on cardiac function: a systematic review

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