摘要
目的:评价生脉注射液干预急性心肌梗死的疗效。方法:系统检索Cochrane图书馆、Pub Med、EMbase、CBM、CNKI、VIP等中外生物医学数据库(截至2015年12月),全面收集有关生脉注射液治疗急性心肌梗死的临床随机对照试验(RCT),文献质量评价参照Cochrane系统评价员手册。采用Rev Man 5.2软件进行Meta分析。结果:本研究共纳入15项研究,共计1114例患者。Meta分析结果显示:生脉注射液改善心功能的总有效率优于常规治疗组[OR=4.37,95%CI(2.49,7.65),P<0.000 01],生脉注射液使血压回升的总有效率也优于常规治疗组[OR=4.45,95%CI(2.17,9.14),P<0.000 01],降低病死率趋势明显[RR=0.61,95%CI(0.45,0.84),P=0.002],对血管再通也显示出一定的作用[OR=3.39,95%CI(2.02,5.70),P<0.000 01]。结论:现有证据表明,生脉注射液显示出能改善心功能,改善梗死后低血压,降低病死率,增加冠脉再通率的作用。由于本研究纳入研究方案差异较大,质量相对不高,故生脉注射液对急性心肌梗死的疗效尚缺乏可靠证据的支持,有待于更多高质量研究的开展以进一步证实其疗效。
Objective:To evaluate the efficacy of Shengmai Injection for acute myocardial infarction. Methods: Ran- domized controlled trials (RCTs) about treating acute myocardial infarction with Shengmai Injection were collected by searching Cochrane library, PubMed, EMbase, CBM, CNKI and VIP( ending Dec. 2015 ). Quality of literature was evalua- ted according to Cochrane system evaluation manual. And then, the Meta - analysis was performed by using RevMan 5.2 software. Results: Fifteen RCTs involving 1114 patients were included. The results of Meta- analysis showed compared with routine treatment alone, Shengmai Injection in combination of routine treatment improved total effective rates for heart function improvement( OR,d. 37 ;95% CI,2.49,7.65 ;P 〈 0. 000 01 ). Also, Shengmai Injection in combination of rou- tine treatment improved total effective rates for blood pressure improvement ( OR, 4.45; 95% CI, 2. 17, 9. 14, P 〈 0.000 01 ). The effect on mortality ( RR,0.61 ;95 % CI,0. 45 ,0. 84 ; P = 0. 002) were significant. The effect on rate of recanalization ( OR,3.39 ; 95 % CI, 2.02,5.70 ; P 〈 0. 000 01) were also significant. Conclusion : Current evidence suggests that Shengmai Injection is effective in treating acute myocardial infarction, especially in improving heart function, hypotension,mortality and vascular patency rate. However, the strength of evidence is affected by poor methodological quality of the included studies. High - quality trials with large sample size are needed to verify its clinical effects.
出处
《中华中医药学刊》
CAS
北大核心
2016年第11期2713-2717,共5页
Chinese Archives of Traditional Chinese Medicine
基金
江苏省药学会-百特生物药学基金科研项目(2014-09)
关键词
生脉注射液
急性心肌梗死
META分析
随机对照试验
疗效
Shengmai Injections
acute myocardial infarction
Meta - analysis
randomized controlled trial
effect