血必净注射液的快速卫生技术评估

A Rapid Health Technology Assessment of Xuebijing Injection

目的:通过对血必净注射液进行快速卫生技术评估,评价其临床应用的有效性、安全性和经济性,并探讨血必净注射液在新型冠状病毒肺炎(COVID-19)中的药学监护,为临床用药决策提供循证医学证据。方法:通过系统检索Pubmed、Embase、the Cochrane Library、CNKI、CBM和CRD Web等数据库,由2位研究者独立地根据纳入标准和排除标准进行文章筛选、质量评价及数据提取,并对数据结果进行分析。结果:共纳入31篇系统评价/Meta分析。结果显示,有效性方面,血必净注射液在治疗脓毒症、脓毒性休克、百草枯中毒、肺部感染、急性胰腺炎、急性呼吸窘迫综合征、急性有机磷中毒、肝硬化自发性细菌性腹膜炎和多器官功能障碍综合征方面均有较好的临床效果。安全性方面,各研究对血必净注射液不良反应的报道较少。经济性方面,尚无相关经济性研究。1篇Meta分析对血必净注射液临床应用的安全性进行了评价,结果显示血必净组的不良事件发生率比安慰剂组低。结论:既往证据表明,血必净注射液在临床应用具有较好的有效性和安全性。但其在COVID-19中应用尚无试验证据。使用本品时,需注意溶媒选择、与其他中药注射剂联用的间隔、配制后的使用时限以及储存条件。血必净注射液说明书的用法和注意事项等内容有待完善。

Objective:Through rapid health technological assessment of Xuebijing injection,to evaluate its efficacy,safety and economy,and to provide current evidence-based medical evidence to clinical decision-makers.Methods:Pubmed,Embase,the Cochrane Library,CNKI,CBM and CRD Web were searched.Two researchers independently conducted article screening,quality evaluation and data extraction based on the inclusion/exclusion criteria,and analyzed the data in the literature.Results:31 systematic reviews or Meta-analyses were included.The results showed that Xuebijing injection had good clinical effects in the treatment of sepsis,septic shock,paraquat poisoning,pulmonary infection,acute pancreatitis,acute respiratory distress syndrome,acute organophosphorus poisoning,cirrhosis spontaneous bacterial peritonitis and multi-organ dysfunction syndrome.In terms of safety,there were few reports on the adverse reactions of Xuebijing.As for cost,there was no relevant economic research concerning Xuebijing injection.One Meta-analysis evaluated the safety of the clinical application of Xuebijing,and the results showed that the incidence of adverse events in the Xuebijing group was lower than that in the placebo group.Conclusion:Previous evidence shows that Xuebijing injection has good efficacy and safety in clinical application.However,there is no experimental evidence for its application in COVID-19.When using this product,it is necessary to pay attention to the selection of solvent,the time interval between the usage of other traditional Chinese medicine injections,the duration of use after configuration and the storage conditions.Besides,the instructions for use and precautions of Xuebijing injection need to be improved.