摘要
目的系统评价生脉注射液治疗急性心肌梗死(AMI)对病死率的影响。方法计算机检索Co- chrane数据库(2007年第3期)、PubMed(1980—2007)、EMBASE(1979—2007.4)、OVID(1979—2007.4)、中国生物医学文献光盘数据库(CBM,1979—2007.4)、中国学术期刊全文数据库(CNKI,1980—2007.4)、中文科技期刊数据库(VIP,1989—2007.4),手工检索国内心血管疾病会议论文集,筛选生脉注射液治疗AMI的随机对照试验(RCT)和半随机对照试验。采用Cochrane Handbook for Systematic Reviews of Interventions 4.2.6中的方法进行文献质量评价,应用RevMan 4.2.9软件进行统计分析。结果共纳入4个RCT的376例AMI患者,纳入研究质量均为C级。Meta分析结果显示,使用生脉注射液的治疗组病死率降低[RR:0.18,95%CI(0.04,0.77)],但使用血管活性药物的生脉注射液治疗组病死率降低趋势不明显[RR:0.67,95%CI(0.29,1.51)]。结论根据当前证据,西医常规治疗联用生脉注射液可以降低AMI病死率,但有必要对使用血管活性药物治疗AMI时是否加用生脉注射液及加用的时机、方法进行进一步研究。由于纳入研究质量较低,从这些研究中所获得的证据强度不高,有待更多高质量研究加以验证。
Objective To systematically evaluate the therapeutic efficacy of Shengmai Injection （SMI） on the fatality rate of patients with acute myocardial infarction （AMI）. Methods Literature associated with randomized controlled trials （RCT） or quasi-RCT of SMI in treating patients with AMI were retrieved by computerized searching from Cochrane Central Register of Controlled Trials （Issue 3, 2007） , PubMed （1980-2007）, EMBASE （1979- 2007.4） , OVID （ 1979 - 2007.4） , Chinese Biological Medicine Database （ 1979 - 2007.4） , CNKI （ 1980 - 2007.4）, VIP （1989 -2007.4）and those in Chinese Conference Treatises in cardiovascular diseases were hand searched （update to Dec 2006）. Quality of them was evaluated with the method recommended in Cochrane Review- er＇s Handbook 4.2.6, and statistical analysis was performed using the Cochrane Collaboration＇s Rev Man 4.2.9 software. Results Four RCT （ conducted in China） , involving 376 AMI patients meeting the inclusion criteria were identified. All the included RCT were graded as C. The results of meta-analyses indicated that the fatality rate in the SMI treated group was cut down [ RR： 0.18, 95% CI （0.04, 0.77） ] , but the decreasing trend become insignificant when SMI was used in combination with vasoactive agents （ RR：0. 67 ,95% CI （0.29, 1.51 ） ]. Conclusions According to the present evidence, the fatality rate can be decreased by combined use of SMI with the conventional therapy of modern medicine. However, it is necessary to do further research on whether SMI is suitable for combined use with vasoactive agent, the opportunity and method of doing that way. As the evidence ob- tained is not strong enough due to the rather poor quality of current studies enclosed, further studies with high-quality, large-scale trials are required for identification.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2008年第12期1069-1073,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
国家科技支撑计划
急性冠脉综合征中西医结合综合治疗方案的研究(No.2006BA104A01
临床试验注册号ChiCTR-TRC-00000021)
关键词
生脉注射液
急性心肌梗死
系统评价
病死率
Shengmai Injection
acute myocardial infarction
systematic review
fatality rate
