Meta - Analysis Of Clinical Efficacy Of Yiqi Warming Yang And Promoting Blood Circulation In Treating Chronic Heart Failure

Purpose: To meta-analysis the clinical efficacy of tradition Chinese medicine of supplementing qi and worming yang and activating blood and promoting diuresis on chronic heart failure.And to provide evidence-based medicine for chronic heart failure interventions with TCM in clinical medicineMaterial and method: Strict inclusion and exclusion criteria and scientific search strategy were formulated to retrieve literature published from 2005 to 2014 by computerized and manual method.Literature associated with RCT in treating CHF with TCM of supplementing qi and worming yang and activating blood and promoting diuresis combined with western conventional treatment. And the eligible literature were included in the meta-analysis.First data entry and Jadad score. Seconedly analysis literature with two classification variables and continuous variable using Rev Man 5.3 statistical software.Results: The analysis included a total of 17 studies, including three high-quality literature and 14 low-quality literature. A total of 1472 cases of patients with CHF.They were divided the treatment group(supplementing qi and worming yang and activating blood and promoting diuresis combined with western conventional treatment) 766 cases of patients and control group(western conventional treatment) 706 cases of patients.Meta-analysis results show that:(1) Efficacy in NYHA in patients: the treatment group showed more benefit compared with the control group and the difference was statistically significant(OR = 3.11,95% CI = 2.33 ~ 4.14, Z = 7.75, P <0.00001);(2) To improve the efficiency of TCM syndromes: the treatment group had more benefit compared with the control group and the difference was statistically significant(OR = 3.25,95% CI = 2.11 ~ 5.00, Z = 5.37, P <0.00001);(3) The increased left ventricular ejection fraction: the treatment group had more benefit compared with the control group and the difference was statistically significant(SMD = 0.98,95% CI = 0.43 ~ 1.53, Z = 3.50, P = 0.0005);(4) In the lower left ventricular end-diastolic diameter: the treatment group had more benefit compared with the control group and the difference was statistically significant(SMD =-0.92,95% CI =-1.53 ~-0.32, Z = 3.00, P = 0.003);(5) To increase in cardiac output: the treatment group had more benefit compared with the control group and the difference was statistically significant(MD = 0.66,95% CI = 0.39 ~ 0.93, Z = 4.76, P <0.00001);(6) The 6-minute walk test distance: the treatment group had more benefit compared with the control group and the difference was statistically significant(MD = 63.61,95% CI = 42.90 ~ 84.33, Z = 6.02, P <0.00001);(7) The level of serum BNP: the treatment group had more benefit compared with the control group and the difference was statistically significant(SMD =-2.21,95% CI =-3.59 ~ 0.83, Z = 3.13, P = 0.002).Conclusion: TCM of supplementing qi and worming yang and activating blood and promoting diuresis combine with conventional western medicine treatment can significantly improve efficacy in NYHA, improve clinical symptoms, improve exercise tolerance, increased LVEF and CO and decreased serum BNP levels and LVEDD in chronic heart failure patients. There is clinical a significant effect, and there is good security.