Meta-analysis Of Traditional Chinese Medicine Adjuvant Therapy For H-type Hypertension

Purpose:To evaluate the clinical efficacy of Chinese medicine supportive treatment of H-type Hypertention by collecting the literatures about H-type Hypertention.Material and method:Use computer to search journals with the key word “Chinese Traditional Medicine”?”TCM”?” H-type Hypertention” in China academic journal full text database of Chinese academic journals(Weipu),CNKI,Wanfang Digital Journal Full-text Data base and CBM.The time limit of searching was from 2015.01.01 to 2020.12.31.According to the inclusion criteria and exclusion criteria formulated with Excel ? Using Jadad evaluation and Cochrane risk assessment toll to access the quality of the journals.Draw forest map and funnel map by Revman 5.3 software for meta-analysis,summary,and discussion.The selected indicators were: Symptoms efficacy,blood pressure reduction efficacy,TCM syndrome efficacy score,Homocysteine,CSBP?CDBP?24h SBP?24h DBP?d SBP?d DBP?n SBP?n DBP.Qualified literatures in conformance with the inclusion and exclusion criteria were selected,based on which a Excel data sheet was established to perform a series of statistical analysises,including cluster analysis by means of SPSS23.0 and data mining in virtue of IBM SPSS Modeler 18.Results:1.A total of 17 RCT literatures were retrieved,all of which were Chinese literatures,Meta-analysis was carried out with 1260 samples,including 625 in the observation group and635 in the control group.2.Meta analysis showed that support treatment of TCM had obvious clinical efficacy in treating H-type Hypertention than pure standard western treatment,compared with the control group,the observation group can significantly improve clinical symptom,[RR=1.30,95%CI:(1.22,1.38),P<0.01],has better effect in lowing arterial pressure,[RR=1.17,95%CI:(1.10,1.24),P<0.01],can better decrease TCM symptom score,[SMD=-1.45,95%CI:(-1.94,-0.96),P<0.01],can better decrease clinical systolic pressure [SMD=-1.00,95%CI:(-1.33,-0.64),P<0.01],can better decrease clinical diastolic pressure[SMD=-0.81,95%CI:(-1.18,-0.44),P<0.01],can better decrease Hcy[SMD=-1.34,95%CI:(-1.75,-0.92),P<0.01],can better decreasing 24 h systolic blood pressure(24h SBP)[SMD=-0.97,95%CI:(-1.26,-0.68),P<0.01],can better decreasing 24 h diastolic blood pressure(24h DBP)[SMD=-1.60,95%CI:(-2.37,-0.83),P<0.01],can better decreasing day systolic blood pressure(d SBP)[SMD=-1.25,95%CI:(-1.79,-0.71),P<0.01],can better decreasing day diastolic blood pressure(d DBP)[SMD=-1.38,95%CI:(-2.12,-0.65),P<0.01],can better decreasing night systolic blood pressure(n SBP)[SMD=-1.30,95%CI:(-1.88,-0.72),P<0.01],can better decreasing night diastolic blood pressure(n DBP)[SMD=-0.61,95%CI:(-0.78,-0.44),P<0.01]?3.A total of 48 literatures were included in this study,and 16 syndrome types,28 therapeutic principles and methods,105 drugs were summarized.Among 16 common syndrome type in clinic,4 types,intercombination of turbid phlegm and blood stasis,Qi deficiency and blood stasis,turbid phlegm.In terms of treatment principle,it is common to remove blood stasis,promote blood circulation,replenish Qi and calm the liver and suppress yang.4.The 105 drugs mentioned in the research literatures were statistically analyzed in terms of drug category,property and taste.There were 18 drug categories,among which the top three were drugs for tonifying deficiency(21.36%),promoting blood circulation and removing blood stasis(16.50%),calm the liver and suppress yang(14.76%);In terms of drug properties,warm drugs(32.82%,)cold drugs(30.10%)and plain drugs(29.90%)were the top three;In terms of drug taste,pungent taste,sweet drugs and bitter drugs accounted for 33.59%,25.83%and 22.14%,respectively.5.The results of clustering analysis of high-frequency drugs can be divided into four categories: The three group was Poria Cocos,Pinellia ternata,pericarpium citri reticulatae.The second group was Ligusticum wallichii,Rhizoma Atractylodis Macrocephalae.The third group was Lgastrodia elata and the root of bidentate achyranthes.The results of correlation analysis showed that the most common drug combination was Poria Cocos,Pinellia ternata,pericarpium citri reticulataeConclusion:1.CTM supportive treatment have obvious curative effect compared with western medicine routine treatment alone,which can significantly improve the clinical efficiency.And further lower the CSBP?CDBP?24h SBP?24h DBP?d SBP?d DBP?n SBP?n DBP.2.CTM supportive treatment can further cure clinical Symptoms and further lower homocysteinethan western medicine routine treatment alone.3.Based on data mining technology,provided reference for the future clinical drugs for diagnosis and treatment.