7种中药注射液联合常规治疗对重症肺炎的疗效及安全性的网状Meta分析  

Network Meta-Analysis of Efficacy and Safety of Seven Chinese Medicinal Injections Combined with Conventional Treatment for Severe Pneumonia

作　　者：关胜男 谢凯 姬文帅 王海峰[1,2,3] GUAN Shengnan;XIE Kai;JI Wenshuai;WANG Haifeng(Henan University of Chinese Medicine,Zhengzhou 450000;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000;The Provincial and Ministry Cooperative Innovation Center for Respiratory Disease Prevention and Treatment of Traditional Chinese Medicine,Zhengzhou 450000)

机构地区：[1]河南中医药大学,郑州450000 [2]河南中医药大学第一附属医院,郑州450000 [3]呼吸疾病中医药防治省部共建协同创新中心,郑州450000

出　　处：《中药药理与临床》2025年第1期116-123,共8页Pharmacology and Clinics of Chinese Materia Medica

基　　金：国家自然科学基金项目(编号:81774222、82074411);河南省高校科技创新团队支持计划(编号:22IRTSTHN029);河南省中医药科学研究专项课题(拔尖人才)(编号:2019ZYBJ05)。

摘　　要：目的:本研究旨在评价7种中药注射液(CMI)联合常规治疗对重症肺炎(SP)的疗效及安全性。方法:计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)数据库、PubMed、EMbase、Cochrane Library和Web of Science数据库,检索时间均从建库至2022年1月1日。由2名研究人员独立进行文献的搜集,按照Cochrane风险评估工具进行质量评价,应用Stata17.0进行网状Meta分析。结果:纳入54篇,共4 011例患者,涉及7种中药注射液。网状Meta分析结果显示:在主要结局指标方面,提高临床有效率疗效在联合西医常规治疗的基础上痰热清注射液+西医常规>醒脑静注射液+西医常规>血必净注射液+西医常规>喜炎平注射液+西医常规>热毒宁注射液+西医常规>参麦注射液+西医常规>参附注射液+西医常规>西医常规;降低病死率方面,参麦注射液+西医常规>血必净注射液+西医常规>热毒宁注射液+西医常规>醒脑静注射液+西医常规>西医常规;在次要结局指标方面,热毒宁注射液、痰热清注射液联合西医治疗在减少住ICU时间(d)、总住院时间(d)、降低CPIS评分及APACHE评分方面疗效显著,无明显不良反应。结论:在西医常规治疗基础上联合上述7种中药注射液均可提高临床疗效,且安全性较好。其中血必净注射液、参麦注射液及痰热清注射液联合西医治疗在提高临床有效率及降低病死率方面有一定优势,但由于本研究的文献质量总体不高,未来希望有更多高质量、多中心的随机对照试验对本研究结果加以验证。Objective:To evaluate the efficacy and safety of seven Chinese medicinal injections(CMIs) combined with conventional treatment for severe pneumonia(SP). Methods:Databases, including China National Knowledge Infrastructure(CNKI),Wanfang Data, VIP,PubMed, EMbase, Cochrane Library, and Web of Science were searched from database inception to January 1,2022. Two investigators independently collected literature, assessed quality using Cochrane risk assessment tools, and performed network Meta-analysis using Stata 17.0. Results:Fifty-four articles involving 4 011 patients and seven CMIs were included. As revealed by network Meta-analysis of the primary outcomes, the therapeutic protocols were ranked as Tanreqing(痰热清) Injection + western medical treatment > Xingnaojing(醒脑静) Injection + western medical treatment > Xuebijing(血必净) Injection + western medical treatment > Xiyanping(喜炎平) Injection + western medical treatment > Reduning(热毒宁) Injection + western medical treatment > Shenmai(参麦) Injection + western medical treatment > Shenfu(参附) Injection + western medical treatment > western medical treatment in terms of improving clinical efficacy. In terms of reducing mortality, the therapeutic protocols were ranked as Shenmai Injection + western medical treatment > Xuebijing Injection + western medical treatment > Reduning Injection + western medical treatment > Xingnaojing Injection + western medical treatment > western medical treatment. Regarding secondary outcomes, in combination with western medical treatment, Reduning Injection and Tanreqing Injection significantly reduced ICU stay time(d),total hospital stay time(d),CPIS score, and APACHE score with notable effectiveness and no significant adverse reactions. Conclusion:These seven Chinese medicinal injections combined with western medical treatment can improve clinical efficacy and demonstrate good safety. Among them, Xuebijing Injection, Shenmai Injection, and Tanreqing Injection combined with western medical treatment show certain

关 键 词：中药注射液 重症肺炎 网状Meta分析 随机对照试验 

分 类 号：R563.1[医药卫生—呼吸系统]