| Objective:To evaluate the effectiveness of Zhengan Xifeng decoction combined with conventional western medicine in the treatment of essential hypertension(Yin deficiency and Yang hyperactivity type)using the method of Meta-analysis,and to provide evidence-based basis for clinical treatment of this disease.Methods:Computer searches of foreign language databases:PubMed,EMbase,Corchane Library,Medline,and Chinese databases:China Knowledge Network(CNKI),WanFang database(WanFang),Vipers database(VIP),and Chinese Medical Biological Literature database(CBM)were conducted to retrieve information on the effectiveness of Zhengan Xifeng decoction combined with western drugs in the treatment of essential hypertension.Randomized Controlled Trials(RCTs)for the treatment of essential hypertension,the search time was set to the database inception to March 2022,and the included literature was identified according to the inclusion and exclusion criteria,while the data in the included literature were extracted,and Stata 15.1 software was used to examine the clinical blood pressure efficacy,the systolic and diastolic blood pressure change levels,TCM evidence of efficacy,lipid indicators:TC,TG,HDL-C,LDL-C and adverse reactions were meta-analyzed and the corresponding forest plots were drawn,and indicators with more than 10 included literature were evaluated for risk of publication bias,funnel plots were drawn,and the corresponding Begg and Egger values were calculated.Results:According to the nadir criteria and the literature search strategy,a total of 22 publications,all in Chinese,were included,published between 2012-2021,and a total of 2466 patients were included,including 1222 patients in the control group and 1244 patients in the treatment group.This study analyzed the effectiveness of Zhengan Xifeng decoction combined with conventional antihypertensive drugs in the treatment of essential hypertension(Yin deficiency and Yang hyperactivity type)in terms of six indicators:changes in blood pressure levels,clinical antihypertensive efficacy,efficacy of TCM symptoms,changes in blood lipid indexes,total TCM symptoms score,and adverse reactions.The specific results are as follows.Meta-analysis results:(1)Changes in blood pressure:A total of 19 papers reported this index,as follows.①Systolic blood pressure index:combined analysis P=0.000<0.05,I2=96.4%>50%,with a high degree of heterogeneity,by subgroup analysis,the subgroup "other group" included in the literature using conventional antihypertensive drugs complex and single number,can not be normal combined analysis,the rest of the subgroup heterogeneity is low(I2<50%).The combined effect size showed that WMD=-12.45,95%CI[-15.35,-9.54],Z=8.39,P=0.000<0.001.The results were extremely statistically significant,indicating that the combination of Zhengan Xifeng decoction with conventional western medicine group was significantly better than the conventional western medicine group alone in improving the systolic blood pressure changes.②Diastolic blood pressure index:combined analysis P=0.000<0.05,I2=96.6%>50%,with a high degree of heterogeneity,by subgroup analysis,the "other group" in the subgroup included in the literature using conventional antihypertensive drugs complex and single number,can not be normal combined analysis,the rest of the subgroup heterogeneity is low(I2<25%).The combined effect size showed that WMD=-7.19,95%CI[-9.17,-5.22],Z=7.15,P=0.000<0.001.The results were statistically significant(P=0.000<0.001),indicating that the diastolic blood pressure changes in the combination of Zhengan Xifeng decoction and conventional western medicine group were significantly better than those in the conventional western medicine group alone in improving blood pressure changes.(2)Clinical antihypertensive efficacy:a total of 14 papers reported this index,and the combined effect size showed that P=0.123>0.05,I2=31.6%<50%,RR=1.20,95%CI[1.15,1.25],Z=8.23,P=0.000<0.001,which was extremely statistically significant,indicating that the group of Zhengan Xifeng decoction was significantly better than the group of conventional western medicine alone in improving clinical antihypertensive(3)The treatment of Chinese medicine symptoms was significantly better than that of the group using conventional Western medicine alone.(3)TCM evidence of efficacy:a total of 6 papers reported this index,and the combined effect size showed that P=0.166>0.05,I2=34.3%<50%,RR=1.25,95%CI[1.16,1.35],Z=5.67,P=0.000<0.001,which was extremely statistically significant,indicating that the Zhengan Xifeng decoction group was significantly better than the conventional Western medicine group alone.(4)Blood lipid index:There are 6 papers reporting this index,as follows.①TC index:combined analysis P=0.000<0.05,I2=80.7%>50%,by subgroup analysis,the heterogeneity of the subgroups was low(I2=0%)and homogeneity was good,combined effect size:SMD=-0.68,95%CI[-0.84,-0.53],Z=8.68,P=0.000<0.001,due to the CCB(benzosulfonic acid Amlodipine)subgroup was not statistically significant(P=0.083>0.05),so it indicates that the efficacy of Zhengan Xifeng decoction combined with Amlodipine benzoate in improving TC indexes in lipid indexes is comparable to conventional western medicine,and combined with other conventional western medicine is significantly better than using conventional western medicine alone.②TG index:combined analysis P=0.001<0.05,I2=75.9%＞50%,by subgroup analysis,the heterogeneity of each subgroup was low(I2<10%)and homogeneity was good,combined effect size:SMD=-0.43,95%CI[-0.58,-0.28],Z=5.59,P=0.000<0.001,due to CCB(amlodipine benzoate Amlodipine)subgroup was not statistically significant(P=0.873>0.05),so it indicates that the efficacy of Zhengan Xifeng decoction combined with Amlodipine benzoate in improving TG index of lipid index is comparable to conventional western medicine,and combined with other conventional western medicine is significantly better than using conventional western medicine alone.③LDL-C index:combined analysis P=0.001<0.05,I2=76.60%＞50%,by subgroup analysis,the heterogeneity of subgroups was low(I2=0%)and homogeneity was good,combined effect size:SMD=-0.62,95%CI[-0.77,-0.46],Z=7.89,P=0.000<0.001,due to CCB(Amlodipine benzoate)subgroup was not statistically significant(P=0.263>0.05),so it indicates that the efficacy of Zhengan Xifeng decoction combined with Amlodipine benzoate in improving LDL-C index of lipid index is comparable to conventional western medicine,and combined with other conventional western medicine is significantly better than using conventional western medicine alone.④HDL-C index:combined effect size showed:p=0.186<0.05,I2=33.4%<50%,SMD=0.40,95%CI[0.25,0.55],Z=5.18,p=0.000<0.001,2 papers intersected with null vertical lines,subgroup analysis was attempted,as the CCB(amlodipine besylate)subgroup was not statistically(P=0.933>0.05),a comprehensive analysis showed that the efficacy of Zhengan Xifeng decoction combined with Amlodipine Benzoate was comparable to that of conventional western medicine in improving HDL-C index in lipid index,while the combination of other conventional western medicine was significantly better than conventional western medicine alone.(5)Total TCM evidence score:A total of 6 papers reported this index,and the combined effect size showed that P=0.297>0.05,I2=18.0%<50%,WMD=-6.45,95%CI[-7.13,-5.77],Z=18.65,P=0.000<0.001,which was extremely statistically significant,indicating that the group of Zhengan Xifeng decoction was significantly better than the group of TCM in improving(6)Adverse effects:There were 10 adverse effects.(6)Adverse effects:A total of 10 papers reported adverse effects,of which 2 had no adverse effects and the remaining 8 had a combined effect size of P=0.321>0.05,I2=13.9%<50%,RR=0.30,95%CI[0.19,0.49],Z=4.87,P=0.000<0.001,which is extremely statistically significant,indicating that the Zhengan Xifeng decoction group is significantly better than the conventional Western medicine group in terms of safety.Zhengan Xifeng decoction group was significantly better than the group using conventional western medicine alone in terms of safety.Conclusion.The treatment of essential hypertension(Yin deficiency and Yang hyperactivity type)by combining conventional western medicine with Zhengan Xifeng Decoction plus reduction was superior to western medicine alone in terms of blood pressure changes,clinical antihypertensive efficacy,Chinese medicine evidence efficacy,improvement in total Chinese medicine evidence score,improvement in blood lipids,and adverse effects. |
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