中药注射剂治疗呼吸机相关性肺炎疗效的网络Meta分析

目的 采用网络Meta分析方法评价中药注射剂治疗呼吸机相关性肺炎的效果,为呼吸机相关性肺炎的临床治疗提供依据.方法 基于万方数据库、中国知网(CNKI)、维普、ScienceDirect、Medline、PubMed、考克兰图书馆等数据库,检索建库至2020年7月1日的中药注射剂治疗呼吸机相关性肺炎的临床随机对照试验文...

A network Meta-analysis on efficacy of traditional Chinese medicine injections in treatment of ventilator-associated pneumonia

Objective To systematically evaluate the efficacy of traditional Chinese medicine injection in treatment of ventilator-associated pneumonia (VAP) by network Meta-analysis, and provide evidence for the optimization of clinical therapy on VAP. Methods The randomized controlled trials (RCTs) of traditional Chinese medicine injections in the treatment of VAP were searched from WanFang Data, CNKI, VIP Database, ScienceDirect, Medline, PubMed, and the Cochrane Library from the time of database establishment to July 1st, 2020. The RCTs were screened according to the inclusion and exclusion criteria, and the data were analyzed by Stata 15.0 software. Results A total of 766 patients were included in 11 RCTs, and there were four kinds of traditional Chinese medicine injections including Shenmai Injection, Tanreqing Injection, Xuebijing Injection, and Xingnaojing Injection involved. Network meta-analysis results showed that compared with routine therapy (RT) alone, the treatment in combination with Xuebijing Injection or Tanreqing Injection significantly improved the effective rate (For Xuebijing Injection + RT, RR=1.54, 95% CI[1.18, 2.00], P=0.00; For Tanreqing + RT, RR=1.26, 95% CI[1.12, 1.42], P=0.00), while combining with Shenmai Injection or Tanreqing Injection significantly reduced the duration of mechanical ventilation (For Shenmai Injection + RT, WMD=−3.10, 95% CI[−4.87, −1.33], P=0.00; For Tanreqing Injection + RT, WMD=−3.04, 95% CI[−3.75, −2.32], P=0.00). Probability ranking results showed that in terms of three therapeutic indicators including duration of mechanical ventilation, procalcitonin (PCT), and clinical pulmonary infection score (CPIS), Tanreqing Injection combined with routine therapy was the best choice for the treatment on VAP. Although the effective rate of Tanreqing Injection combined with routine therapy was lower than that of Xuebijing Injection, no significant difference was observed between them. Conclusion The results demonstrated that Shenmai Injection, Xuebijing Injection or Tanreqing Injection combined with routine therapy were more effective than that of the routine therapy alone on the treatment of VAP, and among three injections, Tanreqing Injection is the best choice.