参附注射液治疗急性左心衰有效性的系统评价

摘要

Objective:To evaluate the efficacy of Shenfu Injection on acute left heart failure.Methods:The data were collected from the Cochrane Library (Issue 4.2015),PubMed (1979 to May 2017),CNKI (1979 to May 2017),V[P (1979 to May 2017),Wangfan database (1979 to May 2017) and SuperStar discovery system (1979 to May 2017).According to the Jadad scoring scale which was revised,the data were extracted.Date analysis was performed with Review Manager 5.3 software.Results:17 trials with 1286 patients met the included criteria.The quality of the including literature was evaluated low.The results of meta-analysis showed that on the basis of routine treatment of Western medicine,Shenfu Injection plus routine Western medicine can significantly improve the comprehensive efficacy of acute left heart failure (RR=1.26,95％ CI [1.14,1.38],P＜0.05);it increased cardiac ejection fraction (WMD=7.18,95％ CI 4.70 to 9.66,P＜0.05);it strengthened cardiac index (WMD=0.66,95％ CI 0.15 to 1.17,P＜0.05);it increased per minute cardiac output volume (WMD=0.59,95％ CI 0.13 to 1.05,P＜0.05);it apparently reduced plasma BNP (brain natriuretic peptide) level (WMD=125.62,95％ CI 75.86 to 175.37,P＜0.05).The differences above were statistically significant.Conclusion:On the basis of routine treatment of Western medicine,Shenfu Injection is more effective than Western medicine alone in the treatment of acute left heart failure.%目的 评价参附注射液治疗急性左心衰的的有效性.方法 计算机检索Cochrane Library(2015年第4期),PubMed 、CNKI 、VIP、万方数据库和超星发现系统从1979年1月到2017年5月.根据修订后的Jadad评分量表对纳入文献进行质量评价,提取数据后用Review Manager 5.3软件进行系统评价.结果 共计纳入17篇文献,合计共1286例患者,文献质量评价均为低质量.Meta分析结果示在西药常规治疗的基础上加用参附注射液较单用西药常规治疗能明显改善急性左心衰患者的综合疗效(RR=1.26,95％CI[1.14,1.38],P＜0.05);提高心脏射血分数(WMD =7.18,95％CI[4.70,9.66],P＜0.05);能增强心脏指数(WMD=0.66,95％CI[0.15,1.17],P＜0.05);增加每分输出量(WMD=0.59,95％CI[0.13,1.05],P＜0.05);降低血浆脑利钠肽水平(WMD=125.62,95％CI[75.86,175.37],P＜ 0.05).结论 在西药常规治疗的基础上加用参附注射液较单用西药常规治疗可提高急性左心衰的临床疗效.