养心汤治疗病毒性心肌炎Meta分析

Meta Analysis of Heart-Nourishing Decoction in Treating Viral Myocarditis

目的:系统评价养心汤治疗病毒性心肌炎的疗效与安全性。方法:计算机检索外文数据库包括Pub Med、EMbase、Cochrane。中文数据库包括中国知网、维普、万方、中国生物医学文献数据库。纳入养心汤治疗病毒性心肌炎的随机对照试验(randomized controlled trial,RCT),按照纳入与排除标准选择试验、评价质量和提取有效数据,采用Cochrane手册临床试验质量评价标准对纳入研究进行方法学质量评价,采用Rev Man 5. 3软件进行数据统计分析。结果:共纳入6项研究,包括410例患者。临床疗效分析结果显示[OR=8. 18,95%CI(4. 13,16. 22)],观察组临床疗效优于对照组。治疗后乳酸脱氢酶(lactate dehydrogenase,LDH)结果显示[OR=-20. 92,95%CI(-32. 43,-9. 42)],观察组治疗后LDH水平低于对照组。安全性评价:纳入的6篇文献中,观察过程中未报道不良反应的发生。结论:养心汤能有效改善病毒性心肌炎患者的临床疗效,LDH水平,且安全性较高。但由于本系统评价纳入的RCT均为小样本量研究,且证据强度不高,故上述结论尚需更多高质量RCT进一步验证。

Objective: To systematically evaluate the efficacy and safety of Heart-Nourishing Decoction in the treatment of viral myocarditis. Methods: The foreign language databases including Pub Med,EMbase and Cochrane,as well as the Chinese databases included Chinese How Net,Weipu,Wanfang and Chinese biomedical literature databases were retrieved by computer. They were included in randomized controlled trial( RCT) of Heart-Nourishing Decoction in the treatment of viral myocarditis. According to inclusion and exclusion criteria,the trials and the quality of evaluation were selected,and the effective data were extracted. Cochrane manual quality evaluation criteria for clinical trials were used to evaluate the methodological quality of the included studies. And Rev Man 5. 3 software was used for statistical analysis. Results: Six studies were included,including 410 patients. Meta analysis showed that the clinical efficacy of the observation group was better than that of control group [OR = 8. 18,95% CI( 4. 13,16. 22)]. After the treatment,lactate dehydrogenase( LDH) showed that [OR =-20. 92,95% CI(-32. 43,-9. 42)]. LDH level in the observation group was lower than that in the control group. Safety evaluation: No adverse reactions were reported in the included 6 literatures. Conclusion: Heart-Nourishing Decoction can effectively improve the clinical efficacy,LDH level and safety of patients with viral myocarditis. However,because the RCTs included in the evaluation of this system are small sample size studies,and the evidence intensity is not high,the above conclusions need to be further verified by more high-quality RCTs.