黄芪注射液联合曲美他嗪治疗病毒性心肌炎疗效与安全性的Meta分析

Meta-analysis of the Efficacy and Safety of Astragali Radix Injection Combined with Trimetazidine in the Treatment of Viral Myocarditis

目的:系统评价黄芪注射液联合曲美他嗪治疗病毒性心肌炎(VMC)的疗效和安全性,以为临床治疗提供循证参考。方法:计算机检索Pub Med、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据库,收集黄芪注射液联合曲美他嗪(试验组)对比西医常规治疗和/或加用曲美他嗪(对照组)治疗VMC的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取和质量评价后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入14项RCT,合计1 324例患者。Meta分析结果显示,试验组患者总有效率[RR=1.32,95%CI(1.25,1.39),P<0.001]、乳酸脱氢酶水平[MD=-99.80,95%CI(-135.52,-64.08),P<0.001]和肌酸激酶水平[MD=-49.66,95%CI(-80.43,-18.90),P=0.002]均显著优于对照组,差异均有统计学意义;两组患者不良反应发生率比较,差异无统计学意义[RR=0.86,95%CI(0.48,1.55),P=0.61]。结论:黄芪注射液联合曲美他嗪治疗VMC的疗效与安全性均较好。

OBJECTIVE：To systematically evaluate the efficacy and safety of Astragali radix injection combined with trimetazi-dine in the treatment of viral myocarditis （VMC）,and provide evidence-based reference for clinical treatment. METHODS：Re-trieved from PubMed,CBM,CJFD,VIP and Wanfang Database,randomized controlled trials（RCT） about Astragali radix injec-tion combined with trimetazidine（test group）vs. western conventional treatment and（or）trimetazidine alone（control group）in the treatment of VMC were collected. After quanlity evaluation and data extraction,Meta-analysis was conducted by using Rev Man 5.2 statistics software. RESULTS：A total of 14 RCT were included,involving 1 324 patients. Results of Meta-analysis showed the total effective rate[RR=1.32,95%CI（1.25,1.39）,P〈0.001],lactate dehydrogenase level [MD=-99.80,95%CI（-135.52,-64.08）, P〈0.001] and creatine kinase level [MD=-49.66,95%CI（-80.43,-18.90）,P=0.002] in test group were significantly lower than those of control group,there was sgnificant difference between 2 groups;and there was no significant difference in the inci-dence of adverse reactions[RR=0.86,95%CI（0.48,1.55）,P=0.61]. CONCLUSIONS：Astragali radix injection combined with trimetazidine has good efficacy and safety in the treatment of VMC.