硝苯地平缓释片联合缬沙坦治疗原发性高血压疗效和安全性的Meta分析

目的：系统评价硝苯地平缓释片联合缬沙坦治疗原发性高血压的疗效和安全性。方法：计算机检索PubMed、CochraneLi-brary、CBM、CNKI、V1P等数据库，按照纳入和排除标准纳入依硝苯地平缓释片联合缬沙坦治疗原发性高血压的随机对照试验（RCT），并补充检索纳入研究的参考文献；按Cochrane系统评价方法由两名评价员独立评价纳入文献质量、提取资料并交叉核对无误后，采用RevMan5．1软件进行统计学分析。结果：共纳入4个RCT，包括共450例患者，其研究质量均为C级。Meta分析结果显示：硝苯地平缓释片联合缬沙坦治疗原发性高血压的显效率RR=1．29，95％CI（1．08～1．55），P〈O．011、总有效率RR=I．19，95％CI（1．10～1．29），P〈0．01]和无效率RR=0．38，95％CI（0．24～0．62），P〈0．01]与单用硝苯地平缓释片比较，两组差异有统计学意义，两组有效率差异无统计学意义RR=I．02，95％CI（0．97～1．32），P〉0．01]。结论：现有证据表明：硝苯地平缓释片联合缬沙坦治疗原发性高血压在显效率，总有效率和无效率方面优于硝苯地平缓释片单用，不良反应与苯地平缓释片单用无明显差异，但远期疗效尚不清楚，尚需更多高质量的随机双盲对照试验证实。

The Therapeutic Effect and Safety of Sustained-release Nifedipine Combined with Valsartan in The Treatment of Essential Hypertension： A Meta-analysis

Objective： To review the clinical curative effect and safety of sustained- release nifedipine combined with valsartan in the treatment of essential hypertension. Methods： We electronically searched PubMed, Cochrane Library, CBM, CNKI, VIP. Rando-mized controlled trials （RCTs） about ustained-release nifedipine combined with valsartan in the treatment of essential hypertension were includ- ed, and the relevant references of the included papers were also searched.Study selection and analysis were undertaken according to the Cochrane Handbook, and RevMan 5.1 was applied for statistical analyses. Results： Four RCTs involving 450 patients with Cardiac Arrhythmia were included. The quality grade of all studies were C.The results of meta-analysis showed that the marked effect rate RR= 1. 29, 95%CI （1.08-1.55）, P〈 0.01], total effective rate RR=I.19, 95%CI （1.10-1.29）, P〈0.01]and ineffective rate RR=0.38, 95%CI （0.24 - 0.62）, P〈0.01 ]were superior in the combination arm to the sustained-release nifedipine alone arm.There were no significant difference between the two groups in effective rate RR=I.02, 95%CI （0.97-1.32）, P〉0.01]. Conclusion： The current evidence available shows that the sustained- release nifedipine combined with valsartan in the treatment of essential hypertension may significantly improve the marked effect rate, total effective rate and reduce the ineffective rate comparing with sustained-release nifedipine alone, and there were no significant difference was found between the two groups in adverse reaction. However, long-term efficacy are not clear, more high-quality RCTs should be conducted.