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参麦注射液的不良反应:系统评价。

Adverse drug reactions of Shenmai injection: a systematic review.

机构信息

Tianjin University of Traditional Chinese Medicine, China.

出版信息

J Evid Based Med. 2010 Aug;3(3):177-82. doi: 10.1111/j.1756-5391.2010.01089.x.

Abstract

OBJECTIVE

To analyze adverse drug reactions (ADRs) associated with Shenmai injection and possible contributing factors.

METHODS

We searched all clinical studies and ADR reports of Shenmai injection from the China National Knowledge Infrastructure (CNKI) database, the Data Bank of Chinese Scientific Journals (VIP), and Chinese Biomedical (CBM) database. We collected relevant information such as gender, age, allergic history, and diseases treated in ADR cases; types, occurrence times, and severity of ADRs; and menstruum and compatibility of Shenmai injection.

RESULTS

Of the 1828 clinical studies of Shenmai injection, 146 (7.99%) mentioned 576 ADR cases; 181 ADR reports mentioned 246 ADR cases. The most commonly affected age group was 40 to 69 (57.32%). In 36 (14.63%) cases, patients were described as having an allergic history. The diseases treated in ADR cases were principally heart failure and coronary artery heart disease. Thirty-eight (15.45%) of the 246 ADR cases in ADR reports described anaphylactic shock, while the most common ADR reported in clinical studies was headache/dizziness. Of the 822 total reported ADR cases, 99 (12.04%) were class III, and 637 (77.50%) were class IV, and there were no fatalities. The menstruum of most Shenmai injections was 5% glucose. Incompatible drugs were given in 68 ADR cases. In ADR cases, the most common dosage of Shenmai injection was 40 to 60 ml; 215 (80.90%) ADR cases occurred in first time medication, mainly in the first 30 minutes after injection.

CONCLUSIONS

Current evidence shows that Shenmai injection had lower ADR occurrence, but some potential factors such as irrational compatibility, dosages may lead to a high risk of ADR. In future, clinicians should follow indications or functions to promote rational use of Chinese Medicine Injections .

摘要

目的

分析参麦注射液相关不良反应(ADR)及其可能的影响因素。

方法

检索中国知网(CNKI)数据库、维普中文科技期刊数据库(VIP)和中国生物医学文献数据库(CBM)中参麦注射液的所有临床研究和 ADR 报告,收集 ADR 病例的性别、年龄、过敏史、用药疾病;ADR 类型、发生次数、严重程度;参麦注射液溶媒、配伍等相关信息。

结果

纳入参麦注射液临床研究 1828 项,其中 146 项(7.99%)提及 576 例 ADR 病例;纳入 ADR 报告 181 项,其中 246 例 ADR 报告。年龄以 40~69 岁为主(57.32%)。36 例(14.63%)患者有过敏史,用药疾病主要为心力衰竭、冠心病。246 例 ADR 报告中 38 例(15.45%)为过敏性休克,临床研究中以头痛/头晕最常见。822 例 ADR 病例中,Ⅲ级 99 例(12.04%),Ⅳ级 637 例(77.50%),无死亡病例。参麦注射液溶媒多为 5%葡萄糖,68 例存在不合理配伍,ADR 病例中参麦注射液最常用剂量为 40~60 ml,215 例(80.90%)首次用药发生 ADR,主要发生在用药后 30 min 内。

结论

目前证据表明参麦注射液 ADR 发生率较低,但不合理配伍、剂量等潜在因素可能导致其 ADR 风险较高。未来临床应遵循适应证或功能,促进中药注射剂的合理使用。

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