血必净注射液治疗脓毒症的药效研究:动物实验系统评价/Meta分析  

Investigate the efficacy of Xuebijing Injection in the treatment of sepsis based on animal models by systematic review and Meta analysis

作　　者：马毓聪 朱惠众 张晨瑶 张雅姿 曹璐佳 庞稳泰 MA Yucong;ZHU Huizhong;ZHANG Chenyao;ZHANG Yazi;CAO Lujia;PANG Wentai(Evidence-based Medicine Center,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学循证医学中心,天津301617

出　　处：《天津中医药》2025年第5期591-600,共10页Tianjin Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金青年项目(82305433);天津市教委科研计划项目(2023KJ145);天津中医药大学新教师科研启动项目(XJS2023210);现代中药创制全国重点实验室青苗基金(CBCM2023204);天津市杰出青年科学基金项目(20JC JQJC00120)。

摘　　要：[目的]系统评价血必净注射液(XBJ)治疗脓毒症的动物实验,探索其药效。[方法]计算机检索中国知网(CNKI)、万方数据知识服务平台(Wanfang Database)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、Cochrane Library、Web of science和Embase数据库。检索时间为建库至2024年4月20日。根据纳排标准独立筛选文献、提取信息并采用SYRCLE动物实验风险评估工具和ARRIVE指南2.0对纳入研究进行评价,运用Review Manager 5.4进行Meta分析。[结果]共纳入33项研究,纳入研究的总体质量为中风险。Meta分析结果显示,XBJ在改善脓毒症动物模型生存率[OR=2.90,95%CI (1.99,4.24),P<0.000 01]、血清白细胞介素-6 (IL-6)[SMD=-2.12,95%CI(-3.61,-0.62),P=0.006]、肿瘤坏死因子-α(TNF-α)[SMD=-2.06,95%CI(-3.12,-1.00),P=0.000 1]、血浆白细胞介素-1β(IL-1β)[MD=-79.38,95%CI(-106.17,-52.58),P<0.000 01]、谷丙转氨酶(ALT)[MD=-46.13,95%CI(-81.95,-10.30),P=0.01]、心肌肌钙蛋白(c TnI)[MD=-0.55,95%CI(-0.90,-0.21),P=0.002]、血管内皮素-1(ET-1)[MD=-1.11,95%CI(-2.09,-0.13),P=0.03]、肺叶湿干比(W/D)[MD=-0.62,95%CI(-1.04,-0.21),P=0.003]等指标方面有较好的药效。根据剂量进行亚组分析显示,XBJ在TNF-α指标中低剂量组表现更优,在W/D指标中高剂量组表现更优。除上述指标外,XBJ的剂量可能不构成干扰因素。[结论]血必净注射液在脓毒症动物的治疗上体现出一定药效,其机制可能为通过下调脂多糖诱导MH-S细胞信号通路,达到降低炎症因子表达,以及通过抑制细胞焦亡,介导JAK2/STAT3等相关信号通路,实现脓毒症损伤器官保护等。XBJ在生存率、器官功能指标和炎症反应相关指标中均有改善作用,但受到研究质量的限制,该结论需要进一步研究加以证实。[Objective]Systematic evaluation of animal experiments to explore the efficacy of Xuebijing Injection(XBJ)in the treatment of sepsis.[Methods]Computerized searches were performed on China Knowledge Network(CNKI),Wanfang Database,Wipro Chinese Scientific and Technical Journal Database(VIP),Chinese Biomedical Literature Database(SinoMed),PubMed,Cochrane Library,Web of science,and Embase databases.The search was conducted from the time of library construction to April 20,2024 Literature was independently screened,information was extracted and included studies were evaluated using the SYRCLE animal experimentation risk assessment tool and the ARRIVE Guidelines 2.0 according to the nerf criteria,and Meta-analysis was performed using Review Manager 5.4.[Results]A total of 33 studies were included,and the overall quality of the included studies was medium risk.Meta-analysis showed that XBJ was effective in improving the survival of sepsis animal model[OR=2.90,95%CI(1.99,4.24),P<0.00001],serum interleukin-6(IL-6)[SMD=-2.12,95%CI(-3.61,-0.62),P=0.006],tumor necrosis factor alpha(TNF-α)[SMD=-2.06,95%CI(-3.12,-1.00),P=0.0001],plasma interleukin-1β(IL-1β)[MD=-79.38,95%CI(-106.17,-52.58),P<0.00001],and alanine transaminase(ALT)[MD=-46.13,95%CI(-81.95,-10.30),P=0.01],cardiac troponin(cTnI)[MD=-0.55,95%CI(-0.90,-0.21),P=0.002],vascular endothelin-1(ET-1)[MD=-1.11,95%CI(-2.09,-0.13),P=0.03],and lung lobe wet to dry ratio(W/D)[MD=-0.62,95%CI(-1.04,-0.21),P=0.003]and other indicators of good efficacy.Subgroup analysis based on dose showed that XBJ performed better in the low-dose group in the TNF-αmetric and in the high-dose group in the W/D metric.In addition to the above metrics,the dose of XBJ may not constitute a confounding factor.[Conclusion]XBJ has shown some efficacy in the treatment of septic animals,and its mechanism may be through the down-regulation of lipopolysaccharide-induced MH-S cell signaling pathway to reduce the expression of inflammatory factors,as well as through the inhibition of cellular pyrokinesis,med

关 键 词：血必净注射液 脓毒症 动物实验 系统评价 Meta分析 

分 类 号：R286[医药卫生—中药学]