黄芪注射液治疗成人病毒性心肌炎疗效的Meta分析

Meta-analysis on curative effect of Huangqi Injection on adult viral myocarditis

目的：评价黄芪注射液治疗成人病毒性心肌炎的临床疗效。方法计算机检索PubMed、MEDLINE、Cochrane Central Register of Controlled Trials、中国学术期刊网络出版总库CNKI （1994-2013）、万方医学数据库（1999-2013）、维普中文科技期刊全文数据库（1989-2013）中关于常规西医疗法联合黄芪注射液治疗（试验组）对比常规西医治疗（对照组）成人病毒性心肌炎的随机对照试验，对符合标准的随机对照试验进行Meta分析。结果共有14篇符合条件文献入选，所有文献质量均为B级。Meta分析结果显示，试验组疗效优于对照组，总效应Z=8.91（P＜0.001），OR值及95％CI：4.55（3.26～6.35）；治疗结束时心电图的ST-T段改变和早搏减少的有效率也具有统计学差异，ST-T段改变OR值及其95％CI：5.82（3.40～9.96），早搏减少OR值及其95％CI：4.88（2.83～8.41）；漏斗图分析结果显示两组疗效和心电图改变的Meta分析结果存在偏倚的可能性较小。结论病毒性心肌炎成人患者在常规治疗基础上联合应用黄芪注射液可明显改善患者临床疗效及症状。

Objective To review the curative effect of Huangqi Injection on adult viral myocarditis. Methods The databases of PubMed, MEDLINE, CCTR, CNKI （1994-2013）, Wanfang （1999-2013） and VIP （1989-2013） were retrieved for collecting the randomized controlled trials （RCTs） on the comparison of treating adult viral myocarditis with routine Western medical therapy combining Huangqi Injection （experimental group） or routine Western medical therapy （control group）. The eligible RCTs were given Meta-analysis. Results There were totally 14 eligible RCTs included and the quality of all RCTs reached grade B. The results of Meta-analysis showed that the curative effect was better in experimental group than that in control group and the total effective rate was Z=8.91 （P〈0.001, OR=4.55, 95%CI：3.26-6.35）. When the treatment ended, the changes of ECG ST-T segment and effective rate of premature beat had statistical difference （changes of ECG ST-T segment：OR=5.82, 95%CI：3.40-9.96;decrease of premature beat：OR=4.88, 95%CI：2.83-8.41）. The analysis results of funnel plots showed that there was barely bias in the Meta-analysis on curative effect and ECG changes. Conclusion Routine Western medical therapy combining Huangqi Injection can significantly improve curative effect and relief the symptoms in the patients with adult viral myocarditis.