参麦注射液治疗小儿病毒性心肌炎的Meta分析

A meta- analysis of shen mai injection treated for viral myocarditis among children

目的分析参麦注射液治疗小儿病毒性心肌炎的疗效及安全性。方法搜集参麦注射液治疗小儿病毒性心肌炎的随机对照试验文献，筛选合格研究，应用Jadad评分法进行质量评价，运用异质性检验、Meta-分析、漏斗图分析等方法统计相关数据。结果7项研究符合纳入标准，无异质性（p=6．24，P=0．397），参麦注射液治疗小儿病毒性心肌炎的有效率高于对照组，总有效率的跗溶并=1．25，95％CI为（1．15，1．36），参麦组比对照组平均有效率高19％，95％CI为（12％，26％），P=0．000。累积Meta分析提示，随着样本含量的增加估计值越精确。Begg秩相关检验提示无发表偏倚（P=0．548）。结论系统评价结果显示参麦注射液治疗小儿病毒性心肌炎有效。由于纳入研究质量普遍较低、存在发表性偏倚的可能等因素影响，降低了分析结论的可靠性。要进一步验证参麦注射液治疗病毒性心肌炎的疗效及安全性，尚需进行设计合理、执行严格、多中心大样本且随访时间足够的随机对照试验。

Objective To analysis the efficacy and safety of shen mai injection treated for viral myocarditis among children. Methods We searched databases to find relevant randomized controlled trials and screen of qualified researches, which was applied with Jadad scoring system for quality asseasment.Thon all the studies applied a meta-analysis,heterogeneity and funnel plot analysis with software of Stata 10.0. Results Seven publications were identified and found no heterogeneity（ Q = 6.24, P = 0.397）.The total rata of eglcacy was higher in shen mai group than control group.The pooled RR for the study was 1.25（95% CI： 1. 15,1.36 ）. The average efficacy in shen mai group was more than control group 19% （95 % CI： 12 %, 26 % ）, P = 0.000. The cumulative summary effects showed that the larger the sample size,the more accurate the estimation.Publication bias were not found in the study,by using Begg＇s test method（ P = 0.548）. Conclusion Meta analysis showed that shen mai injection was effective on the treatment of viral myecarditis among children. Because the incorporation of the quality of research was generally low, the reli-ability of conclusions was reduced. To further verify the efficacy and safety of shen mai injection, we still need to design the randomized controlled trials of reasonable,strict,multi-center large sample and the follow-up of enough time.