Tonifying kidney therapy for stable chronic obstructive pulmonary disease: a systematic review

OBJECTIVE: To evaluate the efficacy and safety of tonifying kidney therapy(Bushen, TK) for stable chronic obstructive pulmonary disease(COPD).METHODS: Randomized controlled trials(RCTs) of TK use for treatment of stable COPD were searched in four databases including Pub Med, the Cochrane Library, Chinese Biomedical Literature Database,and China National Knowledge Infrastructure Database from inception to December 2017. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. Rev Man 5.3 software was used for the Meta-analysis.RESULTS: Eight RCTs involving 809 patients with stable COPD were included. Compared with the conventional Western Medicine(CWM) group, the TK group(TK combined with CWM) showed significant improvements in the effectiveness rates(RR =1.37, 95% CI 1.22 to 1.53, P 0.000 01) and 6-min walk distance in meters(MD 11.92, 95% CI 3.52 to20.32, P = 0.005), this study also showed that the TK group can decrease The Traditional Chinese Medicine Syndrome Score(MD-8.01, 95% CI-12.89 to-3.13, P = 0.001). The lung function [forced expiratory volume in one second%(FEV1%), FEV1/forced vital capacity] showed no difference between the TK and control groups.CONCLUSION: For patients with stable COPD, TK can improve the clinical effectiveness and exercise capacity but fail to improve the patient's symptoms. Because of the low methodological quality of the included trials, additional high-quality and large-scale RCTs are required.     

血必净注射液治疗慢性阻塞性肺疾病的系统评价

目的系统评价血必净注射液联合常规治疗慢性阻塞性肺疾病(COPD)的临床疗效和安全性。方法计算机检索PubM ed、CENTRAL、EMbase、VIP、CNKI、CBM和Wan Fang等数据库,纳入随机对照试验,经过文献筛选和评价质量后提取有效数据进行Meta分析。结果共纳入41个随机对照试验(RCT),合计3 032例患者。Meta分析结果显示,血必净注射液联合常规治疗COPD在总有效率[OR=3.39,95%CI(2.64,4.34),P0.000 01]、FEV1占预计值百分比(FEV1%)[WMD=8.67,95%CI(5.62,11.71),P0.000 01]、第一秒用力呼气量/用力肺活量(FEV1/FVC)[WMD=6.17,95%CI(3.31,9.02),P0.000 1]、氧分压(PaO 2)[WMD=6.45,95%CI(4.26,8.64),P0.000 01]、二氧化碳分压(PaC O2)[WMD=4.35,95%CI(3.17,5.52),P0.000 01]、C反应蛋白(CRP)[WMD=13.36,95%CI(9.95,16.77),P0.000 01]、酸碱度(pH)[WMD=0.03,95%CI(0.02,0.04),P0.000 01]、白细胞总数(WBC)[WMD=2.11,95%CI(1.64,2.58),P0.000 01]、中性粒细胞百分比(N%)[WMD=5.18,95%CI(3.49,6.86),P0.000 01]和住院时间[WMD=-4.77,95%CI(-6.33,-3.22),P0.000 01]等指标上优于单用常规治疗,其差异均具有统计学意义。结论血必净注射液联合常规治疗COPD的临床疗效优于单用常规治疗。     

Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine(TCM) for managing renal fibrosis(RF) in patients with chronic kidney disease(CKD). METHODS: We searched randomized controlled trials(RCTs) from eight databases. RESULTS: Sixteen eligible studies with 1,356 participants were included in this study. Compared to treatment with Western Medicine(WM) alone, the combined treatment with activating blood circul...     

Danshenchuanxiongqin injection in the treatment of unstable angina pectoris: a systematic review and Meta-analysis

OBJECTIVE:To evaluate systematically the efficacy and safety of Danshenchuanxiongqin Injection(DCI)in the treatment of unstable angina pectoris(UAP).METHODS:Randomized controlled trials(RCTs)regarding DCI used for treating UAP were searched in English and Chinese electronic databases from inception to January 2014.Two reviewers independently retrieved RCTs and extracted relevant information.The Cochrane risk of bias method was used to assess the quality of included studies,and a Meta-analysis was conducted with Review Manager5.2 software.RESULTS:Eleven RCTs involving 1034 participants were included.The methodological quality was relatively passable.The Meta-analysis indicated that the combined use of DCI and conventional treatment with Western Medicine(WM)was more efficacious in the outcomes of total effective rate[Relative Risk(RR)=1.27,95%CI(confidence interval;1.18,1.35),P0.000 01],the total effective rate of ECG[RR=1.40,95%CI(1.18,1.66),P0.000 01],total cholesterol[Mean difference(MD)=-0.58,95%CI(-0.83,-0.33),P0.000 01],total triglycerides[MD=-0.36,95%CI(-0.54,-0.17),P=0.0001],and the number of ST-segment depression[MD=-0.36,95%CI(-0.54,-0.17),P=0.0001].There were two adverse drug reactions reported in one study.CONCLUSION:Based on the systematic review,DCI combined with WM appeared to be efficacious in the treatment UAP.However,the evidence of DCI for treating UAP requires large-scale and double-blind RCTs to substantiate these findings.     

Qingkailing injection for the treatment of acute stroke: a systematic review and Meta-analysis

Objective

To evaluate systematically the clinical efficacy and safety of Qingkailing (QKL) injection in the treatment of acute stroke.

Methods

Searches for randomized controlled trials into acute stroke treated with QKL injection were performed in the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wan fang Database, Chinese Biomedical Literature Database, PubMed and Cochrane Library, from January 1979 to March 2013. Two reviewers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a Meta-analysis was conducted with Review Manager 5.2 software.

Results

A total of 13 studies with 1110 participants were included. The quality of the studies was generally low. The Meta-analysis indicated that the combined use of QKL and Western Medicine was significantly superior to control group therapy in terms of the total effective rate. The relative risk (RR) in the acute cerebral hemorrhage (ACH) sub-group was 1.17 [95% confidence interval (CI) (1.08, 1.26), P=0.0001]. In the acute cerebral infarction (ACI) sub-group, RR was 1.27 [95% CI (1.14, 1.42), P<0.0001], and in the ACH and ACI mixed sub-group, RR was 1.34 [95% CI (1.20, 1.50), P<0.00001]. Additionally, QKL promoted the absorption of hematoma [mean difference (MD)= − 3.73, 95% CI (− 4.48, − 2.98), P<0.000 01], decreased neurological damage in ACI [MD= − 5.60, 95% CI (− 8.50, − 2.70), P=0.0002] and ACH [MD= − 4.08, 95% CI (− 8.00, − 0.16), P=0.04], promoted the recovery of awareness [RR=1.56, 95% CI (1.09, 2.21), P=0.01] and reduced the whole blood viscosity coefficient [MD= − 0.75, 95% CI (− 1.47, − 0.03), P=0.04]. There were no adverse drug reactions reported in the included studies.

Conclusion

Based on this systematic review, QKL combined with conventional therapy was effective compared with control treatment. However, because the articles used in the study were not of high quality, further studies should be conducted into the efficacy and safety of QKL in treating acute stroke.     

Effectiveness of redcore lotion in patients with vulvovaginal candidiasis: a systematic review and Meta-analysis

OBJECTIVE:To summarize and evaluate the effectiveness and safety of Redcore lotion on treating vulvovaginal candidiasis(VVC) using a systematic review and Meta-analysis of randomized controlled trials. METHODS:A systematic literature search was performed in five English and three Chinese electronic databases up to October 2019. Randomized controlled trials in the treatment for VVC were included; only studies which compared the effectiveness and safety of Redcore lotion plus miconazole with micon...     

Potassium dehydroandrographolide succinate injection for treatment of infantile pneumonia:a systematic review and Meta-analysis

OBJECTIVE:To evaluate systematically the clinical efficacy and safety of potassium dehydroandrographolide succinate injection(PDS) in treatment of infantile pneumonia.METHODS:Randomized controlled trials(RCTs) of infantile pneumonia treated by PDS were searched in China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang Database,Chinese Biomedical Literature Database,PubMed,and Cochrane Library,from January 1979 to July 2013.Two reviewers independently retrieved the RCTs and extracted the information.The quality of included studies was assessed by the Cochrane risk of bias,and a Meta-analysis was conducted with Review Manager 5.2 software.RESULTS:A total of 9 studies with 1056 participants were included.The quality of the studies was generally no high,only one study mentioned the random method.The Meta-analysis indicated that PDS was significantly superior to the conventional therapy in the total effective rate[relative risk(RR)=1.21,95%CI(1.14,1.27),P0.000 01],the time of temperature recovery[mean difference(MD)=-1.43,95%CI(-1.75,-1.11),P0.000 01],rale disappeared and cough relieving[MD=-1.44,95%CI(-1.93,-0.90),P0.000 01].Six adverse drug reactions from five studies mainly represented rash and diarrhea,and no serious ADRs were reported.CONCLUSION:Based on this systematic review,PDS was proved effective and relatively safe in treatment of infantile pneumonia.However the articles enrolled in the study were not high in quality,studies with higher quality should be conducted for assessment of efficacy and safety of PDS in treatment of infantile pneumonia.     

Effectiveness of Huachansu injection combined with chemotherapy for treatment of gastric cancer in China: a systematic review and Meta-analysis

OBJECTIVE: to evaluate the effectiveness and safety of Huachansu(HCS) injection plus chemotherapy in the treatment of gastric cancer.METHODS: A thorough and systematic retrieval of randomized controlled trials(RCTs) concerning HCS injection for treating gastric cancer was conducted in several electronic databases from inception to May 10, 2018. The quality of the RCTs was assessed by the Cochrane risk of bias tool. And the data about objective remission rate, performance status, adverse drug rea...     

Effectiveness of Chinese herbal medicine combined with conventional medicine on acute exacerbation of chronic obstructive pulmonary disease: a systematic review and Meta-analysis

OBJECTIVE: To systematically evaluate the efficacy and safety of Chinese herbal medicine(CHM) combined with conventional Western Medicine(CWM) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) based on high-quality randomized placebocontrolled trials. METHODS: We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, and Wanfang databases for randomize...     

Effect of Aidi injection plus transarterial chemoembolization on primary hepatic carcinoma: a systematic review and Meta-analysis

OBJECTIVE: To assess the efficacy and safety of Aidi injection plus transarterial chemoembolization(TACE) in patients with primary hepatic carcinoma.METHODS: A comprehensive research of seven electronic databases was performed for comparative studies evaluating Aidi injection combined with TACE for primary hepatic carcinoma until September 2016. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool from the Cochrane Handbook version 5.1.0. Data was synthesized by using Rev Man 5.3 software.RESULTS: Forty-nine studies involving 3435 patients met the inclusion criteria, most of which were low methodological quality. Compared with TACE alone, Aidi injection plus TACE can significantly improve the efficiency rate [RR = 1.33, 95% CI(1.24, 1.43), P 0.000 01], clinical beneficial rate[RR = 1.25, 95% CI(1.17, 1.33), P 0.000 01], survival rate [6 months, RR = 1.19, 95% CI(1.09, 1.29), P 0.0001], 12 months, [RR = 1.37, 95% CI(1.24, 1.52),P 0.000 01], 18 months, [RR = 2.00, 95% CI(1.26,3.20), P 0.004], 24 months, [RR = 1.44, 95% CI(1.22, 1.70), P 0.0001], 36 months, [RR = 1.50, 95%CI(1.07, 2.11), P = 0.02 0.05], quality of life [RR =1.84, 95% CI(1.64, 2.05), P 0.000 01] and immune function [CD3+, MD = 11.12, 95% CI(7.93, 14.30),P 0.000 01], CD4 +, [MD = 10.37, 95% CI(7.29,13.45), P 0.000 01], CD4+/CD8+, [MD = 0.30, 95%CI(0.07, 0.53), P = 0.01 0.05], NK, [MD = 7.49, 95%CI(6.64, 8.34), P 0.000 01]. A significant improvement was also found in improvement of symptoms[RR = 1.64, 95%CI(1.38, 1.94), P 0.000 01], leukopenia [RR = 0.60, 95% CI(0.54, 0.66), P 0.000 01],thrombocytopenia [RR = 0.46, 95% CI(0.34, 0.61),P 0.000 01], nausea and vomiting incidence [RR =0.66, 95% CI(0.54, 0.81), P 0.0001), liver damage rate [RR = 0.57, 95% CI(0.42, 0.77), P = 0.0003 0.05), and kidney damage rate [RR = 0.18, 95% CI(0.05, 0.68), P = 0.01 0.05].CONCLUSION: The results suggested that Aidi injection plus TACE significantly improve the clinical effect of TACE, and reduce the incidence of adverse events. However, rigorous multicenter trials with larger size are warranted to further confirm the findings.     

Effectiveness of acupuncture in postoperative ileus: a systematic review and Meta-analysis

OBJECTIVE: To conduct a systematic review and Meta-analysis of the effectiveness of acupuncture and common acupoint selection for postoperative ileus(POI).METHODS: Randomized controlled trials(RCTs)comparing acupuncture and non-acupuncture treatment were identified from the databases Pub Med, Cochrane, EBSCO(Academic Source Premier and MEDLINE), Ovid(including EvidenceBased Medicine Reviews), China National Knowledge Infrastructure, and Wanfang Data. The data from eligible studies were extracted and a Meta-analysis performed using a fixed-effects model.Results were expressed as relative risk(RR) for dichotomous data, and 95% CI(confidence intervals)were calculated. Each trial was evaluated using the CONSORT(Consolidated Standards of Reporting Trials) and STRICTA(STandards for Reporting Interventions in Controlled Trials of Acupuncture) guide-lines. The quality of the study was assessed using the Grading of Recommendations, Assessment, Development and Evaluation(GRADE) approach.RESULTS: Of the 69 studies screened, eight RCTs were included for review. Among these, four RCTs(with a total of 123 patients in the intervention groups and 124 patients in the control groups) met the criteria for Meta-analysis. The Meta-analysis results indicated that acupuncture combined with usual care showed a significantly higher total effective rate than the control condition(usual care)(RR1.09, 95% CI 1.01, 1.18; P = 0.02). Zusanli(ST 36) and Shangjuxu(ST 37) were the most common acupoints selected. However, the quality of the studies was generally low, as they did not emphasize the use of blinding.CONCLUSION: The results suggested that acupuncture might be effective in improving POI; however,a definite conclusion could not be drawn because of the low quality of trials. Further large-scale,high-quality randomized clinical trials are needed to validate these findings and to develop a standardized method of treatment. We hope that the present results will lead to improved research, resulting in better patient care worldwide.     

Efficacy of Cordyceps sinensis as an adjunctive treatment in hemodialysis patients: a systematic review and Meta-analysis

OBJECTIVE: To evaluate current evidence on the efficacy and safety of Cordyceps sinensis(cordyceps)or its fermented products used as an adjunctive treatment in patients undergoing maintenance hemodialysis.METHODS: The Cochrane Central Register of Controlled Trials(CENTRAL), EMBASE, MEDLINE, China National Knowledge Infrastructure(CNKI) and Wanfang Database were searched for relevant randomized controlled trials up to March 2016. Two review authors independently selected trials for inclusion,extracted data, assessed the methodological quality and rated the quality of evidence with the Grading of Recommendations, Assessment, Development and Evaluation approach.RESULTS: Twelve studies involving 655 participants were included. Evidence of low to moderate-quality showed that cordyceps plus conventional treatment compared to conventional treatment alone significantly improved C-reactive protein [standardized mean difference(SMD)-0.61; 95% confi-dence intervals(CI)-1.00 to-0.22], high-sensitivity C-reactive protein [weighted mean difference(WMD)-3.44 mg/L; 95% CI-3.89 to-2.99], serum albumin(WMD 3.07 g/L; 95% CI 1.59 to 4.55),malondialdehyde(WMD-1.95 nmol/L; 95% CI-2.24 to-1.66), and hemoglobin(WMD 9.56 g/L;95% CI 3.65 to 15.47) levels. However, there was no significant improvement for serum creatinine and low-density lipoprotein cholesterol. Overall, most trials either did not monitor adverse events or poorly documented them.CONCLUSION: Given the small number of trials included, the unclear methodological quality of the included trials, and the high heterogeneity in pooled analyses, the evidence obtained in this review is insufficient to recommend the use of cordyceps as adjunctive treatment in hemodialysis patients.     

亚健康与中医体质类型相关性研究的系统评价和Meta分析＊

目的 总结亚健康与中医体质类型相关性研究及现状，探讨亚健康的中医体质分布规律，为亚健康的中医药养生保健提供循证医学证据，为传统中医功能声称的保健食品功能研究提供方向。方法 计算机检索中国知网（CNKI）、万方数据（WANFANG DATA）、重庆维普（CQVIP）、PubMed及EMBASE数据库，纳入所有评价亚健康与中医体质类型相关性的临床研究文献。采用R version 4.0.4软件进行单率Meta分析、OR值（odds ratio）及其95% CI （confidence interval）表达效应值。结果 共纳入31项研究，研究总样本量为55 059例，其中亚健康人群43 707例，一般人群11 352例。平和质、气虚质、阳虚质、气郁质为亚健康人群占比前四的体质，比例分别为21.4%（95% CI：16.2-27.2%）、21.2%（95% CI：18.0-24.4%）、16.2%（95% CI：13.7-18.7%）、13.5%（95% CI：11.2-16.2%）。对亚健康人群及一般人群进行比较，发现气郁质、气虚质、阳虚质、平和质发生亚健康风险的OR值分别为4.97（95% CI：3.03-8.15）、3.99（95% CI：2.17-7.31）、2.30（95% CI：1.52-3.48）、0.15（95% CI：0.10-0.24），差异均具有统计学意义，表明偏颇体质是发生亚健康的风险因素，而平和质是发生亚健康的保护因素。从性别来看，亚健康男性和女性的气虚质、痰湿质、湿热质的比例相当，而女性的阳虚质、阴虚质、气郁质、血瘀质的比例要高于男性。纳入研究的方法学质量整体偏低，漏斗图分析显示存在发表偏倚风险。结论 气郁质、气虚质、阳虚质是亚健康人群的主要偏颇体质类型，也是发生亚健康的风险因素。建议今后研究进一步探讨3大偏颇体质与亚健康的关联性，为亚健康的中医药养生保健提供有价值的参考。     

肾康注射液联合血液透析对终末期肾病患者营养状况的影响

[目的]探讨肾康注射液联合血液透析对终末期肾病患者营养状况的影响。[方法]选择南京市第一医院血液净化中心收治的120例终末期肾病患者,将所有患者随机分为2组,治疗组予以肾康注射液联合血液透析治疗措施,对照组予以血液透析措施,每组各60例。测定治疗前后两组患者的肾功能、营养状况、电解质、中医证候疗效的改善情况,以及评定疗效,同时对药物不良反应进行记录与比较。[结果]治疗后,治疗组中医证候疗效改善明显,红细胞计数(RBC)、血红蛋白(HGB)、血清总蛋白(TP)、血清白蛋白(ALB)水平及有效率(83.33%)与对照组比较差异具有统计学意义(P0.05)。与治疗前比较,治疗后两组患者的肾功能及营养状况相关指标、电解质相关指标、中医证候疗效均改变明显(P0.05)。治疗期间,所有患者均未出现不良反应。[结论]肾康注射液联合血液透析可较好改善终末期肾病患者的症状及营养状况,提高疗效,且安全性较好。     

肾康注射液联合血液透析治疗慢性肾功能衰竭的临床效果分析

目的:探讨肾康注射液联合血液透析治疗慢性肾功能衰竭的临床效果。方法:按照随机数字表法将92例慢性肾功能衰竭患者均分为实验组和对照组,分别给予肾康注射液联合血液透析治疗和单纯血液透析治疗,比较两组治疗效果。结果:2组患者治疗后Scr和BUN水平均明显下降,与同组治疗前比较,有显著差异;治疗后2组间Scr和BUN水平比较,差异无统计学意义;2组患者治疗后UA水平均明显下降,与同组治疗前比较,有显著差异;实验组患者治疗后UA水平明显低于对照组,有显著差异;2组患者治疗前后HGB水平均未发生明显变化,组间比较差异无统计学意义;2组患者治疗后中医症候积分均明显下降,与同组治疗前比较,有显著差异;治疗后实验组患者中医症候积分明显低于对照组,有显著差异;实验组患者中医症候总有效率明显高于对照组,有显著差异;实验组患者治疗后RBC、HGB、TP、ALB水平均明显提高,与治疗前比较,有显著差异;实验组患者治疗后RBC、HGB、TP、ALB水平均明显高于对照组,有显著差异;2组患者治疗后生存质量评分均明显升高,与同组治疗前比较,有显著差异;实验组患者治疗后生存质量评分明显高于对照组,有显著差异。结论:在血液透析基础上加用肾康注射液能够有效减少透析次数,改善患者肾功能和临床症状,改善患者营养状态,提高生存质量,临床优势明显。     

Cupping therapy for patients with chronic urticaria: A systematic review and meta-analysis

BackgroundChronic urticaria (CU) is a common skin disease, which has a negative effect on quality of life. Current treatments do not fully control the symptoms of urticaria for many CU patients, thus effective and safe treatments for CU are still needed.ObjectiveThis review aims to evaluate the effectiveness and safety of cupping therapy in patients with CU.Search strategyThe search strategy looked for the presence of related keywords, such as “chronic urticaria” and “cupping therapy,” in the title and abstract of research articles indexed in major databases. Randomized controlled trials (RCTs) were selected after querying nine electronic databases from their inception to May 2019 with the above search terms.Inclusion criteriaRCTs were included if they recruited patients with CU who were intervened with dry or wet cupping. Publications could be written in Chinese or English.Data extraction and analysisData were extracted, and the studies were assessed for the quality of their methodological design and risk of bias. Meta-analyses of the RCT data were conducted to assess the total effective rate of the treatment as the primary outcome. Skin disease quality of life index score, recurrence rate, and adverse events were assessed as secondary outcomes. Subgroup analyses were conducted based on different interventions.ResultsThirteen comparisons from 12 RCTs involving 842 participants were included. There were no significant differences between wet cupping and medications in total effective rate (n = 372; risk ratio [RR] = 1.10, 95% confidence interval [CI] 0.97 to 1.25; P = 0.14) or recurrence rate (n = 240; RR = 0.56, 95% CI 0.23 to 1.36; P = 0.20). Cupping therapy, in combination with antihistamine treatment was more efficacious than antihistamines alone, with a greater total effective rate (n = 342; RR = 1.18, 95% CI 1.01 to 1.39; P = 0.03) and lower recurrence rate (n = 342; RR = 0.52, 95% CI 0.32 to 0.84; P = 0.007). Cupping therapy combined with acupuncture was more effective than acupuncture alone (n = 156; RR = 1.25, 95% CI 1.07 to 1.46; P = 0.006). No serious adverse events were reported.ConclusionWet cupping may be as effective as treatment with antihistamines. When cupping therapy is used as an adjuvant therapy to antihistamines or acupuncture, it may enhance the efficacy. Results drawn from these studies should be interpreted with caution and applied with care to clinical practice, because of the poor quality among the studies that were reviewed.Systematic review registrationPROSPERO, CRD42019137451.     

Acupoint application therapies for essential hypertension: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the efficacy and safety of acupoint application therapies(AA) for hypertension. METHODS: We searched Pub Med, EMBASE, the Cochrane Center Controlled Trials Register, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wanfang Med Online Database from their inceptions to October 7, 2019. No language restriction was applied. We included randomized clinical trials testing AA against Western Medicine, AA versus placebo, AA combined with Western ...     

灯盏细辛注射液佐治冠心病心绞痛随机对照试验的系统评价和Meta分析

系统评价灯盏细辛注射液佐治冠心病心绞痛的疗效及安全性。计算机检索Cochrane图书馆,Medline,EMbase,CBM,CNKI,VIP和万方数据库中关于灯盏细辛注射液联合西医常规对冠心病心绞痛治疗的随机对照试验。根据Cochrane Reviewer's Handbook 5.1评价标准和工具评价纳入文献质量,用RevMan 5.2软件进行Meta分析。该研究共纳入30个随机对照试验,总样本数为3 086例,试验组1 572例和对照组1 514例。Meta分析结果显示,灯盏细辛注射液佐治冠心病心绞痛与西医常规治疗相比能够减少心血管事件的发生(OR=0.33;95%CI:[0.16,0.67];P=0.002);灯盏细辛注射液佐治冠心病心绞痛有效率(OR=3.97;95%CI:[3.15,5.02];P<0.000 01)和心电图疗效(OR=2.21;95%CI:[1.83,2.68];P<0.000 01)优于西医常规治疗。漏斗图有一定的不对称,预示可能存在发表偏倚。现有证据表明,灯盏细辛注射液联合常规疗法治疗冠心病心绞痛在临床疗效及心电图改善等方面比单用西医常规疗效较好。但基于研究的局限,所获得的支持证据强度有待提升,且需设计严谨、随访时间更长的临床研究加以证实。     

苦黄注射液治疗病毒性肝炎的有效性和安全性:随机对照试验的系统评价和Meta分析

系统评价苦黄注射液治疗病毒性肝炎的有效性和安全性。系统全面检索国内外8大电子数据库及Clinical Trials,收集关于苦黄注射液治疗病毒性肝炎的随机对照试验。根据Cochrane Handbook 5.1评价标准,2人进行文献筛选、资料提取和质量评价。对最终纳入的文献采用Rev Man 5.3软件进行Meta分析或仅做描述性分析。共计纳入32篇文献,涉及3 188例患者,男性1 951例(61.2%),女性859例(26.9%),未知男女比例378例(11.9%),所纳入的临床研究总体质量偏低。由于研究疾病复杂,干预措施不尽相同,大部分研究按疾病分类进行描述性分析:重度黄疸型病毒性肝炎的试验组总有效率优于对照组;黄疸型肝炎试验组在退黄、肝功能复常率方面优于对照组;在少数Meta分析中,对于黄疸性病毒性肝炎,在苦黄注射液+综合治疗组对比综合治疗组中,前者总有效率高于后者(RR=1.35,95%CI=[1.10,1.66],P=0.61)。另外,当苦黄注射液滴速过快时会出现头晕、心慌、恶心呕吐及皮疹等不良反应,减慢滴速可缓解。根据现有证据,苦黄注射液对病毒性肝炎有一定的疗效,但由于大部分研究未对病毒性肝炎进行病原学、临床表现分类以及干预措施多样性,导致临床异质性较大,各研究间的可比性较差,加之研究质量普遍偏低,影响结果的准确性,需更多设计严紧、高质量、多中心随机双盲对照试验以增加证据强度。