Traditional Chinese medicine treatment for essential hypertension from 2015 to 2019: an overview of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Ya ^1,2 , LIU Yanfei ³ , WANG Zhe ^1,2,3 ,  LIU Yue ^1,2 ,  LI Lizhi ^1,2

1. Center of Cardiovascular Diseases, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, 100091, P.R.China;
2. Institute of Cardiovascular Diseases, Chinese Academy of Traditional Chinese Medicine, Beijing, 100091, P.R.China;
3. Graduate School of Beijing University of Traditional Chinese Medicine, Beijing, 100029, P.R.China;

Corresponding?author：

LIU Yue, Email: liuyue@188.com; LI Lizhi, Email: lilizhi0723@126.com

Keywords：

Traditional Chinese medicine; Essential hypertension; Systematic review; Overview

DOI：

10.7507/1672-2531.201907136

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objectives To evaluate the methodological quality and the reliability of the conclusions of systematic reviews (SRs) on traditional Chinese medicine (TCM) treatment for essential hypertension. Methods PubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were searched to collect the SRs which focused on the TCM for essential hypertension from January 2015 to June 2019. PRISMA statement, AMSTAR 2 tool and GRADE system were respectively applied to evaluate report quality, methodological quality and evidence quality assessment of included outcomes of SRs.Results A total of 25 SRs involving 65 outcomes were included. PRISMA evaluation results showed that the quality of 25 SRs reports was good. However, all studies did not report item 5 " Was an ‘a prior’ design provided?”. AMSTAR 2 tool evaluation results showed that the 25 SRs of quality levels were markedly low, where most problems concerned item 2 " If there is ‘a prior’ published in advance”, item 3 " Were reasons about selection of the study designs explained”, item 7 " Were the list of exclude of studies and justify the exclusions provided”, item 10 " Were the sources of funding for the studies reported”, and item 12 " If meta-analysis was performed, whether the author assesses the potential impact of risk of bias”. The results of grading showed that most outcomes were graded as " low” or " very low” quality. The main factors contributing to downgrading evidence quality were limitations, followed by inconsistencies, inaccuracies and publication bias.Conclusions Current evidences shows that the treatment of essential hypertension by TCM has been supported by low quality evidence-based medical evidence. However, the SRs methodology for the treatment of essential hypertension by TCM is generally poor in quality and the standardization still require improvement.

Citation： WANG Ya, LIU Yanfei, WANG Zhe, LIU Yue, LI Lizhi. Traditional Chinese medicine treatment for essential hypertension from 2015 to 2019: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2019, 19(12): 1460-1469. doi: 10.7507/1672-2531.201907136 Copy

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2.	王擁軍, 吳兆蘇. 《中國心血管病報告 2018》概要. 中國循環雜志, 2019, 34(3): 209-220.
3.	趙晨, 田貴華, 張曉雨, 等. 循證醫學向循證科學發展的內涵和思考. 中國循證醫學雜志, 2019, 19(5): 510-514.
4.	王瓊, 冼紹祥. 中醫藥治療高血壓臨床療效的 Meta 分析. 中國實驗方劑學雜志, 2013, 19(9): 345-349.
5.	李東娜, 楊傳華. 中醫藥治療老年單純收縮期高血壓臨床療效的 Meta 分析. 遼寧中醫雜志, 2012, 39(5): 812-815.
6.	陸新, 蔣嘉誠. 中醫藥治療高血壓病胰島素抵抗(IR)臨床療效的 Meta 分析. 中華中醫藥學刊, 2019, 37(2): 460-465.
7.	楊克虎, 劉雅莉, 袁金秋, 等. 發展和完善中的系統評價再評價. 中國循證兒科雜志, 2011, 6(1): 54-57.
8.	楊衍濤, 馬莉, 楊曉霞, 等. 中醫藥治療原發性高血壓系統評價的再評價. 中國循證醫學雜志, 2014, 14(9): 1070-1076.
9.	David M, Alessandro L, Jennifer T, 等. 系統綜述和薈萃分析優先報告的條目: PRISMA 聲明. 中西醫結合學報, 2009, 7(9): 889-896.
10.	陶歡, 楊樂天, 平安, 等. 隨機或非隨機防治性研究系統評價的質量評價工具 AMSTAR 2 解讀. 中國循證醫學雜志, 2018, 18(1): 101-108.
11.	陳耀龍, 姚亮, 杜亮, 等. GRADE 在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404.
12.	王雪冰, 李曉. 補中益氣湯加味治療高血壓病 Meta 分析. 山西中醫, 2016, 32(9): 46-48.
13.	覃智強. 中醫藥治療高血壓臨床療效的 Meta 分析. 中國中醫藥現代遠程教育, 2017, 15(7): 57-58, 74.
14.	趙君, 杜金行, 汪國梁, 等. 中藥治療原發性高血壓隨機對照試驗的 Meta 分析. 中華中醫藥雜志, 2018, 33(3): 922-926.
15.	安妍. 天麻鉤藤飲治療肝陽上亢型高血壓的 Meta 分析. 沈陽: 遼寧中醫藥大學, 2015.
16.	郎秀秀. 基于隨機對照試驗的松齡血脈康膠囊治療高血壓的 Meta 分析. 濟南: 山東中醫藥大學, 2016.
17.	宋亞偉. 基于隨機對照試驗的牛黃降壓方治療高血壓的 Meta 分析. 濟南: 山東中醫藥大學, 2016.
18.	吳慶慶. 溫膽湯合半夏白術天麻湯治療高血壓的臨床療效 Meta 分析. 中醫研究, 2015, 28(8): 72-74.
19.	劉巍, 褚福永, 袁蓉, 等. 通心絡膠囊治療高血壓病療效及安全性系統評價. 北京中醫藥, 2015, 34(3): 196-201.
20.	李香草. 中醫藥治療陰虛陽亢型高血壓的系統評價. 成都: 成都中醫藥大學, 2016.
21.	梁家華, 陳敏, 蔡銀河, 等. 補腎益心片聯合西藥治療高血壓的 Meta 分析和系統評價. 中西醫結合心腦血管病雜志, 2017, 15(19): 2372-2376.
22.	王雪冰. 松齡血脈康治療原發性高血壓病的臨床療效及安全性系統分析. 湖南中醫雜志, 2016, 32(8): 184-186, 191.
23.	項學貴. 天麻鉤藤飲聯合鈣離子拮抗劑治療高血壓病的有效性及安全性的 Meta 分析. 中國中醫急癥, 2015, 24(12): 2153-2156.
24.	呂冰清, 葛玉紅, 吳曉芳, 等. 天麻鉤藤飲聯合硝苯地平治療原發性高血壓的系統評價和 Meta 分析. 內蒙古中醫藥, 2016, 35(12): 52-54.
25.	郭淼. 天麻鉤藤飲聯用苯磺酸氨氯地平治療原發性高血壓的 Meta 分析. 濟南: 濟南大學, 2016.
26.	朱丹丹. 益氣活血法治療中老年高血壓病臨床療效的 Meta 分析. 廣州: 暨南大學, 2017.
27.	宋傳景, 莊欣. 補中益氣湯對氣虛型高血壓病降壓作用的 Meta 分析. 湖南中醫雜志, 2018, 34(2): 118-119.
28.	Shi S, Li S, Li W, et al. Corn silk tea for hypertension: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med, 2019, 2019: 2915498.
29.	Xiong XJ, Yang XC, Liu W, et al. Therapeutic efficacy and safety of traditional Chinese medicine classic herbal formula. Front Pharmacol, 2018, 9: 466.
30.	Wang H, Liu C, Zhai J, et al. Niuhuang Jiangya Preparation (a traditional Chinese patent medicine) for essential hypertension: a systematic review. Complement Ther Med, 2017, 31: 90-99.
31.	Cao Y, Liu LT, Wu M. Is Chinese herbal medicine effective for elderly isolated systolic hypertension? A systematic review and meta-analysis. Chin J Integr Med, 2017, 23(4): 298-305.
32.	Xiong X, Wang P, Li S. Meta-analysis of the effectiveness of traditional Chinese herbal formula Zhen Wu Decoction for the treatment of hypertension. BMJ Open, 2015, 5(12): e007291.
33.	Chen Z, Wang L, Yang G, et al. Chinese herbal medicine combined with conventional therapy for blood pressure variability in hypertension patients: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med, 2015, 2015: 582751.
34.	Xiong X, Wang P, Duan L, et al. Efficacy and safety of Chinese herbal medicine Xiao Yao San in hypertension: a systematic review and meta-analysis. Phytomedicine, 2019, 61: 152849.
35.	Yang X, Yang G, Li W, et al. Therapeutic effect of ilex hainanensis merr. extract on essential hypertension: a systematic review and meta-analysis of randomized controlled trials. Front Pharmacol, 2018, 9: 424.
36.	Xiong X, Wang P, Li X, et al. Shenqi pill, a traditional Chinese herbal formula, for the treatment of hypertension: a systematic review. Complement Ther Med, 2015, 23(3): 484-493.
37.	張文博, 黃星荷, 李靜. 高血壓的流行趨勢和治療進展. 心血管病學進展, 2019, 40(3): 331-337.
38.	魏強, 吳建臣. 循證醫學的最好證據—系統評價. 中華泌尿外科雜志, 2003, 24(11): 69-70.
39.	鄔新峰, 賴世隆, 梁偉雄. 中醫藥臨床療效評價中結局指標的選擇與應用. 廣州中醫藥大學學報, 2002, 19(4): 251-255.
40.	郭新峰, 朱泉, 賴世隆. 替代指標和中間指標及其在中醫藥療效評價研究中應用價值的思考. 中國中西醫結合雜志, 2005, 25(7): 585-590.

1. 殷國青, 周曉輝. 高血壓流行病學研究現狀. 臨床醫藥文獻電子雜志, 2018, 5(4): 189-190, 192.
2. 王擁軍, 吳兆蘇. 《中國心血管病報告 2018》概要. 中國循環雜志, 2019, 34(3): 209-220.
3. 趙晨, 田貴華, 張曉雨, 等. 循證醫學向循證科學發展的內涵和思考. 中國循證醫學雜志, 2019, 19(5): 510-514.
4. 王瓊, 冼紹祥. 中醫藥治療高血壓臨床療效的 Meta 分析. 中國實驗方劑學雜志, 2013, 19(9): 345-349.
5. 李東娜, 楊傳華. 中醫藥治療老年單純收縮期高血壓臨床療效的 Meta 分析. 遼寧中醫雜志, 2012, 39(5): 812-815.
6. 陸新, 蔣嘉誠. 中醫藥治療高血壓病胰島素抵抗(IR)臨床療效的 Meta 分析. 中華中醫藥學刊, 2019, 37(2): 460-465.
7. 楊克虎, 劉雅莉, 袁金秋, 等. 發展和完善中的系統評價再評價. 中國循證兒科雜志, 2011, 6(1): 54-57.
8. 楊衍濤, 馬莉, 楊曉霞, 等. 中醫藥治療原發性高血壓系統評價的再評價. 中國循證醫學雜志, 2014, 14(9): 1070-1076.
9. David M, Alessandro L, Jennifer T, 等. 系統綜述和薈萃分析優先報告的條目: PRISMA 聲明. 中西醫結合學報, 2009, 7(9): 889-896.
10. 陶歡, 楊樂天, 平安, 等. 隨機或非隨機防治性研究系統評價的質量評價工具 AMSTAR 2 解讀. 中國循證醫學雜志, 2018, 18(1): 101-108.
11. 陳耀龍, 姚亮, 杜亮, 等. GRADE 在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404.
12. 王雪冰, 李曉. 補中益氣湯加味治療高血壓病 Meta 分析. 山西中醫, 2016, 32(9): 46-48.
13. 覃智強. 中醫藥治療高血壓臨床療效的 Meta 分析. 中國中醫藥現代遠程教育, 2017, 15(7): 57-58, 74.
14. 趙君, 杜金行, 汪國梁, 等. 中藥治療原發性高血壓隨機對照試驗的 Meta 分析. 中華中醫藥雜志, 2018, 33(3): 922-926.
15. 安妍. 天麻鉤藤飲治療肝陽上亢型高血壓的 Meta 分析. 沈陽: 遼寧中醫藥大學, 2015.
16. 郎秀秀. 基于隨機對照試驗的松齡血脈康膠囊治療高血壓的 Meta 分析. 濟南: 山東中醫藥大學, 2016.
17. 宋亞偉. 基于隨機對照試驗的牛黃降壓方治療高血壓的 Meta 分析. 濟南: 山東中醫藥大學, 2016.
18. 吳慶慶. 溫膽湯合半夏白術天麻湯治療高血壓的臨床療效 Meta 分析. 中醫研究, 2015, 28(8): 72-74.
19. 劉巍, 褚福永, 袁蓉, 等. 通心絡膠囊治療高血壓病療效及安全性系統評價. 北京中醫藥, 2015, 34(3): 196-201.
20. 李香草. 中醫藥治療陰虛陽亢型高血壓的系統評價. 成都: 成都中醫藥大學, 2016.
21. 梁家華, 陳敏, 蔡銀河, 等. 補腎益心片聯合西藥治療高血壓的 Meta 分析和系統評價. 中西醫結合心腦血管病雜志, 2017, 15(19): 2372-2376.
22. 王雪冰. 松齡血脈康治療原發性高血壓病的臨床療效及安全性系統分析. 湖南中醫雜志, 2016, 32(8): 184-186, 191.
23. 項學貴. 天麻鉤藤飲聯合鈣離子拮抗劑治療高血壓病的有效性及安全性的 Meta 分析. 中國中醫急癥, 2015, 24(12): 2153-2156.
24. 呂冰清, 葛玉紅, 吳曉芳, 等. 天麻鉤藤飲聯合硝苯地平治療原發性高血壓的系統評價和 Meta 分析. 內蒙古中醫藥, 2016, 35(12): 52-54.
25. 郭淼. 天麻鉤藤飲聯用苯磺酸氨氯地平治療原發性高血壓的 Meta 分析. 濟南: 濟南大學, 2016.
26. 朱丹丹. 益氣活血法治療中老年高血壓病臨床療效的 Meta 分析. 廣州: 暨南大學, 2017.
27. 宋傳景, 莊欣. 補中益氣湯對氣虛型高血壓病降壓作用的 Meta 分析. 湖南中醫雜志, 2018, 34(2): 118-119.
28. Shi S, Li S, Li W, et al. Corn silk tea for hypertension: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med, 2019, 2019: 2915498.
29. Xiong XJ, Yang XC, Liu W, et al. Therapeutic efficacy and safety of traditional Chinese medicine classic herbal formula. Front Pharmacol, 2018, 9: 466.
30. Wang H, Liu C, Zhai J, et al. Niuhuang Jiangya Preparation (a traditional Chinese patent medicine) for essential hypertension: a systematic review. Complement Ther Med, 2017, 31: 90-99.
31. Cao Y, Liu LT, Wu M. Is Chinese herbal medicine effective for elderly isolated systolic hypertension? A systematic review and meta-analysis. Chin J Integr Med, 2017, 23(4): 298-305.
32. Xiong X, Wang P, Li S. Meta-analysis of the effectiveness of traditional Chinese herbal formula Zhen Wu Decoction for the treatment of hypertension. BMJ Open, 2015, 5(12): e007291.
33. Chen Z, Wang L, Yang G, et al. Chinese herbal medicine combined with conventional therapy for blood pressure variability in hypertension patients: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med, 2015, 2015: 582751.
34. Xiong X, Wang P, Duan L, et al. Efficacy and safety of Chinese herbal medicine Xiao Yao San in hypertension: a systematic review and meta-analysis. Phytomedicine, 2019, 61: 152849.
35. Yang X, Yang G, Li W, et al. Therapeutic effect of ilex hainanensis merr. extract on essential hypertension: a systematic review and meta-analysis of randomized controlled trials. Front Pharmacol, 2018, 9: 424.
36. Xiong X, Wang P, Li X, et al. Shenqi pill, a traditional Chinese herbal formula, for the treatment of hypertension: a systematic review. Complement Ther Med, 2015, 23(3): 484-493.
37. 張文博, 黃星荷, 李靜. 高血壓的流行趨勢和治療進展. 心血管病學進展, 2019, 40(3): 331-337.
38. 魏強, 吳建臣. 循證醫學的最好證據—系統評價. 中華泌尿外科雜志, 2003, 24(11): 69-70.
39. 鄔新峰, 賴世隆, 梁偉雄. 中醫藥臨床療效評價中結局指標的選擇與應用. 廣州中醫藥大學學報, 2002, 19(4): 251-255.
40. 郭新峰, 朱泉, 賴世隆. 替代指標和中間指標及其在中醫藥療效評價研究中應用價值的思考. 中國中西醫結合雜志, 2005, 25(7): 585-590.

Chinese Journal of Evidence-Based Medicine

Traditional Chinese medicine treatment for essential hypertension from 2015 to 2019: an overview of systematic reviews

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