益气复脉注射液治疗心力衰竭的系统评价

Systematic Review of Yiqi Fumai Injection for Patients with Heart Failure

目的:系统评价益气复脉注射液联合西药常规治疗心力衰竭的临床疗效。方法:计算机检索Pub Med,CENTRAL,EMbase,VIP,CNKI,CBM和Wanfang等数据库,纳入随机对照试验(RCTs),经过文献筛选和评价质量后提取有效数据进行Meta分析。结果:共纳入13个RCTs合计1 001例患者。Meta分析结果显示,益气复脉注射液联合西药常规治疗心力衰竭在提高临床综合疗效[OR=3.09,95%CI(2.05,4.67),P<0.000 01],左室射血分数[MD=4.84,95%CI(3.56,6.13),P<0.000 01],心输出量[MD=0.30,95%CI(0.19,0.42),P<0.000 01],6 min步行距离[MD=39.03,95%CI(25.06,53.00),P<0.000 01],降低NT-pro BNP[MD=-67.72,95%CI(-110.30,-25.13),P=0.002],缩短左心室收缩末期内径[MD=-2.94,95%CI(-4,86,-1.02),P=0.000 3]等指标上均优于单用西药组,其差异均具有统计学意义,但两组在缩短左心室舒张末期内径[MD=-2.06,95%CI(-4.70,0.58),P=0.13]和提高舒张早期二尖瓣血流峰值/舒张晚期二尖瓣血流峰值[MD=0.06,95%CI(-0.03,0.15),P=0.21]的差异无统计学意义。结论:益气复脉注射液联合西药常规治疗心力衰竭的临床疗效优于单用西药。

Objective： To systematically review the effectiveness of Yiqi Fumai injection combined with western medicine for heart failure. Method： Databases such as Pub Med,CENTRAL,EMbase,VIP,CNKI,CBM and Wanfang were electronically searched to collect the randomized controlled trials（ RCTs）. After document screening and quality evaluation,Meta-analysis was conducted for valid data. Result： Thirteen RCTs involving1 001 patients were included. The results of meta-analysis showed that the combination of Yiqi Fumai injection and western medicine was superior to the western medicine alone in improving clinical comprehensive efficacy [OR =3. 09,95% CI（ 2. 05,4. 67）,P 〈 0. 000 01 ],left ventricular ejection fraction [MD = 4. 84,95% CI（ 3. 56,6. 13）,P 〈 0. 000 01],cardiac output [MD = 0. 30,95% CI（ 0. 19,0. 42）,P 〈 0. 000 01],6 minutes walking distance [MD = 39. 03,95% CI（ 25. 06,53. 00）,P 〈 0. 000 01],reducing NT-pro BNP [MD =- 67. 72,95%CI（- 110. 30,- 25. 13）,P = 0. 002 ],and shortening left ventricular end systolic dimension（ LVESD）[MD =- 2. 94,95% CI（- 4. 86,- 1. 02）,P = 0. 000 3],with statistically significant differences between two groups. But there was no significant difference between two groups in shortening left ventricular end diastolic dimension（ LVEDD） [MD =- 2. 06,95% CI（- 4. 70,0. 58）,P = 0. 13] and improving E / A [MD = 0. 06,95% CI（- 0. 03,0. 15）,P = 0. 21]. Conclusion： Combination of Yiqi Fumai injection and western medicine has higher clinical efficacy than western medicine alone for the treatment of heart failure.