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目的评价临床药师参与高血压管理对血压控制的影响。方法计算机检索Pub Med、Embase、Cochrane图书馆、中国期刊全文数据库、维普和万方等数据库,全面收集符合纳入标准的随机对照试验(RCT),检索时限为从建库至2015年9月。由2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的偏倚风险,采用Rev Man 5.3软件进行meta分析。结果纳入8项RCT研究,共计2 056例高血压患者。与传统治疗相比,有临床药师参与的高血压管理收缩压[MD=?5.15 mm Hg,95%CI(?6.54,?3.76),P<0.000 01]和舒张压[MD=?3.01 mm Hg,95%CI(?4.51,?1.51),P<0.000 1]的平均降幅显著增大,血压控制率显著提高[RR=1.45,95%CI(1.32,1.60),P<0.000 01]。结论临床药师参与高血压管理有助于提高治疗效果,医师和药师合作是一种较好的高血压管理模式。
Objective To evaluate the influence of clinical pharmacists on blood pressure control in hypertension management. Methods The databases of Pub Med, Embase, Cochrane Library, Chinese Journal Full-text Database, Vip and Wanfang were searched by computer. The randomized controlled trials (RCTs) were successfully collected. The search period was from the database to September 2015. Two reviewers independently screened the literature for inclusion and exclusion, extracted data, and assessed the risk of bias in the study. Meta-analysis was performed using Rev Man 5.3 software. Results Eight RCTs were included in the study, totaling 2,056 patients with hypertension. Hypertensive management systolic blood pressure (MD 5.15 mm Hg 95% CI 6.54 to 3.76, P 0.0001) and diastolic blood pressure [MD 3.01 mm Hg , 95% CI (? 4.51,? 1.51), P <0.0001] increased significantly and the rate of blood pressure control significantly increased [RR = 1.45,95% CI 1.32,1.60, P <0.000 01]. Conclusion The participation of clinical pharmacists in the management of hypertension helps to improve the therapeutic effect. The cooperation between physicians and pharmacists is a good mode of hypertension management.