参麦注射液联合西医治疗脓毒症心肌损伤疗效的Meta分析  

Meta-analysis of the Efficacy of Shenmai Injection Combined with Western Medicine in the Treatment of Sepsis-induced Myocardial Injury

作　　者：邓雯洁 黄坡 方晓磊[2] Deng Wenjie;Huang Po;Fang Xiaolei(Bejing University of Chinese Medicine,Beijing100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中国中医急症》2025年第3期377-381,393,共6页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82205070)。

摘　　要：目的系统评价参麦注射液联合西医治疗脓毒症心肌损伤的临床疗效。方法由2名研究人员独立计算机检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(维普网)、中国生物医学文献服务系统(SinoMed)、PubMed、Cochrane Library、Web of Science建库至2024年9月17日参麦注射液联合西医治疗(治疗组)对比单用常规治疗(对照组)脓毒症心肌损伤疗效观察的随机对照试验文献(RCT)。依据纳入及排除标准筛选得到相应文献,采用Cochrane偏倚风险评估工具进行文献质量评价,采用RevMan5.4.1软件进行Meta分析。结果最终纳入9篇文献,共620例患者,其中治疗组310例,对照组310例。Meta分析结果显示,与常规治疗相比,参麦注射液联合西医治疗有助于降低脓毒症心肌损伤28 d病死率[OR=0.58,95%CI(0.35,0.96),P=0.04]、改善心肌钙蛋白I的水平[SMD=-1.64,95%CI(-2.80,-0.48),P=0.006]、肌酸激酶同工酶的水平[SMD=-0.88,95%CI(-1.75,-0.01),P=0.05]、左室射血分数[SMD=0.67,95%CI(0.42,0.92),P<0.001]以及B型脑利钠肽的水平[SMD=-5.36,95%CI(-8.52,-2.20),P<0.001]。结论现有证据表明,参麦注射液联合西医治疗能降低脓毒症心肌损伤,改善心功能障碍。Objective:To systematically evaluate the clinical efficacy of Shenmai injection combined with western medicine in the treatment of sepsis-induced myocardial injury(SIMI).Methods:RCTs of Shenmai injection for the treatment of SIMI were retrieved from CNKI,Wanfang Data,VIP,SinoMed,PubMed,and Cochrane Library database and Web of Science from inception to September 17,2024.The articles were screened according to the inclusion and exclusion criteria.Cochrane bias risk assessment tool was used to evaluate the quality of literature and RevMan5.4.1 was used to analyze the data.Results:Totally 9 articles were finally included,involving620 patients,with 310 patients in the treatment group and 310 patients in the control group.Meta-analysis showed that compared with conventional western medicine,Shenmai injection helped to reduce 28 day mortality rates[OR=0.58,95%CI(0.35,0.96),P=0.04],improve the levels of cTnI[SMD=-1.64,95%CI(-2.80,-0.48),P=0.006],CK-MB[SMD=-0.88,95%CI(-1.75,-0.01),P=0.05],LVEF[SMD=0.67,95%CI(0.42,0.92),P<0.001]and NT-proBNP[SMD=-5.36,95%CI(-8.52,-2.20),P<0.001].Conclusion:According to available studies,the combination of Shenmai injection with western medicine can reduce SIMI and improve cardiac dysfunction.

关 键 词：脓毒症 心肌损伤 参麦注射液 随机对照试验 META分析 

分 类 号：R631[医药卫生—外科学]