参麦注射液治疗心力衰竭疗效与安全性的系统评价

目的系统评价西药常规加参麦注射液与单纯西药常规治疗心力衰竭的临床疗效及安全性。方法电子检索中国期刊全文数据库（1979.01～2009.04）、中文科技期刊全文数据库（1989.01～2009.04）、中国生物医学文献光盘数据库（1978～2009）、PubMed（1978～2009.04）和e Cochrane Library（2009年第3期）,手工检索相关杂志,搜集西药常规加参麦注射液与单纯西药常规治疗心力衰竭的随机对照试验,按照Cochrane协作网等的相关方法评价纳入文献质量和提取有效数据进行Meta分析。结果共纳入15个研究,包括1 174例患者。Meta分析结果显示：加用参麦注射液后可提高心力衰竭患者的临床综合疗效RR=1.27,95%CI（1.19,1.35）,P〈0.000 01],增加左室射血分数WMD=7.17,95%CI（4.65,9.70）,P〈0.000 01],改善心室舒张功能权重较小文献：WMD=0.38,95%CI（0.32,0.45）,P〈0.000 01;权重较大文献：WMD=0.38（0.32,0.45）];此外,分别有1项研究显示参麦注射液有使心衰患者增加6分钟步行距离及降低血BNP、IL-6、TNF-α水平的作用。结论西药常规加参麦注射液较单纯西药常规治疗心力衰竭可进一步提高临床疗效。

Shenmai Injection in Heart Failure Patients: A Systematic Review and Meta-analysis

Objective To evaluate the clinical effect and safety of western medicine plus Shenmai Injection versus western medicine alone for heart failure（HF）patients.Methods We searched CNKI（January 1979 to April 2009）,VIP（January 1989 to April 2009）,CBM（1978 to 2009）,PubMed（1978 to April 2009）,The Cochrane Library（Issue 3,2009）,and other relevant databases and journals to identify randomized controlled trials（RCTs）about western medicine plus Shenmai Injection versus western medicine alone for HF patients.The methodological quality was assessed and the data was extralted according to the Cochrane Reviewer＇s Handbook and related methods.Meta-analyses were performed using RevMan 5.0.2 software Results Fifteen eligible studies involving 1174 HF patients were included.The results of meta-analyses showed that western medicine plus Shenmai Injection therapy could precisely improve the general therapeutic effects（RR=1.27,95%CI 1.19 to 1.35,P0.000 01）,increase left ventricular ejection fraction（WMD=7.17,95%CI 4.65 to 9.70,P0.000 01）,and make ventricular diastolic function better（minor weight literature：WMD=0.38,95%CI 0.32 to 0.45,P0.000 01;major weight literature：WMD=0.38,95%CI 0.32 to 0.45）.Meanwhile,only one study indicated that western medicine plus Shenmai Injection could increase 6-minute walking distance,reduce BNP,IL-6,and TNF-α levels,respectively.Conclusion By comparison with western medicine alone,western medicine plus Shenmai Injection can improve the therapeutic effect on HF patients.