血必净注射液辅助治疗儿童感染性心内膜炎的Meta分析

Meta-analysis on Xuebijing Injection(血必净注射液)in Adjuvant Treatment of Infective Endocarditis in Children

目的:通过Meta分析方法评价血必净注射液辅助治疗儿童感染性心内膜炎的有效性和安全性。方法:计算机检索中国知网(CNKI)、万方数据库(Wanfang Database)、维普期刊服务平台(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase和Cochrane Library,收集建库至2022年3月血必净注射液辅助治疗儿童感染性心内膜炎的临床随机对照试验(RCT),由2名研究员独立筛选文献及评价文献质量,使用RevMan 5.4软件进行Meta分析。结果:试验组临床总有效率[OR=5.84,95%CI(2.14,15.92),P=0.0006]、赘生物缩小率[OR=4.98,95%CI(2.68,9.25),P<0.00001]均高于对照组,体温[MD=-1.22,95%CI(-1.28,-1.15),P<0.00001]、白细胞(WBC)[MD=-3.32,95%CI(-4.61,-2.03),P<0.00001]、白介素-6(IL-6)[MD=-33.34,95%CI(-40.94,-25.74),P<0.00001]、C反应蛋白(CRP)[MD=-16.16,95%CI(-20.15,-12.18),P<0.00001]均低于对照组;两组死亡率[OR=0.44,95%CI(0.15,1.29),P=0.13>0.05]及不良反应(P>0.05)比较,差异均无统计学意义。结论:在治疗儿童感染性心内膜炎方面,血必净注射液具有解热、抗炎、缩小心内赘生物的作用,可提高临床治疗总有效率,且安全性好。但纳入研究的质量较低,仍需要进行更严谨的多中心、双盲、RCT对结论进一步验证。

Objective:To evaluate the efficacy and safety of Xuebijing Injection in the adjuvant treatment of infective endocarditis in children by Meta-analysis.Methods:CNKI,Wanfang Database,VIP,CBM,PubMed,Embase and Cochrane Library were searched by computer to collect the clinical randomized controlled trials(RCTs)of Xuebijing Injection in the treatment of infective endocarditis in children from the establishment of the database to March 2022.Two researchers independently screened the literature and evaluated the quality of the literature,and RevMan5.4 software was used for Meta-analysis.Results:The total effective rate[OR=5.84,95%CI(2.14,15.92),P=0.0006]and the reduction rate of neoplasms[OR=4.98,95%CI(2.68,9.25),P<0.00001]in the experimental group were higher than those in the control group.The body temperature[MD=-1.22,95%CI(-1.28,-1.15),P<0.00001],WBC[MD=-3.32,95%CI(-4.61,-2.03),P<0.00001],IL-6[MD=-33.34,95%CI(-40.94,-25.74),P<0.00001],CRP[MD=-16.16,95%CI(-20.15,-12.18),P<0.00001]were lower than those in the control group.There was no significant difference in mortality[OR=0.44,95%CI(0.15,1.29),P=0.13>0.05]and adverse reactions(P>0.05)between the two groups.Conclusion:In the treatment of infective endocarditis in children,Xuebijing Injection has the effects of antipyretic,anti-inflammatory and reducing intracardiac vegetation,which can improve the total effective rate of clinical treatment and has good safety.However,the quality of the included studies is low,and more rigorous multi-center,double-blind,randomized controlled clinical trials are still needed to further verify the conclusions.