黄芪注射液辅助治疗病毒性心肌炎的系统评价

Systematic Review on Astrsgulas Membranaceus Injection in the Treatment of Viral Mycarditis

目的:系统评价黄芪注射液辅助治疗病毒性心肌炎(VMC)的有效性。方法:计算机检索PubMed、Medline、Embase、Co-chrane图书馆和CBM、VIP及CNKI数据库。按纳入与排除标准选择文献,对纳入研究的方法学质量进行评价,提取资料后采用RevMan5.0软件对数据进行Meta分析。结果:共纳入15篇随机对照试验,1886例患者。Meta分析结果显示,黄芪注射液加常规西药治疗VMC的总有效率、病毒学指标阴转率、左室射血分数、肌酸磷酸肌酶、天冬氨酸氨基转移酶水平与单纯西药治疗比较,差异有统计学意义(P<0.05),在改善乳酸脱氢酶水平方面,2组比较差异无统计学意义(P>0.05)。结论:黄芪注射液+牛磺酸/丹参与西药联用治疗VMC比单纯西药治疗疗效更佳。但由于纳入研究较少,研究质量不高,上述结论还需多中心、大样本、随机双盲对照临床试验加以证实。

OBJECTIVE：To evaluate the efficacy of Astragulas membranaceus injection in the treatment of viral myocarditis（VMC）.METHODS：Relevant literatures were retrieved from PubMed,Medline,Embase,Cochrane Library,CBM,VIP,CNKI databases.Methodological quality of included literatures was evaluated and Meta-analysis was conducted using RevMan 5.0 software.RESULTS：1 886 cases of 15 RCTs were included.Results of Meta-analysis showed that there was significantly statistical difference between Astragulas.membranaceus combined with western medicine and western medicine alone in the treatment of VMC in respect of total response rate,virological index negative rate,LVEF,CPK,AST（P0.05）.The level of LDH had no significantly statistical difference（P0.05）.CONCLUSIONS：Compared with western medicine monotherapy,Astragulas.membranaceus injection＋taurine/Salvia miltiorrhiza can significantly improve clinical efficacy.Multi-centre large-scale double-blind randomized controlled trials are required because the scale and quality of included studies are not satisfactory.