摘要
目的系统评价中药注射液(CMI)治疗急性心肌梗死(AMI)后心力衰竭(HF)的疗效。方法计算机检索CNKI、WanFang Data、VIP、The Cochrane Library、PubMed和EMbase数据库,搜集关于CMI治疗AMI后HF的随机对照试验(RCTs),检索时限均为从建库至2021年10月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用ADDIS1.16.6和Stata 16.0软件进行网状meta分析。结果共纳入55项研究,包括4760例AMI后HF患者,提取出3种CMIs,分别为参麦注射液、参附注射液、心脉隆注射液。网状meta分析结果显示,心脉隆注射液在提高总有效率、减小左心室舒张末内径(LVEDD)方面疗效优于参麦注射液及参附注射液,参麦注射液在降低B型利钠肽(BNP)方面优于心脉隆注射液及参附注射液,参附注射液在提高左心室射血分数(LVEF)、降低心率方面优于参麦注射液及心脉隆注射液。结论在常规西药治疗基础上联合此3种CMIs均可提高AMI后HF的临床疗效。其中,在提高总有效率、减小LVEDD方面心脉隆注射液更好,降低BNP方面参麦注射液更有优势,提高LVEF、降低心率方面参附注射液疗效最好。
Objective This study aimed to systematically evaluate the efficacy of Chinese medicine injection(CMI)in the treatment of heart failure(HF)after acute myocardial infarction(AMI).Methods China National Knowledge Infrastructure(CNKI),WanFang Data,VIP,The Cochrane Library,PubMed,and EMbase databases were electronically searched from inception to October 2021 to identify randomized controlled trials(RCTs)on CMI for treating HF after AMI.Two reviewers independently screened literature,extracted data,and evaluated the bias risk of included studies.Network meta-analysis was then performed by ADDIS1.16.6 software and Stata 16.0 software.Results A total of 55 studies were included involving 4760 patients with HF after AMI and 3 types of CMIs,including Shenmai,Shenfu,Xinmailong injections.The results of network meta-analysis showed that Xinmailong injection was superior to Shenmai injection and Shenfu injection in improving the total effective rate and reducing left ventricular end diastolic diameter(LVEDD);Shenmai injection was superior to Xinmailong injection and Shenfu injection in reducing B-type natriuretic peptide(BNP);Shenfu injection was superior to Shenmai injection and Xinmailong injection in increasing left ventricular ejection fraction(LVEF)and reducing heart rate(HR).Conclusions The combined 3 types of CMIs for treating HF after AMI can improve the clinical efficacy when compared with conventional Western medicine treatment.Among them,Xinmailong injection is better in improving the total effective rate and reducing LVEDD,Shenmai injection is more advantageous in reducing BNP,and Shenfu injection has the best efficacy in improving LVEF and reducing HR.
作者
王东英
郭旭男
边云飞
Wang Dongying;Guo Xunan;Bian Yunfei(The Second Clinical Medical College of Shanxi Medical University,Taiyuan 030001,China;Department of Cardiovascular,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中国医师杂志》
CAS
2022年第10期1479-1487,1492,共10页
Journal of Chinese Physician
基金
国家自然科学基金(82070472)
