心脉隆注射液治疗慢性肺源性心脏病的疗效及安全性的Meta分析

Meta-analysis on the Efficacy and Safety of Xinmailong Injection in the Treatment of Chronic Pulmonary Heart Disease

目的系统评价心脉隆注射液治疗慢性肺源性心脏病(CPHD)的疗效和安全性。方法计算机检索中国知网(CNKI)、万方数据知识服务平台(Wanfang)、维普中文科技期刊(VIP)、PubMed和the Cochrane Library数据库,收集心脉隆注射液治疗CPHD相关的随机对照试验(RCT)。筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件对数据进行Meta分析。结果共纳入19篇文献,涉及1758例患者。与常规治疗(对照组)相比,常规治疗加用心脉隆注射液(试验组)能提高总有效率[RR=1.21,95%CI(1.15,1.28),P<0.00001],降低肺动脉收缩压[MD=-8.88,95%CI(-10.33,-7.43),P<0.00001]、肺动脉舒张压[MD=-8.27,95%CI(-12.93,-3.62),P=0.0005]及肺动脉平均压[MD=-5.68,95%CI(-7.45,-3.91),P<0.00001],降低B型利钠肽[SMD=-3.64,95%CI(-5.03,-2.25),P<0.00001]或氨基末端B型利钠肽前体[SMD=-5.13,95%CI(-7.24,-3.02),P<0.00001];与对照组相比,试验组能缩小右心室内径、升高动脉血氧分压及动脉血氧饱和度、降低二氧化碳分压、提高6 min步行距离,差异均有统计学意义(P<0.05)。加用心脉隆注射液治疗未增加不良反应发生率。结论常规治疗基础上加用心脉隆注射液能进一步提高治疗CPHD的疗效,降低肺动脉压力,改善呼吸衰竭、右心功能,提高运动耐力,且安全性较好。

Objective To systematically evaluate the efficacy and safety of Xinmailong injection in the treatment of chronic pulmonary heart disease(CPHD).MethodsCNKI, Wanfang, VIP, PubMed and the Cochrane Library databases were searched by computer to collect the randomized controlled trials(RCT)of Xinmailong injection for the treatment of CPHD.After screening the literatures,the data were extracted and the bias risk of the included studies was evaluated,the RevMan 5.3 software was used for Meta-analysis of the data.Results A total of 19 studies were included,involving 1 758 patients. Compared with conventional treatment(control group),conventional treatment combined with Xinmailong injection(test group)can improve the total efficiency [RR=1.21,95% CI(1.15,1.28),P<0.000 01],decreased PASP [MD=-8.88,95% CI(-10.33,-7.43),P<0.000 01],PADP [MD=-8.27,95%CI(-12.93,-3.62),P=0.000 5] and MPAP [MD=-5.68,95% CI(-7.45,-3.91),P<0.000 01],decreased BNP [SMD=-3.64,95% CI(-5.03,-2.25),P<0.000 01] or NT-proBNP [SMD=-5.13,95% CI(-7.24,-3.02),P<0.000 01]. Compared with the control group,experimental group can reduce RVD,raise PaO2 and SaO2,to reduce PaCO2 and improve 6-MWT, the differences had statistical significances(P < 0.05). The addition of Xinmailong injection did not increase the incidence of adverse reactions.Conclusion The addition of Xinmailong injection on the basis of conventional treatment can further improve the efficacy of curing CPHD,reduce pulmonary artery pressure,improve right heart function,respiratory failure,exercise endurance and has better safety.