作者：谭雨晴，李军，陈恒文，解紫从，白栋汉，孟超

单位：

1.100053北京市，中国中医科学院广安门医院心血管科 2.100029北京市，北京中医药大学研究生院 通信作者：李军，E-mail：gamyylj@163.com

Units：

1.Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing 100053, China 2.Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China Corresponding author: LI Jun, E-mail: gamyylj@163.com

关键词：

扩张型心肌病; 中医药; 系统评价; 再评价;

Keywords：

Dilated cardiomyopathy; Traditional Chinese medicine; Systematic review; Re-evaluation

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.050

Funds：

国家自然科学基金资助项目（81973836，82074396）；北京市中医药科技发展资金项目（JJ-2020-69）；首都卫生发展科研专项重点攻关项目（2020-1-4151）；中国中医科学院中医药科技重大成果引导项目（ZZ13-ZD-04）

摘要：

背景目前尚缺乏特定有效的扩张型心肌病(DCM)治疗方法,而中医药治疗有其独特优势。随着循证医学的发展,国内外公开发表的中医药治疗DCM的系统评价研究逐年增多,但这类系统评价的方法学质量、报告质量、证据等级及其能否为临床工作者提供医疗决策尚未可知。目的 针对中医药治疗DCM的系统评价进行再评价,以期为临床提供更有力的证据支持。方法 计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统及PubMed、Embase、Cochrane Library公开发表的中医药治疗DCM的系统评价或Meta分析,检索时间为建库至2021-07-17。分别采用AMSTAR-2量表、PRISMA声明、GRADE系统对纳入文献的方法学质量、报告质量、证据等级进行再评价。结果 最终纳入文献15篇,其中英文3篇、中文12篇。文献质量再评价结果显示:纳入文献的方法学均存在较大缺陷,其中有9篇文献方法学质量低、6篇文献方法学质量极低;文献报告质量评分为15～21分,平均(18.6±2.1)分,可见纳入文献的报告质量尚可;5篇文献指标证据等级中等,8篇文献指标证据等级低,2篇文献指标证据等级极低,局限性及发表偏倚是导致纳入文献证据等级降低的主要原因。结论 中医药治疗DCM系统评价的质量有待提高,建议研究者严格按照AMSTAR-2量表、PRISMA声明、GRADE系统等多种工具对纳入的研究进行评价,把控纳入文献的方法学质量、报告质量和证据等级,以为临床提供更严谨、可靠的证据支持。

Abstract：

【Abstract】　Background There is no specific and effective treatment on dilated cardiomyopathy (DCM) at present,and traditional Chinese medicine (TCM) has its unique advantages. With the development of evidence-based medicine,the systematic review of TCM in the treatment of DCM at home and abroad has been increasing year by year. However, themethodological quality, reporting quality and evidence level of the systematic reviews and whether can provide medical decisionsfor clinicians remains to be seen. Objective To re-evaluate the systematic review of TCM in the treatment of DCM, in orderto provide stronger evidence support for clinical practice. Methods Systematic reviews and meta-analysis of TCM in thetreatment of DCM published on CNKI, Wanfang Date, VIP, SinoMed and PubMed, Embase and Cochrane Library were searchedby computer. The retrieval time was from the establishment of the database to 2021-07-17. The methodological quality, reportingquality, and evidence level of the included literature were re-evaluated by AMSTAR-2 Scale, PRISMA Statement, and GRADESystem, respectively. Results Finally, 15 literature were included, including 3 in English and 12 in Chinese. The results ofmethodological quality re-evaluation of all the included literature showed that, the methodology of all the included literaturehad major defects, the methodological quality of 9 literature were low, and the methodological quality of 6 literature were verylow; reporting quality score was 15-21 points, with an average score of (18.6±2.1) points, showed that the reporting quality ofincluded literature was acceptable; the evidence level of 5 literature were moderate, the evidence level of 8 literature were low andthe evidence level of 2 literature were very low. Limitations and publication bias were the main reasons for the reduction of theevidence level of the included literature. Conclusion The quality of systematic review of TCM in the treatment of DCM needsto be improved. It is recommended that researchers should be in strict accordance with AMSTAR-2 Scale, PRISMA Statement,GRADE System and other tools in evaluating the included literature, and control the methodological quality, reporting quality andevidence level of the included literature, in order to provide more rigorous and reliable evidence support for clinical practice.

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