参附注射液在心脏手术中心肌保护作用的荟萃分析

摘要

Objective:To evaluate the use of shenfu injection, in the open heart surgery for the circulation protection in cardiopulmo-nary bypass operation.Methods:Set the inclusive criteria and search strategy, search VIP, Wanfang, CNKI and CBM database, draw the RCT papers regarding the open heart surgeries, the quality of the papers was analyzed,analyze the data with RevMan 5.0 software.Results:18 articles included in the study, a total of 900 cases met the inclusion criteria.Meta-analysis showed:shenfu group and control group in the heart of auto-resuscitation rate (OR=3.90, 95%CI:2.23~6.80, P<0.00001), within 1~2h after blood troponin (cTnI) detection value (MD=-0.18, 95%CI:-0.24~-0.12,P<0.00001), after extubation time (MD=-3.39, 95% CI:-4.18~-2.59, P<0.00001), etc.the difference was statistically significant.Conclusion: Shenfu injection is of significant value in the cardiopulmonary bypass operations, however huge amount of high quality clinical evidences are still requested to prove the outcome of the medicine.Especially the comparison of outcome by the various administration routes and different dosages needs to be classified by the study on large samples.%目的：采用Meta分析方法，评价参附注射液在心脏手术中心肌保护作用。方法：制定原始文献的纳入标准及检索策略，检索维普中文科技期刊全文数据库（ VIP）、万方医学数据库（ Wanfang）、中国知网（ CNKI）和中国生物医学文献数据库（ CBM），提取有关心脏手术中应用参附注射液病例的随机对照临床试验（ RCT）文献，评价纳入研究的文献质量，并提取有效数据后采用RevMan5.0软件进行Meta分析。结果：纳入研究的18篇文献，共计900例符合纳入标准。 Meta分析结果显示：参附组与对照组在心脏自动复跳率（OR＝3.90，95％CI：2.23～6.80，P＜0.00001）、术后1～2h内血肌钙蛋白（cTnI）检测值（MD＝-0.18，95％CI：-0.24～-0.12，P＜0.00001）、术后拔除气管插管时间（MD＝-3.39，95％CI：-4.18～-2.59，P＜0.00001）等方面的差异有统计学意义。结论：参附注射液在心脏手术中心肌保护作用效果显著。但仍需高质量的临床证据进一步验证，尤其是参附注射液不同用药途径以及不同用药量之间的比较，需大样本研究资料验证。