| Objective The aim of this meta-analysis is to evaluate the effects of Qili Qiangxin capsules on cardiac function, brain natriuretic peptide/N-terminal pro brain natriuretic peptide, left ventricular ejection fraction,6-min walk distance and quality of life in patients with chronic heart failure on the basis of published randomized controlled trials.Methods Chinese National Knowledge Infrastructure, Wanfang, Vip, Pubmed, Embase and Cochrane library were systematically reviewed for relevant randomized controlled trials published up to November 2014, in which the effects of Qili Qiangxin capsules for people with chronic heart failure were explored. "Qiliqiangxin", "Qili Qiangxin", "chronic heart failure", "clinical trial", "randomized controlled trial",and "randomized" were searched in both Chinese and English. Additionally, the reference lists of included trials and relevant reviews were also examined for potential trials. Interested endpoints including the classification of cardiac function, brain natriuretic peptide, N-terminal pro brain natriuretic peptide, left ventricular ejection fraction,6-min walk distance and quality of life. The primary searched articles were screened by author according predefined inclusion and exclusion criteria. The methodological quality of included trials was evaluated using bias risk assessment tool (version 5.1.0) provided by Cochrane handbook of systematically reviews. Dichotomous variables were calculated using risk ratio and corresponding 95% confidence internal. Continuous variables were calculated using weight mean difference or standard mean difference and corresponding 95% confidence internal. Between-study heterogeneity was assessed using I2, which describes the percentage of total variation across studies due to heterogeneity rather than chance. If there is a little heterogeneity, the meta-analysis was performed with the fixed-effects model, otherwise, the random-effects model was used. The presence of publication bias was evaluated by Begg's test and Egger's test. A P-value< 0.05 was judged as statistically significant. All statistical analyses were performed using Stata 12.0.Results Seven hundred and forty-nine articles were identified by the initial literature search, and seventy-nine articles involving 7119 patients were included according inclusion criteria consequently. On a background of standard therapy, Qili Qiangxin capsules supplementation could further improve the patients' cardiac function. After treatment, the efficiency [RR=1.33, 95%CI:(1.24,1.43), P<0.001] and total efficiency [RR=1.23, 95%CI:(1.19,1.26), P<0.001] of experimental arms were better than control arms. Additionally, Qili Qiangxin capsules could reduce the levels of brain natriur -etic peptide [WMD=-86.64,95%CI:(-120.13,-53.15), P<0.001] and N-terminal brain natriuretic peptide [WMD=-236.46, 95%CI:(-308.12,-164.81), P<0.001], and improve the left ventricular ejection fraction [WMD=5.16,95%CI:(4.24,6.08), P<0.001],6-min walk distance [WMD-48.52,95%CI:(40.15,56.88), P<0.001] and quality of life [WMD=-6.42,95%CI:(-7.58,-5.26), P<0.001] compared with control arms.Conclusion On a background of standard treatment, Qili Qiangxin capsules could further improve patients'cardiac function, quality of life, left ventricular ejection fraction and 6-min walk distance, and reduce the levels of brain natriuretic peptide and N-terminal brain natriuretic peptide. However, it is necessary to conduct a larger, high quality randomized controlled trial to confirm these effects. |
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