参附注射液治疗心力衰竭的系统评价再评价

目的评价已发表的参附注射液治疗心力衰竭系统评价/Meta分析的方法学质量,并对临床疗效证据进行系统评估和汇总分析。方法计算机检索CNKI、WanFang、VIP、SinoMed、PubMed、The Cochrane library和EMbase数据库,收集已发表的参附注射液治疗心力衰竭的系统评价,检索时限为建库至2018年12月2日。应用AMSTAR2量表评价其方法学质量,GRADE对证据质量进行分级评估。结果共纳入12篇参附注射液治疗心力衰竭系统评价/Meta分析。AMSTER2量表评价显示,纳入研究质量均较低,评分在6.5~10.5分。GRADE证据分级结果显示,2篇文献的临床综合疗效、6-MWT和证候有效率3个结局指标证据质量为中级。余下所报告结局指标证据质量均为低级或极低级。结论参附注射液治疗心力衰竭系统评价/Meta分析的方法学质量不高,证据质量等级整体偏低,应加强对系统评价员和临床研究者方法学培训,提升临床试验和系统评价质量。

Revaluation of Systematic Reviews of Shenfu Injection on Heart Failure

Objective:To evaluate the methodological quality and evidence level of systematic review/meta analysis of Shenfu Injection on heart failure.Methods:CNKI,WanFang,VIP,SinoMed,PubMed,The Cochrane library and EMbase were searched from establishment to December 2 nd,2018 to collect SRs of Shenfu Injection on heart failure.The methodological quality was evaluated by the AMSTAR2 scale and the GRADE tool was used for the assessment of evidence level.Results:12 SRs were included.The methodological quality assessment showed that the included studies were generally in low-quality,with scores ranging from 6.5 to 10.5.The GRADE evidence grading results showed that the quality levels of clinical comprehensive efficacy,6-MWT and syndrome efficacy of the 2 literatures were moderate.The results were low or very low for the remaining outcomes.Conclusion:The methodological quality of SRs of Shenfu Injection on heart failure is poor,and the level of evidence is generally low.In order to improve the quality of clinical trials and systematic evaluation,we should strengthen the method-ological training of systematic evaluators and clinical researchers.