益血生胶囊治疗缺铁性贫血的Meta分析

Meta-Analysis on Yixuesheng Capsules in the Treatment of Iron-Deficiency Anemia

目的:系统评价益血生胶囊治疗缺铁性贫血(IDA)的疗效,进而为临床用药提供思路。方法:在the Cochrane Library、PubMed、Embase、中国知网、万方数据库和维普数据库中检索益血生胶囊治疗IDA的随机对照试验(RCT),检索时间为建库至2023年11月。文献质量评价和Meta分析的工具分别为Cochrane风险偏倚评估工具和RevMan 5.4软件。结果:符合标准的RCT研究有13篇,共涉及1295例患者。Meta分析结果显示,相比于单纯补充铁剂,采用益血生胶囊联合补铁剂的方式可提高总有效率(RR=1.23,95%CI=1.17~1.29,P<0.00001),提高治疗后血红蛋白(MD=14.85,95%CI=12.65~17.05,P<0.00001)、红细胞(MD=0.77,95%CI=0.41~1.14,P<0.0001)、平均红细胞体积(MD=6.07,95%CI=1.75~10.39,P=0.006)、平均红细胞血红蛋白含量(MD=3.62,95%CI=3.14~4.11,P<0.00001)、血清铁(MD=3.95,95%CI=2.51~5.38,P<0.00001)和血清铁蛋白(MD=16.49,95%CI=9.00~23.97,P<0.0001)等指标水平,差异均有统计学意义;但在提高治疗后转铁蛋白受体水平(MD=-5.42,95%CI=-13.51~2.67,P=0.19)和降低不良反应发生率(RR=0.69,95%CI=0.42~1.12,P=0.14)方面无显著优势。结论:益血生胶囊联合补铁剂在治疗IDA方面具有一定的优势,但仍需要更多高水平、大规模的RCT研究提供数据支持。

OBJECTIVE:To systematically review the efficacy of Yixuesheng capsules in the treatment of iron-deficiency anemia(IDA),so as to provide ideas for clinical medication.METHODS:The Cochrane Library,PubMed,Embase,CNKI,Wangfang Data and VIP databases were retrieved to collect randomized controlled trials(RCT)of Yixuesheng capsules in the treatment of IDA.The retrieval time was from the establishment of the data base to Nov.2023.The tools for literature quality and Meta-analysis were Cochrane System Evaluator Manual and RevMan 5.4 statistical software.RESULTS:Totally 13 RCTs were enrolled,including 1295 patients.Meta-analysis showed that compared with simply supplement of iron,the combination of Yixuesheng capsules and iron supplements can improve the total effective rate(RR=1.23,95%CI=1.17-1.29,P<0.00001),hemoglobin(MD=14.85,95%CI=12.65-17.05,P<0.00001),erythrocyte(MD=0.77,95%CI=0.41-1.14,P<0.0001),mean erythrocyte volume(MD=6.07,95%CI=1.75-10.39,P=0.006),mean corpuscular hemoglobin(MD=3.62,95%CI=3.14-4.11,P<0.00001),serum iron(MD=3.95,95%CI=2.51-5.38,P<0.00001)and serum ferritin(MD=16.49,95%CI=9.00-23.97,P<0.0001)after treatment,the differences were statistically significant.However,there was no significant advantage in increasing the level of transferrin receptor after treatment(MD=-5.42,95%CI=-13.51-2.67,P=0.19)and reducing the incidence of adverse drug reactions(RR=0.69,95%CI=0.42-1.12,P=0.14).CONCLUSIONS:The combination of Yixuesheng capsules and iron supplements has certain advantages in the treatment of IDA,yet more high-level and large-scale RCT is needed to provide data support.