浏览全部资源
扫码关注微信
1.中国中医科学院广安门医院心血管科,北京 100053
2.北京中医药大学研究生院,北京 100105
Published:15 April 2023,
Received:19 September 2022,
Revised:29 January 2023,
扫 描 看 全 文
郑超楠,李军,解紫从等.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 Δ[J].中国药房,2023,34(07):872-877.
ZHENG Chaonan,LI Jun,XIE Zicong,et al.Efficacy and safety of Shenfu injection combined with chemical medicine in the treatment of coronary heart disease combined with heart failure: a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(07):872-877.
郑超楠,李军,解紫从等.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 Δ[J].中国药房,2023,34(07):872-877. DOI: 10.6039/j.issn.1001-0408.2023.07.20.
ZHENG Chaonan,LI Jun,XIE Zicong,et al.Efficacy and safety of Shenfu injection combined with chemical medicine in the treatment of coronary heart disease combined with heart failure: a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(07):872-877. DOI: 10.6039/j.issn.1001-0408.2023.07.20.
目的
2
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
2
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、the Cochrane Library,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RevMan 5.3软件进行Meta分析和Egger’s检验,运用TSA 0.9.5.10 Beta软件进行试验序贯分析。
结果
2
纳入17项研究,共计1 355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
<0.000 01]、脑钠肽降低水平[MD=-96.06,95%CI(-116.47,-75.64),
P
<0.000 01]、左室射血分数提高水平[MD=5.32,95%CI(4.03,6.60),
P
<0.000 01]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
2
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。
OBJECTIVE
2
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
2
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
2
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
2
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.
参附注射液冠心病心力衰竭疗效Meta分析试验序贯分析
coronary heart diseaseheart failureefficacymeta-analysistrial sequential analysis
中国康复医学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会. 慢性稳定性心力衰竭运动康复中国专家共识[J]. 中华心血管病杂志,2014,42(9):714-720.
国家卫生计生委合理用药专家委员会,中国药师协会.冠心病合理用药指南:第2版[J].中国医学前沿杂志,2018,10(6):1-130.
PACHO C,DOMINGO M,NÚÑEZ R,et al. Predictive biomarkers for death and rehospitalization in comorbid frail elderly heart failure patients[J]. BMC Geriatr,2018,18(1):109.
罗秀琼,苟红霞,陈洪梅,等. 老年冠心病合并心力衰竭患者自我效能和生活质量现状及影响因素调查研究[J]. 预防医学情报杂志,2020,36(11):1455-1459.
孙杨. 冠心病合并心力衰竭中医治则治法研究[D]. 沈阳:辽宁中医药大学,2017.
梁春华. 参附注射液对慢性心力衰竭心肾阳虚证患者免疫功能和细胞因子的影响[J]. 慢性病学杂志,2019,20(3):441-443.
施洋,王玲燕,李澜,等. 参附注射液对心血管疾病的临床及药理学研究进展[J]. 天津中医药,2016,33(10):637-640.
中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南:2014[J]. 中华心血管病杂志,2014,42(2):98-122.
郑筱萸. 中药新药临床研究指导原则:试行[M]. 北京:中国医药科技出版社,2002:77-85.
陈灏珠,林果为. 实用内科学[M]. 13版. 北京:人民卫生出版社,2009:1371.
SUB-COMMITTEE G. 1999 World Health Organization international society of hypertension guidelines for the management of hypertension guidelines sub-committee[J]. J Hypertension,1999,17(2):151-183.
陈志朝. 参附注射液治疗冠心病慢性心衰的临床价值[J]. 实用中西医结合临床,2020,20(15):6-7.
黄敏旋,周衍国,谢锦智,等. 参附注射液治疗老年性冠心病慢性心力衰竭的效果[J]. 慢性病学杂志,2019,20(9):1396-1397,1400.
李晓迪. 参附注射液治疗冠心病慢性心力衰竭的效果观察[J]. 中外医学研究,2019,17(28):156-157.
刘莉莉,张海波. 参附注射液对冠心病心衰患者心率变异性的影响分析[J]. 数理医药学杂志,2020,33(11):1707-1708.
毛兴珍. 参附注射液治疗冠心病慢性心力衰竭患者的临床效果[J]. 包头医学院学报,2016,32(12):92-93.
田丽娜. 参附注射液对冠心病心力衰竭患者心功能指标及临床疗效的影响[J]. 山西医药杂志,2010,39(5):464.
王红,姜涛. 参附注射液辅助常规化学药治疗冠心病慢性心力衰竭[J]. 深圳中西医结合杂志,2018,28(19):46-48.
吴红金,段姝伟. 参附注射液治疗冠心病心力衰竭的临床研究[J]. 中西医结合心脑血管病杂志,2009,7(5):505-507.
吴淑红. 参附注射液对冠心病心力衰竭常规治疗效果的促进作用观察[J]. 中医药临床杂志,2016,28(10):1451-1453.
伍琼,黄超. 参附对冠心病心力衰竭患者血清脂蛋白a的影响[J]. 实用医学杂志,2012,28(17):2948-2950.
杨丽敏. 参附注射液对冠心病心力衰竭30例血浆C反应蛋白浓度临床分析[J]. 中国医药指南,2009,7(12):206-207.
张春茹,吕健,郝丹. 参附注射液在冠心病合并心衰治疗中对心功能及心率变异性的影响分析[J]. 健康女性,2021(19):104.
张志民. 参附注射液治疗老年性冠心病慢性充血性心力衰竭30例[J]. 福建中医药,2003,34(4):24.
周锴,林盛毅,杨伟敏. 参附注射液对冠心病心力衰竭患者NT-proBNP的影响[J]. 中国中医急症,2013,22(9):1625-1626.
周晓芳. 参附注射液联合磷酸肌酸钠治疗冠心病合并急性左心衰的临床研究[J]. 四川生理科学杂志,2021,43(3):403-405.
周志天,李翊卫,祝红明. 参附注射液对冠心病心力衰竭患者血浆C反应蛋白浓度的影响[J]. 天津中医药,2005,22(3):209-210.
罗玉梅. 参附注射液治疗冠心病心衰的临床疗效分析[J]. 西藏医药,2017,38(1):36-38.
何志凌,招煦杰,谢雯雯. 参附注射液对心源性休克动物模型心功能指标的影响及通过NF-κB通路的调控机制研究[J]. 中华中医药学刊,2021,39(9):248-252,274.
ZHANG X P,LI K R,YU Q,et al. Ginsenoside Rh2 inhibits vascular endothelial growth factor-induced corneal neovascularization[J]. FASEB J,2018,32(7):3782-3791.
蓝国辉. 参附注射液联合维拉帕米治疗低血压性阵发性室上性心动过速疗效观察[J]. 中医临床研究,2021,13(25):109-112.
杨玉红,杨阳,裴树亮,等. 参附注射液联合多巴胺对急性下壁心肌梗死介入术后低血压病人血压的影响[J]. 中西医结合心脑血管病杂志,2019,17(11):1675-1677.
林潘宏,李航,刘楚永. 小剂量多巴胺、呋塞米静脉泵入联合参附注射液治疗Ⅰ型心肾综合征合并利尿剂抵抗的疗效及对神经内分泌系统和炎性反应的影响[J]. 现代中西医结合杂志,2019,28(8):871-875.
HEIDENREICH P A,BOZKURT B,AGUILAR D,et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure:a report of the American College of Cardio- logy/American Heart Association Joint Committee on clinical practice guidelines[J]. Circulation,2022,145(18):e895-e1032.
0
Views
8
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution