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参附注射液联合化学药治疗冠心病合并心力衰竭有效性和安全性的Meta分析
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| 篇名： | 参附注射液联合化学药治疗冠心病合并心力衰竭有效性和安全性的Meta分析 |
| TITLE： | Efficacy and safety of Shenfu injection combined with chemical medicine in the treatment of coronary heart disease combined with heart failure：a meta-analysis |
| 摘要： | 目的 系统评价参附注射液联合化学药治疗冠心病合并心力衰竭的有效性和安全性。方法计算机检索中国知网、中国生物医学文献服务系统、维普网、万方数据、PubMed、Embase、theCochraneLibrary，检索时限为建库起至2022年8月。收集参附注射液联合化学药（试验组）对比化学药（对照组）治疗冠心病合并心力衰竭的随机对照试验，筛选文献、提取资料后，分别使用Cochrane手册、GRADE系统进行质量评价和评级。采用RevMan5.3软件进行Meta分析和Egger’s检验，运用TSA0.9.5.10Beta软件进行试验序贯分析。结果纳入17项研究，共计1355例患者。GRADE证据质量等级均为低级。Meta分析显示，试验组患者的心功能疗效[RR＝1.23，95%CI（1.16，1.30），P＜0.00001]、脑钠肽降低水平[MD＝－96.06，95%CI（－116.47，－75.64），P＜0.00001]、左室射血分数提高水平[MD＝5.32，95%CI（4.03，6.60），P＜0.00001]均显著优于对照组；两组患者不良反应发生率比较，差异无统计学意义[RR＝0.52，95%CI（0.22，1.22），P＝0.13]。序贯分析结果显示，本研究的纳入样本量已达Meta分析所需要求；Egger’s检验结果提示结果稳健，发表偏倚无显著影响。结论参附注射液联合化学药治疗冠心病合并心力衰竭可进一步改善患者的临床症状及相关指标，暂未观察到明显不良反应。 |
| ABSTRACT： | OBJECTIVE To systematically evaluate the efficacy and safety of Shenfu injection combined with chemical medicine in the treatment of coronary heart disease combined with heart failure. METHODS Retrieved from CNKI， CBM， VIP， Wanfang， PubMed， Embase and the Cochrane Library， randomized controlled trials （RCTs） about Shenfu injection combined with chemical medicine （trial group） versus chemical medicine （control group） in the treatment of heart failure with coronary heart disease were collected during the inception to August 2022. After literature screening and data extraction， the qualities of included literature were evaluated and rated by using Cochrane manual and GRADE system. Meta-analysis and Egger’s were performed with RevMan 5.3 software， and TSA 0.9.5.10 Beta software was used for trial sequential analysis. RESULTS Seventeen studies were included， with a total sample of 1 355 patients. The quality grade evidence of GRADE was all low. Meta-analysis showed that cardiac function efficacy [RR＝1.23， 95%CI （1.16，1.30）， P＜0.000 01]， the decrease of brain natriuretic peptide [MD＝－96.06， 95%CI （－116.47， －75.64）， P＜0.000 01] and the increase of left ventricular ejection fraction [MD＝5.32， 95%CI （4.03，6.60）， P＜0.000 01] in trial group were significantly better than control group； there was no statistical significance in the incidence of ADR between 2 groups [RR＝0.52，95%CI（0.22，1.22），P＝0.13]. The results of sequential analysis showed that the sample size included in this study met the requirements of meta-analysis； the results of Egger’s test showed that the results were robust and publication bias had no significant effect on the results. CONCLUSIONS Shenfu injection combined with chemical medicine in the treatment of coronary heart disease combined with heart failure can further improve the clinical symptoms and related indicators， and no serious adverse reaction is observed. |
| 期刊： | 2023年第34卷第07期 |
| 作者： | 郑超楠；李军；解紫从；查玉玲；姜春云；张乐松 |
| AUTHORS： | ZHENG Chaonan，LI Jun，XIE Zicong，ZHA Yuling，JIANG Chunyun，ZHANG Lesong |
| 关键字： | 参附注射液；冠心病；心力衰竭；疗效；Meta分析；试验序贯分析 |
| KEYWORDS： | Shenfu injection； coronary heart disease； |
| 阅读数： | 134 次 |
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