化瘀解毒之血必净注射液治疗重症肺炎疗效的系统评价

Stasis-resolving and Detoxifying Ef ect of Xuebijing Injection on Severe Pneumonia: A Systematic Review

目的 系统评价常规方案联合血必净注射液治疗重症肺炎的临床疗效，以期为临床实践提供更可靠的证据。方法 计算机检索PubMed（1990～2013.4）、EMbase（1990～2013.4）、The Cochrane Library （2013年第4期）、CNKI（1982～2013.4）、WanFang Data（1990～2013.4）、VIP（1989～2013.4）和CBM（1978～2013.4）数据库，查找有关采用血必净注射液治疗重症肺炎的随机对照试验（RCT）。由2位研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后，采用RevMan 5.2软件进行Meta分析。结果 最终共纳入12个研究，包括860例患者。Meta分析结果显示：常规方案联合血必净注射液与单纯常规方案比较，联合血必净组在总有效率、显效率、感染程度指标（WBC、CPIS、CRP）、炎症细胞因子（IL-6、IL-8、TNF-α）水平及平均住院天数等方面均优于常规治疗组，且差异均有统计学意义；但两组病死率差异无统计学意义。纳入研究均未报告明显不良反应。结论 现有证据显示，常规治疗联合血必净注射液较单纯常规治疗对重症肺炎有较好的治疗效果。但受纳入研究质量所限，上述结论尚需开展更多高质量、大样本的RCT加以验证。

ObjectiveTo systematically review the effectiveness of Xuebijing injection combined with routine therapy versus routine therapy alone in treating severe pneumonia. MethodsDatabases including PubMed （1990-2013.4）, EMbase （1990-2013.4）, The Cochran Library （Issue 4, 2013）, CNKI （1982-2013.4）, WangFang Data （1990-2013.4）, VIP （1989-2013.4） and CBM （1978-2013.4） were searched from inception to April, 2013, for randomized controlled trials （RCTs） on Xuebijing injection for severe pneumonia. Studies were screened according to the inclusion and exclusion criteria, data were extracted, and methodological quality was evaluated. Meta-analysis was then performed using RevMan 5.2 software. ResultsA total of 12 studies involving 860 patients were included. The results of meta-analysis showed that, routine therapy plus Xuebijing injection had higher total effective and excellent rates, and the combined therapy reduced the average hospitalization days, and they had better improvement in WBC, CRP, CPIS, IL-6, IL-8, TNF-α. ConclusionThis current evidence shows that Xuebijing injection has a better clinical efficacy in treating severe pneumonia. Traditional Chinese herbs with the function of “promoting blood circulation to remove blood stasis” may exert their pharmacological effects via a multi-target way in treating severe pneumonia, which have a great potential for both clinical work and scientific research. Due to the limited quality and quantity of the included studies, better designed RCTs are needed to support Xuebijing’s clinical efficacy in the treatment of severe pneumonia.