参附注射液治疗休克的系统评价及Meta分析

System Evaluation and Meta analysis of Shenfu Injection in the Treatment of Shock

目的:系统评估常规治疗基础上加用参附注射液对休克的影响。方法:检索中国知网(CNKI)、中国医学文献数据库(CBMdisc)、万方、维普等数据库,结合手工检索搜集有关参附注射液治疗休克的随机对照试验,按照Cochrane协作网推荐的方法评价纳入研究的方法学质量,应用Rev Man5软件对纳入文献进行异质性检验和合并效应量分析。结果:符合纳入标准的文献共17篇共计974例,其研究质量均为C级。Meta分析表明,参附注射液配合西医常规能更好地提高休克的临床疗效[RR=2.38,95%CI(1.59,3.56),P<0.0001],升高收缩压[WMD=6.52,95%CI(3.60,9.44),P<0.0001],改善心率[WMD=12.24,95%CI(8.81,15.67),P<0.00001],增加心室射血分数[WMD=9.79,95%CI(2.67,16.91),P=0.007],与单纯西医常规治疗比较差异有统计学意义。结论:在西医常规基础上加用参附注射液治疗休克有一定的疗效优势。

Objective：To evaluate the effectiveness and safety of ShenFu Injection plus Routine Western Medicine for Shock. Methods： Four electronic literature databases including CNKI, Wanfang Data, VIP, and SinoMed were searched to identify eligible controlled examing ShenFu for Shock, We also hand-searched relevant Chinese journals for potentially eligible clinical studies. The quality of included studies was assessed against entries of the Risk of Bias table as recommended in the Cochrane handbook, Data was analyzed using RevMan 5. Results： A total of seventeen studies involving 974 patients met the inclusion criteria for this review, quality of these studies are C level. Meta-analysis showed that ： ShenFu Injection combined with Routine Western Medicine has better effect on shock in improving the clinical efficacy [RR=2.38, 95% CI（1.59, 3.56）,P 〈0.0001~.elevating systolic blood pressure[WMD =6.52, 95% CI（3.60, 9.44） ,P 〈 O. 0001 ]. improving heat rate [ WMD = 12.24, 95% CI （ 8.81, 15.67 ） , P 〈 0. 00001 ]. increasing ejection fraction and improving cardiac function [ WMD = 9.79, 95% CI （ 2.67, 16.91 ） , P = 0. 007 ]. There was statistically significant difference compared with the pure western medicine treatment. Conclusion： On the basis of Routine Western Medicine combined with Shenfu Injection in the treatment of shock has some advantages in efficacy.