参麦注射液治疗糖尿病酮症酸中毒临床疗效的Meta分析

Meta-analysis of the Efficacy of Shenmai Injection in Emergency Treatment of Diabetic Ketoacidosis

目的参麦注射液治疗糖尿病酮症酸中毒临床疗效的系统性评价分析。方法选取中国知网(CNKI)、万方医学、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMBase等数据库,查找参麦注射液治疗糖尿病酮症酸中毒的随机对照试验,使用软件RevMan(5.4)进行文献质量评估,对其临床有效率及相关生化指标进行Meta分析及敏感性分析。结果纳入研究的随机对照试验共有5项,涉及糖尿病肾病患者共有354例。Meta分析结果显示,经参麦注射液干预的治疗组总有效率[OR=4.31,95%CI(1.94,9.56),Z=3.59,P<0.05]高于对照组,差异有统计学意义(P<0.05);治疗组尿酮转阴时间[MD=-3.44,95%CI(-0.554,-1.24),Z=3.06,P<0.05]、血糖恢复时间[MD=-2.95,95%CI(-5.10,-0.80),Z=2.69,P<0.05]、胰岛素用量[MD=-12.77,95%CI(-14.70,-10.84),Z=12.97,P<0.05]均少于对照组,差异有统计学意义(P<0.05)];治疗组的C反应蛋白(CRP)[MD=-2.96,95%CI(-3.33,-2.60),Z=16.04,P<0.05]、血肌酐(Scr)[MD=-18.54,95%CI(-24.10,-12.98),Z=6.53,P<0.05]、血尿素氮(BUN)[MD=-3.69,95%CI(-4.97,-2.42),Z=5.67,P<0.05]、动脉血气pH值[MD=0.14,95%CI(0.06,0.22),Z=3.58,P<0.05]、血钾[MD=-0.40,95%CI(-0.40,-0.24)Z=7.91,P<0.05]治疗效果均优于对照组,差异有统计学意义(P<0.05)。结论参麦注射液可有效控制糖尿病酮症酸中毒,值得临床推广。

Objective:To conduct a systematic evaluation and analysis of clinical efficacy of Shenmai Injection in the treatment of diabetic ketoacidosis.Methods:CNKI,Wanfang Medicine,VIP,CBM,PubMed,EMBase and other databases were selected to search for randomized controlled trials(RCTs)of Shenmai Injection in the treat⁃ment of diabetic ketoacidosis,and the RevMan(5.4)software was used to evaluate the quality of the literature.Me⁃ta-analysis and sensitivity analysis of biochemical indicators were performed.Results:A total of 5 RCTs were in⁃cluded,involving a total of 354 patients with diabetic nephropathy.The results of meta-analysis showed that the to⁃tal effective rate[OR=4.31,95%CI(1.94,9.56),Z=3.59,P<0.05]of the experimental group treated with Shenmai Injection was higher than that of the control group,and the difference was statistically significant(P<0.05);the time of urine ketone to negative[MD=-3.44,95%CI(-0.554,-1.24),Z=3.06,P<0.05],blood sugar recovery time[MD=-2.95,95%CI(-5.10,-0.80),Z=2.69,P<0.05],insulin dosage[MD=-12.77,95%CI(-14.70,-10.84),Z=12.97,P<0.05]in the experimental group were all lower than those in the control group,and the difference was statistically significant(P<0.05);CRP[MD=-2.96,95%CI(-3.33,-2.60),Z=16.04,P<0.05],Scr[MD=-18.54,95%CI(-24.10,-12.98),Z=6.53,P<0.05],BUN[MD=-3.69,95%CI(-4.97,-2.42),Z=5.67,P<0.05],arterial blood gas pH[MD=0.14,95%CI(0.06,0.22),Z=3.58,P<0.05],serum potassium[MD=-0.40,95%CI(-0.40,-0.24)Z=7.91,P<0.05]in the experimental group were all better than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Shenmai Injection can effectively control diabetic keto⁃acidosis.