参附注射液治疗老年患者心力衰竭的系统评价

Shenfu Injection for Heart Failure in Old Patients:A Meta-analysis

目的评价参附注射液治疗老年人心力衰竭疗效和安全性。方法计算机检索Cochrane图书馆,Medline(1950年-2013年10月),Embase(1980年-2013年10月),中国知网(1979年1月-2013年10月)、万方(1986年1月-2013年10月)、维普(1989年1月-2013年10月)数据库,全面收集参附注射液联用西药常规治疗(试验组)与西药常规治疗疗效(对照组)比较的随机对照试验(RCT),分别由2名研究者根据纳入与排除标准,独立筛选文献、提取资料并评价文献质量,采用Revman 5.1软件进行Meta分析。结果共纳入8个研究559例患者,研究质量均为C级。Meta分析结果显示:与对照组比较,试验组临床疗效明显提高、症状改善[RR=1.20,95%CI(1.11,1.29),P<0.000 01],左室舒张末期内径减小明显[MD=5.90,95%CI(3.97,7.84),P<0.000 01]、6 min步行试验距离增加[MD=62.48,95%CI(43.12,81.84),P<0.000 01],但左室射血分数两组差异无统计学意义[MD=4.79,95%CI(-0.07,9.65),P=0.05]。结论参附注射液与西药常规治疗联用能进一步提高老年心力衰竭患者的临床疗效,且安全性较好。

Objective To evaluate the efficacy and safety of shenfu injection for heart failure in old patients. Methods The Cochrane Library, Medline （1950 -- 2013）, Embase （1980 -- 2013）, CNKI （1979 -- 2013）, VIP （1989 -- 2013） and Wanfang （1986 -- 2013） were searched and the randomized controlled trials （RCTs） meeting the inclusion criteria were included, and then the data were analyzed by Revman 5.1. Results Eight studies were included, with 559 participants, and the quality of the studies were grade C. The results of Meta-analysis were： compared with the control group, the shenfu injection could significantly improve the clinical efficacy [RR=l.20, 95%CI （1.11, 1.29）, P 〈 0.000 01 ], reduce the left ventricular end diastolic diameter [MD=5.9, 95%CI （3.97, 7.84）, P 〈 0.000 01], and increase the 6-minute walk distance [MD=62.48, 95%CI （43.12, 81.84）, P 〈 0.000 01 ], but there was no significant difference in left ventricular ejection fraction [MD=4.79, 95%CI （-0.07, 9.65）, P=-0.05]. Conclusion The combined administration of shenfu injection and western medicine can highly improve the efficacy for heart failure in old patients.