中药静脉制剂治疗急性心力衰竭的证据图谱研究OA

Objective To apply an evidence mapping approach to systematically retrieve and sort clinical literature regarding intravenous traditional Chinese medicine preparations for acute heart failure,so as to visualize the distribution of relevant clinical evidence.Methods The China Biology Medicine(CBM),VIP Database,China National Knowledge Infrastructure(CNKI),Wanfang Data,the Cochrane Library,PubMed,Embase,and Web of Science were searched from database inception to February 2023.Clinical studies,systematic reviews,and guideline pathway research on the treatment of acute heart failure with Chinese medicine intravenous preparation were included.The evidence map research method was employed,combining textual descriptions with tables,bubble charts,and other analyses to characterize evidence distribution.The AMSTAR 2 scale was used to assess the methodological quality of the included literature.Results ① A total of 343 clinical studies,9 systematic reviews,and 2 guidelines and consensus articles were included.② The majority of randomized controlled trials(RCT)are small sample(60-100 cases),single center,and short-term(intervention duration is mostly 14 days).③ There are many types of outcome indicators to choose from,with cardiac function indicators,total effective rate,and safety indicators being the most common.However,there is no standardized and unified core outcome indicator,which fails to fully reflect the advantages of traditional Chinese medicine and lacks evidence of long-term efficacy.④ The overall quality of the methodology included in the systematic review is low,with AMSTAR 2 rating only at low and very low levels.Seven items show evidence of effectiveness,and two items have potential therapeutic effects;The quality of RCT research needs to be improved,and most studies are difficult to provide definitive and effective clinical evidence.⑤ There is still a lack of comprehensive diagnostic and treatment gu idelines.Conclusions Traditional Chinese medicine intravenous preparations have certain advantages in the clinical efficacy and safety of treating acute heart failure,but the overall quality of related research evidence is relatively low;In the future research of traditional Chinese medicine,it is necessary to standardize the selection of clinical drugs,reflect the key advantages of traditional Chinese medicine treatment,improve the selection of outcome indicators,improve the methodological quality of systematic reviews,conduct more large-scale,multi center,and high-quality clinical studies,produce high-quality evidence-based research,and fully leverage the unique advantages of traditional Chinese medicine in treating acute heart failure.