基于Meta分析的黄芪注射液治疗肺源性心脏病系统评价研究

Systematic Review on Huangqi Injection in Treatment of Pulmonary Heart Disease Based on Meta Analysis

目的:系统评价黄芪注射液治疗肺源性心脏病的临床疗效及安全性,为临床治疗与合理用药提供循证依据。方法:计算机检索中国期刊全文数据库、中文科技期刊全文数据库、万方数据库、中国生物医学文献数据库、PubMed、Cochrane Library及Embase等数据库,全面检索黄芪注射液治疗肺源性心脏病的随机对照试验(对照组患者采用西医常规治疗,观察组患者在对照组基础上加用黄芪注射液),采用Cochrane风险评价表评价其研究质量,提取资料并通过RevMan 5.2软件进行文献荟萃分析(Meta分析)。结果:共纳入35篇文献,累计受试者3 349例。Meta分析结果显示,观察组患者的临床治疗总有效率比对照组高27%,差异有统计学意义(RR=1.27,95%CI=1.23~1.32,P<0.000 01);观察组患者动脉血氧分压改善程度(MD=6.41,95%CI=4.69~8.14,P<0.000 01)、动脉血氧饱和度改善程度(MD=4.63,95%CI=0.10~9.17,P=0.04)、全浆黏度改善程度(MD=-0.19,95%CI=-0.26^-0.12,P<0.000 01)、全血高切黏度改善程度(MD=-2.22,95%CI=-3.70^-0.73,P=0.003)、全血低切黏度改善程度(MD=-1.46,95%CI=-2.82^-0.09,P=0.04)、红细胞聚集指数降低程度(MD=-0.38,95%CI=-0.67^-0.08,P=0.01)及右心室内径降低程度(MD=-4.25,95%CI=-5.56^-2.93,P<0.000 01)明显优于对照组,差异均有统计学意义。结论:临床治疗肺源性心脏病的过程中,在西医常规治疗的基础上加用黄芪注射液可以提高疗效,但其安全性仍需进一步探讨。

OBJECTIVE： To systematically review the clinical efficacy and safety of Huangqi injection in treatment of pulmonary heart disease, so as to provide evidence-based references for rational medication. METHODS：Randomized controlled trials on Huangqi injection in treatment of pulmonary heart disease（ the control group was given western medicine for conventional therapy,the observation group was given Huangqi injection based on the control group） were retrieved from CNKI,VIP,Wanfang,CBM,PubMed,Cochrane Library and Embase. Cochrane bias assessment tool was adopted to evaluate the literature quality,data extracting was conducted and RevMan 5. 2 was used to carry out Meta analysis. RESULTS： A total of 35 studies was involved,including 3 349 subjects. Results of Meta analysis indicated the total effective rate of observation group was 27% higher than that of the control group,with statistically significant difference（ RR = 1. 27,95% CI = 1. 23-1. 32,P〈0. 000 01）; the improvements of arterial partial pressure of oxygen（ MD = 6. 41,95% CI = 4. 69-8. 14,P〈0. 000 01）,arterial oxygen saturation（ MD =4. 63,95% CI = 0. 10-9. 17,P = 0. 04）,whole plasma viscosity（ MD =-0. 19,95% CI =-0. 26-0. 12,P〈0. 000 01）,blood high shear viscosity（ MD =-2. 22,95% CI =-3. 70-0. 73,P = 0. 003）,blood low shear viscosity（ MD =-1. 46,95% CI =-2. 82-0. 09,P = 0. 04）,the decrease of red cell assembling index（ MD =-0. 38,95% CI =-0. 67-0. 08,P = 0. 01） and the decrease of right ventricular internal dimension（ MD =-4. 25,95% CI =-5. 56-2. 93,P〈0. 000 01） of observation group were significantly better than those of the control group,with statistically significantly differences. CONCLUSIONS： During the treatment of pulmonary heart disease,the combination of western medicine for conventional with Huangqi injection therapy can improve clinical efficacy,while its safety still needs to be discussed.