注射用益气复脉(冻干)治疗心力衰竭的Meta分析Effects of Yiqifumai injection(lyophilization) on heart failure patients:a Meta-analysis of randomized clinical trials
熊尧,徐程,陈嘉音,杨悦
XIONG Yao,XU Cheng,CHEN Jia-yin,YANG Yue
摘要(Abstract)：
目的系统评价注射用益气复脉(冻干)治疗心力衰竭的临床有效性与安全性。方法计算机检索中国期刊全文数据库、Pubmed等电子数据库,检索时间均从数据库建库至2017年3月。采用Cochrane协作网提供的偏倚风险评估工具对纳入研究进行方法学质量评价。在严格质量评价的基础上采用分析软件Rev Man5.3选择总有效率、左心室射血分数、左心室舒张末内径、每分搏出量、脑钠肽和6分钟步行试验共六项内容作为结果指标项进行Meta分析。结果最终纳入25个随机对照实验,共2 381例患者。结果显示,相比西医常规治疗组,注射用益气复脉(冻干)联合西医常规治疗在提高总有效率[OR=2.96,95%CI(2.23,3.94),P<0.000 1],改善心功能如增加射血分数[SMD=0.88,95%CI(0.65,1.10),P<0.000 1]、减小左心室舒张末内径[SMD=-0.37,95%CI(-0.75,0.01),P=0.06]、增加每分博出量[MD=0.12,95%CI(0.06,0.18),P=0.000 1],改善血液指标如降低血液中脑钠肽浓度[SMD=-1.30,95%CI(-1.75,-0.85),P<0.000 1],改善行动能力如增加6 min步行距离[SMD=0.92,95%CI(0.56,1.28),P<0.000 1]等方面有显著作用。结论注射用益气复脉(冻干)联合西医常规治疗在治疗心力衰竭方面具有良好的效果。受所纳入文献的研究数量及质量所限,需开展更多高质量的研究以对结论予以进一步验证。
Objective To systemically reviewthe efficacy and safety of Yiqifumai injection( lyophilization)for the heart failure( HF) patients. Methods We searched Pub Med,CNKI and other electronic datasets for randomized controlled trials( RCTs) dated through March 2017 to assess the treatment effects of Yiqifumai injection( lyophilization) in HF patients. Statistical analyses were performed using ReviewManager 5. 3.Results Twenty-fiverandomized controlled trials( n = 2 381 patients) were included which showed that Yiqifumai( lyophilization) could improve clinical comprehensive effects( OR,2. 96; 95% CI,2. 23 to 3. 94,P < 0. 000 1),the left ventricular ejection fraction( LVEF)( SMD,0. 88; 95% CI,0. 65 to 1. 10,P <0. 000 1),and cardiac output( CO)( MD,0. 12; 95% CI,0. 06 to 0. 18,P = 0. 000 1). It could lower left ventricular end-diastolic diameter( LVEDD)( SMD,-0. 37; 95% CI,-0. 75 to 0. 01,P = 0. 06),and reduce brain natriuretic peptide( BNP)( SMD,-1. 30; 95% CI,-1. 75 to-0. 85,P < 0. 000 1). Furthermore,certain improvement in 6-minute walk test( 6 MWT) was also observed( SMD,0. 92; 95% CI,0. 56 to 1. 28,P < 0. 000 1). Conclusions Yiqifumai injection( lyophilization) combined with conventional western medicine has good clinical performance in to treating heart failure. Due to the limitations of number and quality of the included RCTs in this study,the study calls for more high quality RCTs to further investigate the effects.
关键词(KeyWords)：
注射用益气复脉(冻干);心力衰竭;Meta分析
Yiqifumai injection(lyophilization);heart failure;Meta-analysis
基金项目(Foundation): 国家自然科学基金面上项目(71473202)
作者(Author):
熊尧,徐程,陈嘉音,杨悦
XIONG Yao,XU Cheng,CHEN Jia-yin,YANG Yue
DOI: 10.14066/j.cnki.cn21-1349/r.2017.05.013
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