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

1.	殷国青, 周晓辉. 高血压流行病学研究现状. 临床医药文献电子杂志, 2018, 5(4): 189-190, 192.
2.	王拥军, 吴兆苏. 《中国心血管病报告 2018》概要. 中国循环杂志, 2019, 34(3): 209-220.
3.	赵晨, 田贵华, 张晓雨, 等. 循证医学向循证科学发展的内涵和思考. 中国循证医学杂志, 2019, 19(5): 510-514.
4.	王琼, 冼绍祥. 中医药治疗高血压临床疗效的 Meta 分析. 中国实验方剂学杂志, 2013, 19(9): 345-349.
5.	李东娜, 杨传华. 中医药治疗老年单纯收缩期高血压临床疗效的 Meta 分析. 辽宁中医杂志, 2012, 39(5): 812-815.
6.	陆新, 蒋嘉诚. 中医药治疗高血压病胰岛素抵抗(IR)临床疗效的 Meta 分析. 中华中医药学刊, 2019, 37(2): 460-465.
7.	杨克虎, 刘雅莉, 袁金秋, 等. 发展和完善中的系统评价再评价. 中国循证儿科杂志, 2011, 6(1): 54-57.
8.	杨衍涛, 马莉, 杨晓霞, 等. 中医药治疗原发性高血压系统评价的再评价. 中国循证医学杂志, 2014, 14(9): 1070-1076.
9.	David M, Alessandro L, Jennifer T, 等. 系统综述和荟萃分析优先报告的条目: PRISMA 声明. 中西医结合学报, 2009, 7(9): 889-896.
10.	陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具 AMSTAR 2 解读. 中国循证医学杂志, 2018, 18(1): 101-108.
11.	陈耀龙, 姚亮, 杜亮, 等. GRADE 在系统评价中应用的必要性及注意事项. 中国循证医学杂志, 2013, 13(12): 1401-1404.
12.	王雪冰, 李晓. 补中益气汤加味治疗高血压病 Meta 分析. 山西中医, 2016, 32(9): 46-48.
13.	覃智强. 中医药治疗高血压临床疗效的 Meta 分析. 中国中医药现代远程教育, 2017, 15(7): 57-58, 74.
14.	赵君, 杜金行, 汪国梁, 等. 中药治疗原发性高血压随机对照试验的 Meta 分析. 中华中医药杂志, 2018, 33(3): 922-926.
15.	安妍. 天麻钩藤饮治疗肝阳上亢型高血压的 Meta 分析. 沈阳: 辽宁中医药大学, 2015.
16.	郎秀秀. 基于随机对照试验的松龄血脉康胶囊治疗高血压的 Meta 分析. 济南: 山东中医药大学, 2016.
17.	宋亚伟. 基于随机对照试验的牛黄降压方治疗高血压的 Meta 分析. 济南: 山东中医药大学, 2016.
18.	吴庆庆. 温胆汤合半夏白术天麻汤治疗高血压的临床疗效 Meta 分析. 中医研究, 2015, 28(8): 72-74.
19.	刘巍, 褚福永, 袁蓉, 等. 通心络胶囊治疗高血压病疗效及安全性系统评价. 北京中医药, 2015, 34(3): 196-201.
20.	李香草. 中医药治疗阴虚阳亢型高血压的系统评价. 成都: 成都中医药大学, 2016.
21.	梁家华, 陈敏, 蔡银河, 等. 补肾益心片联合西药治疗高血压的 Meta 分析和系统评价. 中西医结合心脑血管病杂志, 2017, 15(19): 2372-2376.
22.	王雪冰. 松龄血脉康治疗原发性高血压病的临床疗效及安全性系统分析. 湖南中医杂志, 2016, 32(8): 184-186, 191.
23.	项学贵. 天麻钩藤饮联合钙离子拮抗剂治疗高血压病的有效性及安全性的 Meta 分析. 中国中医急症, 2015, 24(12): 2153-2156.
24.	吕冰清, 葛玉红, 吴晓芳, 等. 天麻钩藤饮联合硝苯地平治疗原发性高血压的系统评价和 Meta 分析. 内蒙古中医药, 2016, 35(12): 52-54.
25.	郭淼. 天麻钩藤饮联用苯磺酸氨氯地平治疗原发性高血压的 Meta 分析. 济南: 济南大学, 2016.
26.	朱丹丹. 益气活血法治疗中老年高血压病临床疗效的 Meta 分析. 广州: 暨南大学, 2017.
27.	宋传景, 庄欣. 补中益气汤对气虚型高血压病降压作用的 Meta 分析. 湖南中医杂志, 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.	张文博, 黄星荷, 李静. 高血压的流行趋势和治疗进展. 心血管病学进展, 2019, 40(3): 331-337.
38.	魏强, 吴建臣. 循证医学的最好证据—系统评价. 中华泌尿外科杂志, 2003, 24(11): 69-70.
39.	邬新峰, 赖世隆, 梁伟雄. 中医药临床疗效评价中结局指标的选择与应用. 广州中医药大学学报, 2002, 19(4): 251-255.
40.	郭新峰, 朱泉, 赖世隆. 替代指标和中间指标及其在中医药疗效评价研究中应用价值的思考. 中国中西医结合杂志, 2005, 25(7): 585-590.

1. 殷国青, 周晓辉. 高血压流行病学研究现状. 临床医药文献电子杂志, 2018, 5(4): 189-190, 192.
2. 王拥军, 吴兆苏. 《中国心血管病报告 2018》概要. 中国循环杂志, 2019, 34(3): 209-220.
3. 赵晨, 田贵华, 张晓雨, 等. 循证医学向循证科学发展的内涵和思考. 中国循证医学杂志, 2019, 19(5): 510-514.
4. 王琼, 冼绍祥. 中医药治疗高血压临床疗效的 Meta 分析. 中国实验方剂学杂志, 2013, 19(9): 345-349.
5. 李东娜, 杨传华. 中医药治疗老年单纯收缩期高血压临床疗效的 Meta 分析. 辽宁中医杂志, 2012, 39(5): 812-815.
6. 陆新, 蒋嘉诚. 中医药治疗高血压病胰岛素抵抗(IR)临床疗效的 Meta 分析. 中华中医药学刊, 2019, 37(2): 460-465.
7. 杨克虎, 刘雅莉, 袁金秋, 等. 发展和完善中的系统评价再评价. 中国循证儿科杂志, 2011, 6(1): 54-57.
8. 杨衍涛, 马莉, 杨晓霞, 等. 中医药治疗原发性高血压系统评价的再评价. 中国循证医学杂志, 2014, 14(9): 1070-1076.
9. David M, Alessandro L, Jennifer T, 等. 系统综述和荟萃分析优先报告的条目: PRISMA 声明. 中西医结合学报, 2009, 7(9): 889-896.
10. 陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具 AMSTAR 2 解读. 中国循证医学杂志, 2018, 18(1): 101-108.
11. 陈耀龙, 姚亮, 杜亮, 等. GRADE 在系统评价中应用的必要性及注意事项. 中国循证医学杂志, 2013, 13(12): 1401-1404.
12. 王雪冰, 李晓. 补中益气汤加味治疗高血压病 Meta 分析. 山西中医, 2016, 32(9): 46-48.
13. 覃智强. 中医药治疗高血压临床疗效的 Meta 分析. 中国中医药现代远程教育, 2017, 15(7): 57-58, 74.
14. 赵君, 杜金行, 汪国梁, 等. 中药治疗原发性高血压随机对照试验的 Meta 分析. 中华中医药杂志, 2018, 33(3): 922-926.
15. 安妍. 天麻钩藤饮治疗肝阳上亢型高血压的 Meta 分析. 沈阳: 辽宁中医药大学, 2015.
16. 郎秀秀. 基于随机对照试验的松龄血脉康胶囊治疗高血压的 Meta 分析. 济南: 山东中医药大学, 2016.
17. 宋亚伟. 基于随机对照试验的牛黄降压方治疗高血压的 Meta 分析. 济南: 山东中医药大学, 2016.
18. 吴庆庆. 温胆汤合半夏白术天麻汤治疗高血压的临床疗效 Meta 分析. 中医研究, 2015, 28(8): 72-74.
19. 刘巍, 褚福永, 袁蓉, 等. 通心络胶囊治疗高血压病疗效及安全性系统评价. 北京中医药, 2015, 34(3): 196-201.
20. 李香草. 中医药治疗阴虚阳亢型高血压的系统评价. 成都: 成都中医药大学, 2016.
21. 梁家华, 陈敏, 蔡银河, 等. 补肾益心片联合西药治疗高血压的 Meta 分析和系统评价. 中西医结合心脑血管病杂志, 2017, 15(19): 2372-2376.
22. 王雪冰. 松龄血脉康治疗原发性高血压病的临床疗效及安全性系统分析. 湖南中医杂志, 2016, 32(8): 184-186, 191.
23. 项学贵. 天麻钩藤饮联合钙离子拮抗剂治疗高血压病的有效性及安全性的 Meta 分析. 中国中医急症, 2015, 24(12): 2153-2156.
24. 吕冰清, 葛玉红, 吴晓芳, 等. 天麻钩藤饮联合硝苯地平治疗原发性高血压的系统评价和 Meta 分析. 内蒙古中医药, 2016, 35(12): 52-54.
25. 郭淼. 天麻钩藤饮联用苯磺酸氨氯地平治疗原发性高血压的 Meta 分析. 济南: 济南大学, 2016.
26. 朱丹丹. 益气活血法治疗中老年高血压病临床疗效的 Meta 分析. 广州: 暨南大学, 2017.
27. 宋传景, 庄欣. 补中益气汤对气虚型高血压病降压作用的 Meta 分析. 湖南中医杂志, 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. 张文博, 黄星荷, 李静. 高血压的流行趋势和治疗进展. 心血管病学进展, 2019, 40(3): 331-337.
38. 魏强, 吴建臣. 循证医学的最好证据—系统评价. 中华泌尿外科杂志, 2003, 24(11): 69-70.
39. 邬新峰, 赖世隆, 梁伟雄. 中医药临床疗效评价中结局指标的选择与应用. 广州中医药大学学报, 2002, 19(4): 251-255.
40. 郭新峰, 朱泉, 赖世隆. 替代指标和中间指标及其在中医药疗效评价研究中应用价值的思考. 中国中西医结合杂志, 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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