血必净治疗新型冠状病毒肺炎有效性和安全性的Meta分析  

Meta-Analysis of Efficacy and Safety of Xuebijing(血必净)in the Treatment of Coronavirus Disease 2019

作　　者：罗太敏 杨旭平 杨丽 秦先涛[1] 崔建蓉[1] Luo Taimin;Yang Xuping;Yang Li;Qin Xiantao;Cui Jianrong(Department of Pharmacy,Chengdu Seventh People’s Hospital,Chengdu 610000;Department of Pharmacy,Affiliated Hospital of Southwest Medical University,Luzhou 646000)

机构地区：[1]成都市第七人民医院药剂科,成都610000 [2]西南医科大学附属医院药学部,泸州646000

出　　处：《中药药理与临床》2022年第5期136-141,共6页Pharmacology and Clinics of Chinese Materia Medica

摘　　要：目的:通过Meta分析评价血必净注射液(血必净)治疗新型冠状病毒肺炎(COVID-19)的有效性和安全性。方法:计算机检索PubMed、The Cochrane Library、Embase、以及中国知网、万方、维普等数据库发表的血必净治疗COVID-19的随机对照试验(RCT)、队列研究和病例对照研究,对照组为常规治疗,试验组在常规治疗基础上加用血必净治疗。结局指标为:总有效率、28 d死亡率、核酸转阴率、肺部CT恢复率、C-反应蛋白(CRP)、白细胞计数(WBC)、淋巴细胞计数(LYM)、红细胞沉降率(ESR)等炎性指标以及不良反应/不良事件(ADR/ADE)的发生率。采用Cochrane 6.3手册和纽卡斯尔·渥太华(NOS)量表评估文献的质量;使用RevMan 5.4软件对纳入文献进行Meta分析。结果:纳入9篇文献,其中RCT 5篇、队列或病例对照研究4篇,包含457例患者,血必净组230例,对照组227例。结果显示,血必净组总有效率高于常规治疗组(OR=2.55,95%CI[1.06~6.10,P<0.05);血必净组28 d死亡率比常规治疗组低(OR=0.30,95%CI[0.12~0.74],P<0.01);血必净组核酸转阴率与常规治疗组没有显著差异(OR=0.89,95%CI[0.35~2.27,P>0.05);血必净组肺部CT恢复率高于常规治疗组(OR=4.52,95%CI[1.29~15.84,P<0.05);治疗后血必净组CRP水平低于常规治疗组(MD=-11.12,95%CI[-21.60~-0.63],P<0.05);血必净组WBC水平与常规治疗组没有显著差异(MD=0.21,95%CI[-0.08~0.49],P>0.05);治疗后血必净组较常规治疗组LYM水平显著升高(MD=0.23,95%CI[0.11~0.36],P<0.01);与常规治疗组比较,在重型/危重型COVID-19(MD=-9.40,95%CI[-13.22~-5.58],P<0.01)及COVID-19其它型(MD=-5.53,95%CI[-6.62~-4.45],P<0.01)的患者中血必净组ESR显著降低;血必净组ADR/ADE与常规治疗组没有显著差异(OR=1.05,95%CI[0.57~1.94],P>0.05)。结论:血必净在提高COVID-19患者的总有效率、降低28 d死亡率、提高肺部CT恢复率、改善部分炎性指标等方面有一定的优势,但血必净药性猛烈,临床在选用本品时,还需�Objective:To evaluate the efficacy and safety of Xuebijing(血必净)in the treatment of coronavirus disease 2019(COVID-19)by Meta-analysis.Methods:The randomized controlled trials(RCTs),cohort studies,and case-control studies of Xuebijing on the treatment of COVID-19 published in PubMed,the Cochrane Library,EMBase,China National Knowledge Infrastructure(CNKI),Wanfang,and VIP Chinese Technology Periodical Database were retrieved by computer.The control group was treated with routine treatment,and the experimental group was treated with Xuebijing based on the routine treatment.The outcome indexes included the total effective rate,mortality in 28 days,nucleic acid negative conversion rate,lung CT recovery rate,C-reactive protein(CRP),white blood cell count(WBC),lymphocyte count(LYM),erythrocyte sedimentation rate(ESR),and the incidence of adverse reactions/adverse events(ADR/ADE).Cochrane 6.3 manual and Newcastle Ottawa(NOS)scale were used to evaluate the quality of literature.Revman 5.4 was used to conduct Meta-analysis.Results:Nine papers were included,including five RCTs and four cohort studies or case-control studies.There were 457 patients,including 230 in the Xuebijing group and 227 in the control group.The results showed that the total effective rate of Xuebijing group was higher than that of the control group[OR=2.55,95%CI(1.06~6.10),P<0.05].The mortality of the Xuebijing group in 28 days was lower than that of the control group[OR=0.30,95%CI(0.12~0.74),P<0.01].There was no significant difference in the nucleic acid negative conversion rate between the Xuebijing group and the control group[OR=0.89,95%CI(0.35~2.27),P>0.05].The lung CT recovery rate in the Xuebijing group was higher than that in the control group[OR=4.52,95%CI(1.29~15.84),P<0.05].The CRP level in the Xuebijing group was lower than that in the control group[MD=-11.12,95%CI(-21.60~-0.63),P<0.05].There was no significant difference in the WBC level between the Xuebijing group and the control group[MD=0.21,95%CI(-0.08~0.49),P>0.05].The level of L

关 键 词：新型冠状病毒肺炎 COVID-19 血必净 META分析 总有效率 核酸转阴率 

分 类 号：R259[医药卫生—中西医结合]