参附注射液治疗急性心力衰竭有效性的Meta分析  

Efficacy of Shenfu Injection for Acute Heart Failure:a Meta-analysis

作　　者：郭丽君 王安铸 高风 郑源[1] 马晓昌[2] 陈可冀[2] GUO Lijun;WANG Anzhu;GAO Feng;ZHENG Yuan;MA Xiaochang;CHEN Keji(Beijing University of Chinese Medicine,Beijing 100029,China;Cardiovascular Disease Center,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院心血管病中心,北京100091

出　　处：《世界中医药》2020年第16期2387-2396,共10页World Chinese Medicine

基　　金：国家自然科学基金项目(81273932)。

摘　　要：目的:系统评价参附注射液联合常规西药治疗急性心力衰竭的疗效和安全性。方法:检索中国知网(CNKI)、万方数据知识服务平台、重庆维普资讯有限公司(VIP)、中国生物医学文献数据库(Sinomed)、Embase、PubMed、Web of science和Cochrance Library数据库,搜集关于参附注射液治疗急性心力衰竭的随机对照试验,检索时限均从建库至2019年6月。由2位研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件对临床有效率、脑钠肽(BNP)、N端前脑钠肽(NT-proBNT)、左室射血分数(LVEF)左室短轴缩短分数(LVFS)、不良反应发生率等进行Meta分析。结果:最终纳入22个RCT,共1753例患者。Meta分析结果显示,参附注射液联合常规西药治疗较常规西药治疗可以提高临床有效率,改善BNP、NT-proBNP、LVEF、左室短轴缩短分数(LVFS)和中医证候积分。不良反应发生率2组差异无统计学意义。结论:参附注射液联合常规西药治疗急性心力衰竭可提高患者临床有效率,降低BNP、NT-proBNP水平,改善心功能(提高LVEF、LVFS水平),安全性较好。但受纳入研究的数量和质量限制,上述结论尚需要开展更多研究予以验证。Objective:To systematically review the efficacy and safety of Shenfu Injection combined with the basal therapy for acute heart failure.Methods:Databases including CNKI,WanFang Data,VIP,Chinese Biomedical Literature Database,Embase,PubMed,Web of science and Cochrance Library were electronically searched from inception to June 2019 to collect randomized controlled trials on Shenfu Injection in the treatment of acute heart failure.A total of 2 researchers independently screened literature,extracted data,and assessed risk of bias of included studies.Then,Meta-analysis was performed on the the clinical effective rate,BNP,NT-proBNP,LVEF and incidence of adverse reactions,etc.via RevMan 5.3 software.Results:A total of 22 RCTs involving 1753 patients were included.The results of meta-analysis showed that:compared with control group,the Shenfu Injection combined with the routine therapy could improve the clinical effective rate,BNP level,NT-proBNP level,LVEF,LVFS and traditional Chinese medicine(TCM)syndrome score.However,there were no significant differences between 2 groups in rate of adverse reaction.Conclusion:Shenfu Injection combined with the Western mediicne can improve the clinical efficiency,reduce BNP,NT-proBNP levels,improve cardiac function(LVEF,LVFS)with good safety.Due to limited quality and quantity of the included studies,more studies are required to verify the conclusions above.

关 键 词：参附注射液 中医药 急性心力衰竭 临床疗效 有效率 系统综述 META分析 随机对照试验 

分 类 号：R242[医药卫生—中医临床基础]