Qishen Yiqi dropping pill in the treatment of chronic heart failure: an overview of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

FAN Maoxia ¹ ,  DAI Guohua ² , GAO Wulin ² , GUAN Hui ² , LI Runmin ¹ , REN Lili ²

1. The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan 250014, P. R. China;
2. Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, P. R. China;

Corresponding?author：

DAI Guohua, Email: daiguohua202208@163.com

Keywords：

Qishen Yiqi dropping pill; Chronic heart failure; Overview of systematic reviews; AMSTAR-2; ROBIS; PRISMA; GRADE

DOI：

10.7507/1672-2531.202301078

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically summarize and evaluate the existing evidence of Qishen Yiqi dropping pill (QSYQ) in the treatment of chronic heart failure (CHF), and to evaluate its quality. Methods The PubMed, Cochrane Library, EMbase, Web of Science, CNKI, CBM, WanFang Data databases were electronically searched to collect systematic reviews/meta-analyses(SRs/MAs) related to objectives from inception to December 31, 2022. Two researchers independently screened the literature and extracted data, and assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of included SRs/MAs by using Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic(ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results This overview included 17 SRs/MAs. The methodological quality, reporting quality, risk of bias, and quality of evidence for outcome measures of SRs/MAs were all unsatisfactory. All SRs/MAs were of low quality according to the results of the AMSTAR-2 assessment. And only a small number of SRs/MAs were assessed as low risk of bias based on the results of the ROBIS assessment. The evaluation results of the PRISMA checklist showed that the report quality of the 24 studies included was relatively complete. According to the GRADE system evaluation results, 94% of the 84 outcome indicators were low-quality and very low-quality evidence. Limitations were the main factors leading to their degradation, followed by publication bias, inconsistency, imprecision and indirectness. Conclusion At present, QSYQ has good clinical efficacy in the treatment of CHF, but the standardization and scientificity of clinical research and secondary research reports are insufficient, resulting in low quality of clinical recommendations evidence. In the future, it is necessary to further standardize and improve the quality of clinical and secondary research.

Citation： FAN Maoxia, DAI Guohua, GAO Wulin, GUAN Hui, LI Runmin, REN Lili. Qishen Yiqi dropping pill in the treatment of chronic heart failure: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2023, 23(9): 1060-1065. doi: 10.7507/1672-2531.202301078 Copy

1.	中華醫學會心血管病學分會心力衰竭學組, 中國醫師協會心力衰竭專業委員會, 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2018. 中華心血管病雜志, 2018, 46(10): 760-789.
2.	邱伯雍. 慢性心力衰竭流行病學及防治研究進展. 中華實用診斷與治療雜志, 2017, 31(6): 619-621.
3.	中國中西醫結合學會心血管疾病專業委員會, 中國醫師協會中西醫結合醫師分會心血管疾病專業委員會. 慢性心力衰竭中西醫結合診療專家共識. 心腦血管病防治, 2016, 16(5): 340-347.
4.	趙林丹, 王漢卿, 趙志強, 等. 射血分數正常心力衰竭的中醫診療進展. 中華中醫藥雜志, 2022, 37(6): 3343-3345.
5.	陳家顯, 劉先霞, 陳躍武, 等. 芪參益氣滴丸對慢性心力衰竭大鼠心肌細胞凋亡的抑制作用及其機制. 吉林大學學報(醫學版), 2020, 46(5): 972-978, 1113.
6.	許祖建, 戴小華, 湯麗芬, 等. 芪參益氣滴丸對冠心病PCI術后患者心功能及心絞痛療效的影響. 時珍國醫國藥, 2019, 30(9): 2208-2209.
7.	馬莉, 劉志超, 高晟瑋, 等. 芪參益氣滴丸治療心血管疾病藥理作用與臨床應用研究進展. 藥物評價研究, 2022, 45(4): 780-787.
8.	謝東霞, 黃顯章, 毛秉像. 芪參益氣滴丸改善心梗模型大鼠心室重構的相關機制. 中國實驗方劑學雜志, 2011, 17(6): 180-183.
9.	陳慧, 李春, 石天嬌, 等. 芪參益氣滴丸對心衰大鼠RAAS系統的實驗研究. 北京中醫藥大學學報, 2014, 37(8): 538-542.
10.	Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 2021, 372: n160.
11.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
12.	Whiting P, Savovi? J, Higgins JP, et al. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol, 2016, 69: 225-234.
13.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
14.	王拴虎, 毛靜遠, 侯雅竹, 等. 西藥常規加用芪參益氣滴丸治療慢性心力衰竭隨機對照試驗的系統評價. 中國中西醫結合雜志, 2013, 33(11): 1468-1475.
15.	裴英豪, 朱翠玲, 朱明軍, 等. 芪參益氣滴丸治療慢性心力衰竭的療效及安全性系統評價. 中國中醫急癥, 2013, 22(9): 1472-1475.
16.	曲鳳, 邢冬梅, 鄭文科, 等. 芪參益氣滴丸治療缺血性心力衰竭的系統評價. 中國實驗方劑學雜志, 2014, 20(3): 213-218.
17.	劉軍剛, 顧萬紅, 劉效栓, 等. 芪參益氣滴丸治療慢性心力衰竭的Meta分析. 中國新藥與臨床雜志, 2014, 33(3): 189-195.
18.	高長春, 徐國良, 秦玲. 芪參益氣滴丸治療慢性充血性心力衰竭有效性及安全性的Meta分析. 中國中醫急癥, 2014, 23(2): 232-234.
19.	田野, 顧健霞. 芪參益氣滴丸治療冠心病心力衰竭的Meta分析. 中國中醫急癥, 2016, 25(9): 1725-1727, 1742.
20.	單秋月, 張聞, 呂露, 等. 用芪參益氣滴丸抑制慢性心力衰竭患者心室重構效果的Meta分析. 當代醫藥論叢, 2017, 15(11): 71-73.
21.	章軼立, 王娟, 李園, 等. 芪參益氣滴丸治療慢性心力衰竭(氣虛血瘀證)的Meta分析. 中國實驗方劑學雜志, 2019, 25(21): 162-169.
22.	郭嬌, 劉新燦, 孫天福. 芪參益氣滴丸聯合西藥治療慢性心力衰竭的臨床療效和安全性分析. 中國循證心血管醫學雜志, 2020, 12(5): 519-524.
23.	李雪靖, 張慧玲, 王曉麗, 等. 芪參益氣滴丸治療慢性心力衰竭的循證藥物經濟學評價. 中國醫院用藥評價與分析, 2020, 20(12): 1472-1477, 1482.
24.	牛振超, 林文勇, 李益萍, 等. 芪參益氣滴丸辨證施治對慢性心力衰竭療效影響的Meta分析. 藥物評價研究, 2021, 44(5): 1076-1087.
25.	謝鋒, 段廣靖, 王斌, 等. 芪參益氣滴丸聯合曲美他嗪治療慢性心力衰竭的Meta分析. 海南醫學院學報, 2021, 27(9): 689-694, 700.
26.	張秀文, 戴雁彥, 王宗亮, 等. 芪參益氣滴丸聯合曲美他嗪治療慢性心力衰竭的Meta分析. 世界中西醫結合雜志, 2021, 16(1): 23-28, 33.
27.	葛昭, 劉春香, 林姍姍, 等. 芪參益氣滴丸治療射血分數降低心力衰竭療效及安全性的系統評價. 湖南中醫雜志, 2022, 38(1): 115-123.
28.	Wang H, Li L, Qing X, et al. Efficacy of Qishen Yiqi drop pill for chronic heart failure: an updated meta-analysis of 85 studies. Cardiovasc Ther, 2020, 2020: 8138764.
29.	Wang M, Shan Y, Wu C, et al. Efficacy and safety of Qishen Yiqi dripping pill for heart failure with preserved ejection fraction: a systematic review and meta-analysis. Front Pharmacol, 2021, 11: 626375.
30.	Chen L, Wang R, Liu H, et al. Clinical efficacy and safety of Qishen Yiqi dropping pill combined with conventional western medicine in the treatment of chronic heart failure: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6612653.
31.	陳煒堅, 陳慕鏇, 林挺, 等. 中藥注射劑治療心律失常的系統評價再評價. 中國醫院藥學雜志, 2020, 40(23): 2445-2452.
32.	黃帆, 趙思怡, 戴琳, 等. 運用雷達圖對針灸治療原發性骨質疏松癥的系統評價再評價. 中國循證醫學雜志, 2019, 19(5): 602-608.
33.	楊繼, 張垚, 高晟瑋, 等. 麝香保心丸治療冠心病心絞痛系統評價的再評價. 中國中醫急癥, 2021, 30(5): 785-789.
34.	劉亦琳, 徐桂興, 黃柳楊, 等. 針灸治療支氣管哮喘的系統評價再評價. 中國循證醫學雜志, 2022, 22(8): 955-963.
35.	Yang K, Liu Y, Yuan J. Re-evaluation of systematic reviews in development and improvement. CJEBP, 2011, 6(1): 54-57.

1. 中華醫學會心血管病學分會心力衰竭學組, 中國醫師協會心力衰竭專業委員會, 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2018. 中華心血管病雜志, 2018, 46(10): 760-789.
2. 邱伯雍. 慢性心力衰竭流行病學及防治研究進展. 中華實用診斷與治療雜志, 2017, 31(6): 619-621.
3. 中國中西醫結合學會心血管疾病專業委員會, 中國醫師協會中西醫結合醫師分會心血管疾病專業委員會. 慢性心力衰竭中西醫結合診療專家共識. 心腦血管病防治, 2016, 16(5): 340-347.
4. 趙林丹, 王漢卿, 趙志強, 等. 射血分數正常心力衰竭的中醫診療進展. 中華中醫藥雜志, 2022, 37(6): 3343-3345.
5. 陳家顯, 劉先霞, 陳躍武, 等. 芪參益氣滴丸對慢性心力衰竭大鼠心肌細胞凋亡的抑制作用及其機制. 吉林大學學報(醫學版), 2020, 46(5): 972-978, 1113.
6. 許祖建, 戴小華, 湯麗芬, 等. 芪參益氣滴丸對冠心病PCI術后患者心功能及心絞痛療效的影響. 時珍國醫國藥, 2019, 30(9): 2208-2209.
7. 馬莉, 劉志超, 高晟瑋, 等. 芪參益氣滴丸治療心血管疾病藥理作用與臨床應用研究進展. 藥物評價研究, 2022, 45(4): 780-787.
8. 謝東霞, 黃顯章, 毛秉像. 芪參益氣滴丸改善心梗模型大鼠心室重構的相關機制. 中國實驗方劑學雜志, 2011, 17(6): 180-183.
9. 陳慧, 李春, 石天嬌, 等. 芪參益氣滴丸對心衰大鼠RAAS系統的實驗研究. 北京中醫藥大學學報, 2014, 37(8): 538-542.
10. Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 2021, 372: n160.
11. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
12. Whiting P, Savovi? J, Higgins JP, et al. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol, 2016, 69: 225-234.
13. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
14. 王拴虎, 毛靜遠, 侯雅竹, 等. 西藥常規加用芪參益氣滴丸治療慢性心力衰竭隨機對照試驗的系統評價. 中國中西醫結合雜志, 2013, 33(11): 1468-1475.
15. 裴英豪, 朱翠玲, 朱明軍, 等. 芪參益氣滴丸治療慢性心力衰竭的療效及安全性系統評價. 中國中醫急癥, 2013, 22(9): 1472-1475.
16. 曲鳳, 邢冬梅, 鄭文科, 等. 芪參益氣滴丸治療缺血性心力衰竭的系統評價. 中國實驗方劑學雜志, 2014, 20(3): 213-218.
17. 劉軍剛, 顧萬紅, 劉效栓, 等. 芪參益氣滴丸治療慢性心力衰竭的Meta分析. 中國新藥與臨床雜志, 2014, 33(3): 189-195.
18. 高長春, 徐國良, 秦玲. 芪參益氣滴丸治療慢性充血性心力衰竭有效性及安全性的Meta分析. 中國中醫急癥, 2014, 23(2): 232-234.
19. 田野, 顧健霞. 芪參益氣滴丸治療冠心病心力衰竭的Meta分析. 中國中醫急癥, 2016, 25(9): 1725-1727, 1742.
20. 單秋月, 張聞, 呂露, 等. 用芪參益氣滴丸抑制慢性心力衰竭患者心室重構效果的Meta分析. 當代醫藥論叢, 2017, 15(11): 71-73.
21. 章軼立, 王娟, 李園, 等. 芪參益氣滴丸治療慢性心力衰竭(氣虛血瘀證)的Meta分析. 中國實驗方劑學雜志, 2019, 25(21): 162-169.
22. 郭嬌, 劉新燦, 孫天福. 芪參益氣滴丸聯合西藥治療慢性心力衰竭的臨床療效和安全性分析. 中國循證心血管醫學雜志, 2020, 12(5): 519-524.
23. 李雪靖, 張慧玲, 王曉麗, 等. 芪參益氣滴丸治療慢性心力衰竭的循證藥物經濟學評價. 中國醫院用藥評價與分析, 2020, 20(12): 1472-1477, 1482.
24. 牛振超, 林文勇, 李益萍, 等. 芪參益氣滴丸辨證施治對慢性心力衰竭療效影響的Meta分析. 藥物評價研究, 2021, 44(5): 1076-1087.
25. 謝鋒, 段廣靖, 王斌, 等. 芪參益氣滴丸聯合曲美他嗪治療慢性心力衰竭的Meta分析. 海南醫學院學報, 2021, 27(9): 689-694, 700.
26. 張秀文, 戴雁彥, 王宗亮, 等. 芪參益氣滴丸聯合曲美他嗪治療慢性心力衰竭的Meta分析. 世界中西醫結合雜志, 2021, 16(1): 23-28, 33.
27. 葛昭, 劉春香, 林姍姍, 等. 芪參益氣滴丸治療射血分數降低心力衰竭療效及安全性的系統評價. 湖南中醫雜志, 2022, 38(1): 115-123.
28. Wang H, Li L, Qing X, et al. Efficacy of Qishen Yiqi drop pill for chronic heart failure: an updated meta-analysis of 85 studies. Cardiovasc Ther, 2020, 2020: 8138764.
29. Wang M, Shan Y, Wu C, et al. Efficacy and safety of Qishen Yiqi dripping pill for heart failure with preserved ejection fraction: a systematic review and meta-analysis. Front Pharmacol, 2021, 11: 626375.
30. Chen L, Wang R, Liu H, et al. Clinical efficacy and safety of Qishen Yiqi dropping pill combined with conventional western medicine in the treatment of chronic heart failure: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2021, 2021: 6612653.
31. 陳煒堅, 陳慕鏇, 林挺, 等. 中藥注射劑治療心律失常的系統評價再評價. 中國醫院藥學雜志, 2020, 40(23): 2445-2452.
32. 黃帆, 趙思怡, 戴琳, 等. 運用雷達圖對針灸治療原發性骨質疏松癥的系統評價再評價. 中國循證醫學雜志, 2019, 19(5): 602-608.
33. 楊繼, 張垚, 高晟瑋, 等. 麝香保心丸治療冠心病心絞痛系統評價的再評價. 中國中醫急癥, 2021, 30(5): 785-789.
34. 劉亦琳, 徐桂興, 黃柳楊, 等. 針灸治療支氣管哮喘的系統評價再評價. 中國循證醫學雜志, 2022, 22(8): 955-963.
35. Yang K, Liu Y, Yuan J. Re-evaluation of systematic reviews in development and improvement. CJEBP, 2011, 6(1): 54-57.

Chinese Journal of Evidence-Based Medicine

Qishen Yiqi dropping pill in the treatment of chronic heart failure: an overview of systematic reviews

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