中药联合环磷腺苷葡胺治疗病毒性心肌炎的Meta分析

Meta-analysis on Chinese Materia Medica Combined with Meglumine Adenosine Cyclphosphate in the Treatment of Viral Myocarditis

目的系统评价中药联合环磷腺苷葡胺治疗病毒性心肌炎的疗效。方法计算机检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、Embase数据库建库至2021年4月10日的中药联合环磷腺苷葡胺治疗病毒性心肌炎的随机对照试验(RCT),由2名研究人员独立筛选文献、提取资料并评价纳入文献的质量,采用RevMan 5.3、Stata/SE 12.0软件进行统计分析。结果共纳入7个RCT,涉及患者749例,其中试验组377例,对照组372例。Meta分析结果显示:试验组总有效率(RR=1.35,95%CI[1.25,1.45],P<0.01)、肌酸激酶同工酶(MD=-5.00,95%CI[-6.41,-3.59],P<0.01)、乳酸脱氢酶(MD=-16.66,95%CI[-28.13,-5.19],P<0.01)、脑钠肽(MD=-264.19,95%CI[-287.73,-240.64],P<0.01)、C反应蛋白(MD=-4.87,95%CI[-5.76,-3.98],P<0.01)等均优于对照组。结论中药联合环磷腺苷葡胺治疗病毒性心肌炎临床疗效优于常规疗法,鉴于纳入的文献样本量有限,因此需要更多高质量、多中心、大样本的RCT进一步验证。

Objective To systematically analyze the efficacy of Chinese materia medica combined with meglumine adenosine cyclphosphate in the treatment of viral myocarditis.Methods Randomized controlled trials(RCTs)of Chinese materia medica combined with meglumine adenosine cyclphosphate in the treatment of viral myocarditis were retrieved from CNKI,VIP,Wanfang,PubMed,CBM,Cochrane Library and Embase from establishment to 10th,April,2021.After two researchers independently selected the literature,extracted data and evaluated the quality of methodology included in the study,Meta-analysis was carried out by using RevMan 5.3 and Stata/SE12.0 software.Results Seven RCTs were included,including 749 patients.Among them,377 patients were in experimental group and 372 patients were in control group.The Meta-analysis results showed the total effective rate in the experimental group(RR=1.35,95%CI[1.25,1.45],P<0.01),the level of MB isoenzyme of creatine kinase(MD=-5.00,95%CI[-6.41,-3.59],P<0.01),the level of lactate dehydrogenase(MD=-16.66,95%CI[-28.1,-5.19],P<0.01),the level of plasma brain natriuretic peptide(MD=-264.19,95%CI[-287.73,-240.64],P<0.01),and the level of C-reactive protein(MD=-4.87,95%CI[-5.76,-3.98],P<0.01),which were all better than those of the control group.Conclusion Chinese materia medica combined with meglumine adenosine cyclphosphate in the treatment of viral myocarditis show better efficacy compared with routine therapy.However,in view of the limited sample size of the included literature,more high-quality,multi-center,large-sample RCTs are needed for further verification.