血必净注射液辅助治疗老年重症肺炎随机对照研究的Meta分析

Meta-analysis of the Efficacy and Safety of Xuebijing Injection in Adjuvant Treatment of Senile Severe Pneumonia

目的评价血必净注射液辅助治疗老年重症肺炎的有效性及安全性。方法检索中国知网(CNKI)、万方数据数据库(Wanfang Data)、维普数据库(VIP)、中国生物医学文献数据库(SinoMed)以及PubMed,收集血必净注射液辅助治疗老年重症肺炎的随机对照研究。采用NoteExpress软件进行文献的筛选,RevMan 5.2软件进行数据分析,二分类变量和连续性变量分别采用比值比(Relative risk,RR)和均数差(Mean Differences,MD)及其95%的可信限(CI)作为统计量。结果纳入18个研究,共1503例患者。Meta分析显示,血必净注射液联合西医常规治疗在提高有效率[RR=1.21,95%CI(1.16,1.27),P<0.00001]、降低病死率[RR=0.34,95%CI(0.16,0.72),P=0.005]、缩短住院时间[MD=-3.78,95%CI(-5.38,-2.35),P<0.00001]、提高氧分压[MD=10.80,95%CI(5.78,15.82),P<0.00001]、提高血氧饱和度[MD=4.24,95%CI(2.34,6.14),P<0.00001]、降低二氧化碳分压[MD=-7.32,95%C(I-10.36,-4.27),P<0.00001]方面疗效均优于西医常规治疗,但对提高氧合指数差异无统计学意义[MD=30.54,95%C(I-7.89,69.05),P=0.12]。所有纳入研究未见严重不良反应。结论血必净注射液联合西医常规疗法治疗老年重症肺炎疗效优于西医常规治疗,安全性较好。但由于纳入研究的质量偏低,需要高质量的研究为血必净注射液治疗重症肺炎提供明确的证据。

Objective Xuebijing pneumonia. Methods CNKI, WANFANG, VIP, SinoMed, PubMed were searched to collect the randomized controlled study of Xuebijing injection for adjuvant therapy of senile severe pneumonia. Literatures were screened using NoteExpress software. RevMan.5.2 software was used for data analysis. Statistics of the binary variable and continuous variable were expressed using Relative risk(RR)and Mean differences(MD)and their 95% confidence interva(lCI). Results A total of 1503 patients in 18 studies were included. Meta-analysis showed that compared with conventional treatment of western medicine, Xuebijing injection combined with conventional treatment had more significant efficacy in improving the effective rate [RR=1.21, 95% CI(1.16, 1.27), P < 0.000 01];reducing mortality[RR=0.34,95% C(I0.16,0.72),P=0.005],shortening hospital stay [MD=-3.78,95%C(I-5.38,-2.35),P < 0.000 01],improving PO2[MD=10.80,95% CI(5.78,15.82),P < 0.000 01],improving SaO2[MD=4.24,95% CI(2.34,6.14),P < 0.000 01],reducing PCO2[MD=-7.32,95% CI(-10.36,-4.27),P < 0.000 01],but no significant difference in improving oxygenation index(PO2/FIO2)[MD =30.54,95% CI(-7.89,69.05),P=0.12].No serious adverse reaction was found in all included studies. Conclusion Xuebijing injection combined with conventional western medicine in the treatment of senile severe pneumonia has better efficacy and safety than western medicine treatment. However,due to the low quality of the included studies,better-quality studies are needed to verify the effectiveness and safety of Xuebijing injection in adjuvant treatment of senile severe pneumonia.