摘要
目的对比常用中药注射剂治疗冠心病心力衰竭的疗效和安全性,为临床提供循证证据。方法计算机全面检索中英文数据库中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、EMbase、the Cochrane Library。收集并提取相关文献及数据,并进行文献质量评价,使用RevMan 5.3对纳入文献进行直接Meta分析,使用Stata 16对所有文献进行网状Meta分析。结果共纳入文献42篇,涉及中药注射剂7种,均为中文文献,文献质量一般。直接Meta分析结果显示:在常规治疗的基础上分别加用参附注射液、参麦注射液、大株红景天注射液、丹红注射液、生脉注射液、心脉隆注射液、益气复脉注射液均能提高冠心病心力衰竭病人的治疗有效率、左室射血分数(LVEF)、B型利钠肽(BNP)/N末端B型利钠肽原(NT-proBNP)水平。网状Meta分析结果显示,M常规治疗联合中药注射液的治疗有效率排序结果为:联用参麦注射液>大株红景注射液>参附注射液>心脉隆注射液>丹红注射液>生脉注射液>益气复脉注射液>常规治疗;LVEF排序结果为:联用参麦注射液>益气复脉注射液>心脉隆注射液>大株红景天注射液>参附注射液>丹红注射液>生脉注射液>常规治疗;BNP排序结果为:联用大株红景天注射液>生脉注射液>参麦注射液>丹红注射液>心脉隆注射液>参附注射液>常规治疗;NT-proBNP排序结果为:联用益气复脉注射液>心脉隆注射液>参附注射液>大株红景天注射液>丹红注射液>参麦注射液>常规治疗。安全性分析显示,联用参麦注射液、大株红景天注射液、益气复脉注射液不良反应较少。结论7种中药注射剂联合常规治疗均能进一步改善病人的治疗有效率、LVEF、BNP/NT-proBNP,但由于存在文献干预措施非直接比较,以及文献质量一般,仍需根据临床问题具体分析使用。
Objective To compare the efficacy and safety of common Chinese medicine injections in the treatment of coronary heart disease heart failure.Methods CNKI,WanFang,VIP,SinoMed,PubMed,EMbase,and the Cochrane Library were searched to collect relevant literature.Direct Meta-analysis of the included literature was performed using RevMan 5.3,and Network Meta-analysis of the included literature was performed using Stata 16.Results A total of 42 literatures were included,including 7 Chinese medicine injections,all of which were Chinese literatures,and the literature quality was general.Direct Meta-analysis results showed that routine treatment plus Shenfu Injection,Shenmai Injection,Dazhu Rhodiola Injection,Danhong Injection,Shengmai Injection,Xinmailong Injection,Yiqi Fumai Injection could improve the therapeutic efficiency,ejection fraction,and B-type natriuretic peptide(BNP)/N-terminal B-type pro-natriuretic peptide(NT-proBNP)respectively.Network Meta-analysis showed that the effective rate of treatment was as follows:Shenmai Injection>Dazhu Rhodiola Injection>Shenfu Injection>Xinmailong Injection>Danhong Injection>Shengmai Injection>Yiqi Fumai Injection>routine treatment,the effective rates of treatment for ejection fraction were as follows:Shenmai Injection>Yiqi Fumai Injection>Xinmailong Injection>Dazhu Rhodiola Injection>Shenfu Injection>Danhong Injection>Shengmai Injection>routine treatment,that for BNP were as follows:Dazhu Rhodiola Injection>Shengmai Injection>Shenmai Injection>Danhong Injection>Xinmailong Injection>Shenfu Injection>routine treatment,that for NT-proBNP were as follows:Yiqi Fumai Injection>Xinmailong Injection>Shenfu Injection>Dazhu Rhodiola Injection>Danhong Injection>Shenmai Injection>routine treatment.The safety analysis showed that the adverse reactions of Shenmai Injection,Dazhu Rhodiola Injection,and Yiqi Fumai Injection were less.Conclusion Seven injections combined with conventional treatment can further improve treatment efficiency,ejection fraction,and BNP/NT-proBNP.However,due to non-direct comparison of literature interventions and the general literature quality,the injections still should be used according to specific clinical problems.
作者
贾梦楠
朱明军
王永霞
李彬
于瑞
李洁薇
郑超楠
于丽
JIA Mengnan;ZHU Mingjun;WANG Yongxia;LI Bin;YU Rui;LI Jiewei;ZHENG Chaonan;YU Li(Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《中西医结合心脑血管病杂志》
2022年第2期214-224,共11页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
国家自然科学基金项目(No.82030120)
国家重点研发计划重点专项课题(No.2019YFC1710000,2019YFC1710003)
国家中医药管理局中医药循证能力建设项目(No.2019XZZX-XXG003)
河南省中原千人计划——中原名医项目(No.2018JDZX009)。
关键词
冠心病心力衰竭
中药注射剂
随机对照研究
网状Meta分析
coronary heart disease heart failure
traditional Chinese medicine injections
randomized controlled trial
network Meta-analysis
