益气养阴中药静脉制剂治疗慢性心力衰竭系统评价的再评价  

Reevaluation of Benefiting Qi and Nourishing Yin Chinese Medicinal Injection in the Treatment of Chronic Heart Failure

作　　者：曹雅雯 林姗姗 杨颖 王贤良[1] 毕颖斐[1] 赵志强[1] 毛静远[1] CAO Yawen;LIN Shanshan;YANG Ying;WANG Xianliang;BI Yingfei;ZHAO Zhiqiang;MAO Jingyuan(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300381 [2]天津中医药大学,天津301617

出　　处：《中西医结合心脑血管病杂志》2022年第15期2719-2725,2737,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家中医药管理局中成药治疗优势病种临床应用指南标准化项目(No.SATCM-2015-BZ402);国家中医药管理局中医药循证能力建设项目(No.2019XZZX-XXG007);教育部“创新团队发展计划”(No.IRT_16R54);天津市科技计划项目课题(No.15ZXLCSY00020)。

摘　　要：目的对益气养阴中药静脉制剂治疗慢性心力衰竭相关系统评价/Meta分析进行再评价。方法计算机检索中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据库(WanFang Data)、中国生物医学文献数据库(CBM)、PubMed、EMbase the Cochrane Library数据库,检索时限为建库至2021年10月31日,收集益气养阴中药静脉制剂治疗慢性心力衰竭的系统评价/Meta分析,并补充检索原始研究,由两位研究者独立筛选文献和提取资料后,采用AMSTAR2量表评价纳入系统评价/Meta分析的方法学质量,并运用R软件进行网状Meta分析。结果共纳入9篇Meta分析,涉及3种中药静脉制剂,补充纳入原始研究4篇。AMSTAR2评价结果显示,8篇为低质量,1篇为极低质量。网状Meta分析结果显示:在增加6 min步行试验距离及左室射血分数方面,生脉注射液联合西医常规治疗疗效最佳;在改善纽约心脏协会心功能分级及降低N末端B型利钠肽原方面,参麦注射液联合西医常规治疗疗效最佳;在降低B型利钠肽方面,注射用益气复脉(冻干)联合西医常规治疗疗效最佳;3种中药静脉制剂均未见严重不良事件。结论不同益气养阴中药静脉制剂治疗慢性心力衰竭疗效优势不一,安全性均良好,但缺乏对终点指标的关注。本研究纳入系统评价研究设计较为规范,但方法学质量仍较低,报告不完整或是其主要原因。Objective To reevaluate the Benefiting Qi and Nourishing Yin Chinese medicinal injection for the treatment of chronic heart failure.Methods China National Knowledge Infrastructure(CNKI),Wipro Chinese Full-text Database of Scientific and Technological Journals(VIP),WanFang DATA,China Biomedical Medicine(CBM)disc,PubMed,and the Cochrane Library database were searched.The retrieval time was from the establishment of the database to October 31,2021.SR/Meta-analysis of the treatment of chronic heart failure with Benefiting Qi and Nourishing Yin Chinese medicinal injection were collected,and the original studies were supplemented to retrieve.After two researchers independently screened the literature and extracted data,AMSTAR2 scale was used to evaluate the methodological quality of the included SR/Meta-analysis,and R software was used to conduct network Meta-analysis.Results A total of 9 Meta-analyses were included,involving 3 intravenous preparations of Chinese medicinal injection,and 4 original studies were supplemented.The results of AMSTAR2 evaluation showed that there are 8 articles with low quality and 1 article with very low quality.The results of network Meta-analysis showed that Shengmai injection combined with conventional western medicine showed the best effect in increasing the 6 minutes walking distance and left ventricular ejection fraction,Shenmai injection combined with conventional western medicine has the best effect on improving New York Heart Association cardiac function classification and reducing N-terminal pro-B-type natriuretic peptide.In reducing B-type natriuretic peptide,Yiqi Fumai(lyophilized)combined with conventional western medicine showed the best effect.No serious adverse events were observed in the three intravenous preparations of traditional Chinese medicine.Conclusion Benefiting Qi and Nourishing Yin Chinese Medicinal Injection preparations in the treatment of chronic heart failure showed different efficacy advantages and good safety,but lack of attention to pay the end points.The

关 键 词：慢性心力衰竭 益气养阴 中药静脉制剂 系统评价 再评价 

分 类 号：R259[医药卫生—中西医结合]