摘要
目的系统评价血必净注射液治疗脓毒症的临床疗效和安全性。方法检索PubMed、Cochrane Library、中国知网(CNKI)、万方数据库、维普数据库等,2000年1月至2019年7月发表的有关血必净治疗脓毒症的随机对照试验。对照组为常规治疗;试验组为常规治疗基础上联用血必净注射液治疗。纳入文献经Cochrane偏倚风险评价表进行评价,用RevMan 5.3软件对血必净注射液治疗脓毒症患者28 d病死率、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、白细胞计数(WBC)、C-反应蛋白(CRP)及安全性进行Meta分析,并用漏斗图评价28 d病死率的发表偏倚。结果共纳入14篇文献、累计938例患者,其中试验组475例,对照组463例。Meta分析显示,与对照组比较,试验组28 d病死率明显下降〔相对危险度(RR)=0.52,95%可信区间(95%CI)为0.40~0.67,P<0.00001,I^2=0%〕,APACHEⅡ评分明显降低〔均数差(MD)=-5.48,95%CI为-7.52^-3.43,P<0.00001,I^2=86%〕,WBC明显下降(MD=-2.26,95%CI为-3.35^-1.17,P<0.0001,I^2=87%),CRP明显下降(MD=-37.43,95%CI为-56.70^-18.16,P=0.0001,I^2=99%)。14篇文献均未报道血必净注射液的安全性,但也均无参与者中途退出研究的报道。漏斗图分析显示,报道28 d病死率的各研究间存在发表偏倚。结论血必净注射液能够改善脓毒症患者的临床症状,显著降低病死率,具有较高的临床应用价值。
Objective To evaluate the efficacy and safety of Xuebijing injection for treating sepsis by systematic review.Methods Randomized controlled trials(RCT)of relevant Xuebijing injection for sepsis were searched in PubMed,Cochrane Library,CNKI,Wanfang database,VIP database from January 2000 to July 2019.Patients in control group were given conventional treatment,while patients in experimental group were treated with Xuebijing injection combined with conventional treatment.The qualities of the included trials were evaluated according to the Cochrane bias risk assessment tool.Meta-analysis of 28-day mortality,acute physiology and chronic health evaluationⅡ(APACHEⅡ),white blood cell count(WBC),C-reactive protein(CRP)and safety for sepsis patients with Xuebijing injection were conducted by RevMan 5.3 software.And the funnel chart was used to evaluate the publication bias of 28-day mortality.Results Fourteen clinical studies involving 938 patients in total were enrolled,among whom 475 cases in experimental group and 463 cases in control group.Meta-analysis showed that compared with the control group,the 28-day mortality,APACHEⅡscore,WBC and CRP of the experimental group were significantly decreased[28-day mortality:relative risk(RR)=0.52,95%confidence interval(95%CI)was 0.40 to 0.67,P<0.00001,I^2=0%;APACHEⅡscore:mean difference(MD)=-5.48,95%CI was-7.52 to-3.43,P<0.00001,I^2=86%;WBC:MD=-2.26,95%CI was-3.35 to-1.17,P<0.0001,I^2=87%;CRP:MD=-37.43,95%CI was-56.70 to-18.16,P=0.0001,I^2=99%].None of the 14 literatures reported the safety of Xuebijing injection,and there were no reports of participants'withdrawnness in halfway.Funnel chart analysis showed that there was a publication bias among studies with 28-day mortality.Conclusion Xuebijing injection can improve the clinical symptoms,significantly reduce the mortality,and has high clinical application value.
作者
吴玉娇
张晶
漆立军
Wu Yujiao;Zhang Jing;Qi Lijun(Department of Pharmacy,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,Hubei,China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2020年第6期691-695,共5页
Chinese Critical Care Medicine
