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Background@#and Purpose The present study aimed to compare the efficacy and tolerability of different blood pressure (BP)-lowering strategies. @*Methods@#Randomized controlled trials that compared various antihypertensive treatments and stroke outcomes were included. Eligible trials were categorized into three scenarios: single or combination antihypertensive agents against placebos; single or combination agents against other agents; and different BP-lowering targets. The primary efficacy outcome was the risk reduction pertaining to strokes. The tolerability outcome was the withdrawal of drugs, owing to drug-related side effects (PROSPERO registration number CRD42018118454 [20/12/2018]). @*Results@#The present study included 93 trials (average follow-up duration, 3.3 years). In the pairwise analysis, angiotensin-converting enzyme inhibitors (ACEis) and beta-blockers (BBs) were inferior to calcium channel blockers (CCBs) (odds ratio [OR], 1.123; 95% confidence interval [CI], 1.008 to 1.252) (OR, 1.261; 95% CI, 1.116 to 1.425) for stroke prevention, BB was inferior to angiotensin II receptor blockers (ARB) (OR, 1.361; 95% CI, 1.142 to 1.622), and diuretics were superior to ACEi (OR, 0.871; 95% CI, 0.771 to 0.984). The combination of ACEi+CCB was superior to ACEi+diuretic (OR, 0.892; 95% CI, 0.823 to 0.966). The network meta-analysis confirmed that diuretics were superior to BB (OR, 1.34; 95% CI, 1.11 to 1.58), ACEi+diuretic (OR, 1.47; 95% CI, 1.02 to 2.08), BB+CCB (OR, 2.05; 95% CI, 1.05 to 3.79), and renin inhibitors (OR, 1.87; 95% CI, 1.25 to 2.75) for stroke prevention. Regarding the tolerability profile, the pairwise analysis revealed that ACEi was inferior to CCB and less tolerable, compared to the other treatments. @*Conclusions@#Monotherapy using diuretics, CCB, or ARB, and their combinations could be employed as first-line treatments for stroke prevention in terms of efficacy and tolerability.
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Objective To investigate the syndrome elements of chronic gastritis; To provide references for syndrome differentiation and treatment of chronic gastritis. Methods Totally 300 patients of chronic gastritis were investigated through a pre-designed scale. Syndrome elements were summarized with factor analysis. Results There were 6 common factors (syndrome elements) picked up by factor analysis. Syndrome elements of disease locations were stomach, spleen, liver, and syndrome elements of disease characteristics were qi deficiency, qi stagnation, blood stasis, stagnated heat, damp obstruction, and dampness-heat, which were consistent with clinical observation. Conclusion It is feasible to apply factor analysis to syndrome elements of chronic gastritis, which can provide references for syndrome differentiation and treatment.
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Pulmonary fibrosis is a kind of intractable disease threatening human health in the respiratory system, which heavily affects life quality of patients. The current Western medicine in clinical drug treatment still does not have significant efficacy, with adverse reactions. In recent years, TCM has shown unique advantages in pulmonary fibrosis models of animals experimental study. This article reviewed the research progress in molecular mechanism of TCM for the protection and treatment of pulmonary fibrosis, discussed its action targets, and provide references for the clinical research and treatment of pulmonary fibrosis.