摘要
目的 评价血必净注射液治疗急性呼吸窘迫综合征（ARDS）的疗效和安全性.方法 检索2000年至2010年中国期刊网全文数据库（CNKI）、万方数据库、中文科技期刊数据库、中国生物医学文献数据库（CBM）、PubMed、Cochrane 临床试验数据库中有关血必净注射液治疗ARDS的临床随机对照试验文献,提取文献中的相关资料,采用Cochrane RevMan 5.0软件进行荟萃分析（Meta分析）.结果 符合纳入标准的文献共13篇,疗效指标以病死率、痊愈率、机械通气时间、入住重症监护病房（ICU）时间、氧合指数（PaO2/FiO2）、动脉血氧分压（PaO2）等进行分析.Meta分析显示：血必净组病死率明显低于对照组[优势比（OR）为0.41,95%可信区间（95%CI）为0.27～0.62,P＜0.000 1];痊愈率明显高于对照组（OR为2.58,95%CI为1.49～4.48,P=0.000 7）;机械通气时间较对照组明显缩短[权重均数差值（WMD）为2.03,95%CI为3.38～0.68,P=0.003];入住ICU时间较对照组明显缩短（WMD为3.60,95%CI为4.49～2.71,P〈0.000 01）;治疗后PaO2/FiO2、PaO2均较对照组明显升高（PaO2/FiO2：WMD为56.15,95%CI为42.97～69.33;PaO2：WMD为8.87,95%CI为5.70～12.04,均P＜0.000 01）.试验未报告有严重不良反应发生.结论 血必净注射液治疗ARDS有一定优势;但纳入的文献方法学质量较低,有待更多高质量的试验进一步验证.
Objective To evaluate the efficacy and safety of Xuebijing injection （血必净注射液） for treatment of acute respiratory distress syndrome （ARDS）. Methods Searches were applied to the following electronic databases： the CNKI, Wanfang, VIP Database for Chinese Technical Periodicals, CBM, PubMed and the Cochrane; in the registers from 2000 to 2010, literatures regarding randomized controlled trials （RCTs） of Xuebijing injection in treating ARDS were reviewed. Data were collected and the Cochrane Collaboration＇s RevMan 5.0 was used for Meta analysis. Results Thirteen RCTs conformed to the inclusion criteria were reviewed, the main indicators of efficacy included fatality rate, cure rate, the duration of mechanical ventilation and stay in intensive care unit （ICU）, oxygenation index （PaO2/FiO2）, arterial partial pressure of oxygen （PaO2）, etc. Meta analysis results demonstrated that the clinical therapeutic effect for ARDS treated with Xuebijing injection and routine western medicine was better than that treated by routine western medicine alone, and reflected mainly in the following ： reducing the mortality rate [odds ratio （OR） ： 0.41, 95 % confidence interval （95%CI）： 0.27 - 0.62, P〈0. 000 1], enhancing the cure rate （OR：2. 58, 95%CI： 1.49 - 4.48, P ： 0. 000 7）, decreasing the duration of mechanical ventilation [weighted mean difference （WMD）： 2.03, 95%CI： -3.38 0.68, P=0.003] and of staying in ICU （WMD：-3.60, 95~ CI： - 4.49 2.71, P^0.000 01）, increasing PaOJFiO2 and PaO2 （PaO2/FiO2： WMD 56.15, 95%CI 42.97 - 69.33; PaO2： WMD 8.87, 95%CI 5.70 12.04, both P〈0. 000 01）. There were no serious adverse reactions in both groups. Conclusion Xuebijing injection for the treatment of ARDS has certain advantages, but the quality of the inclusive literatures was not very high, thus further analyses with higher standard trials are needed.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2011年第2期69-74,共6页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
国家重点基础研究发展计划（973计划）项目资助（2006CB504605）
河南省高校新世纪优秀人才支持计划项目资助（2006HANCET-05）
