参附注射液治疗心源性休克有效性和安全性系统评价

目的:评价参附注射液治疗心源性休克有效性和安全性。方法:纳入参附注射液治疗心源性休克为研究对象的随机对照试验,对每个纳入研究进行偏倚风险和质量评估,统计学分析采用RevMan 5.1.4软件。用GRADE profiler软件和标准评估证据质量。结果:本系统评价纳入6个随机对照试验,共367例患者,Meta分析得出参附注射液合基础治疗在治疗病死率、有效率、2h后心率、2h后及2周后收缩压、舒张压及射血分数都优于基础治疗组,但改善收缩末期容积(ESV)和舒张末期容积(EDV)与基础治疗组比较,无统计学差异。GRADE证据质量评估为很低级别证据。参附注射液治疗心源性休克不良反应少,因此相对安全。结论:参附注射液治疗心源性休克安全、有效,但证据质量低,仍需高质量研究产生的证据支持。

Systematic review on efficacy and safety of Shenfu Injection for cardiogenic shock

Objective: To assess the efficacy and safety of Shenfu Injection for cardiogenic shock.Methods: Randomized controlled trials(RCTs) involving Shenfu Injection for cardiogenic shock were included.The qualitv and risk of bias were evaluated.The Cochrane Collaboration’s RevMan 5.1.4 software was used for data analyses and ’GRADE profiler’ software was used for the evidence classification of this system review’s evaluation results.Results: A total of 6 trials involving 367 patients were included.Meta analyses showed that the mortality,the effective rate,after therapy 2h HR,after therapy 2h SBP,after therapy 2h DBP and EF were higher when Shenfu injection plus basic therapy group compared with basic therapy group.However,in improving ESV and EDV have no significant difference.GRADE evidence classification was very low.Conclusion: Shenfu Injection for cardiogenic shock with few adverse reactions was a relative safe.More high quality and large-scaled randomized controlled trials were required in the future in order to define the role of Shenfu Injection for cardiogenic shock.