心脉隆注射液与多种药物联合治疗慢性心力衰竭的疗效和安全性对比的Meta分析

A Meta-Analysis of the Efficacy and Safety of Xinmailong Injection in the Treatment of Chronic Heart Failure Combined with Various Drugs

目的:进一步评价心脉隆注射液治疗慢性心力衰竭(CHF)的疗效和安全性。方法:检索PubMed、The Cochrane Library、CNKI等数据库自建库至2019年12月31日有关心脉隆注射液与多种药物治疗CHF的研究,采用RevMan 5.3软件,选取合适的模型对各研究的临床总有效率、脑钠肽(BNP)、左心室射血分数(LVEF)等指标进行Meta分析。结果:共纳入21个研究,Meta分析结果表明,与对照组相比,心脉隆组可明显降低患者的BNP、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、C反应蛋白(CRP)水平和中医证候总积分,增加LVEF、6 min步行距离(6MWD)及心脏指数(CI),提高临床总有效率(P<0.05)。心脉隆组与对照组之间不良反应发生率差异无统计学意义(P=0.15>0.05)。结论:常规治疗基础上,与应用其他治疗心力衰竭药物相比,单独或联合应用心脉隆注射液治疗CHF的疗效显著,但是安全性方面还需要更全面、准确和客观的大样本研究来进一步证实。

Objective:To further evaluate the efficacy and safety of Xinmailong injection in the treatment of chronic heart failure(CHF).Methods:This study searched PubMed,the Cochrane Library,CNKI and other databases from the establishment of the database to 31 December 2019 for studies related to Xinmailong injection and various drugs in the treatment of CHF.Meta-analysis was carried out with RevMan 5.3 software,and indicators such as overall clinical efficacy,blood brain natriuretic peptide(BNP),and left ventricular ejection fraction(LVEF),ect.were included.Results:A total of 21 studies were included,and Meta-analysis showed that compared with the control groups,the Xinmailong groups can significantly reduce the patients'BNP,left ventricular enddiastolic dimension(LVEDD),left ventricular end systolic diameter(LVESD),C-reactive protein(CRP)levels and the total score of TCM syndromes,increase LVEF,6 minutes'walking distance(6MWD)and cardiac index(CI),and improve the total clinical efficacy(P<0.05).There was no significant difference in the incidence of adverse reactions between the Xinmailong groups and the control groups(P=0.15>0.05).Conclusion:On the basis of conventional treatment,compared with the application of other therapeutic drugs for CHF,Xinmailong injection alone or in combination has a significant effect on CHF,but the safety aspect needs to be further confirmed by a more comprehensive,accurate and objective large sample study.