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[参麦注射液治疗急性心肌梗死的Meta分析]

[Meta-analysis of Shenmai injection treatment for acute myocardial infarction].

作者信息

Hu Jing, Zhang Wen, Xie Yan-Ming, Wang Lian-Xin, Nie Xiao-Lu, Zhang Yue-Lun

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2012 Sep;37(18):2760-7.

Abstract

OBJECTIVE

To assess the efficacy and safety of Shenmai injection for acute myocardial infarction (AMI).

METHOD

All clinical studies of Shenmai for AMI were searched from Cochrane library, Medline, EMbase, CBM, CNKI, Wanfang and VIP. For efficacy analysis of Shenmai, randomized controlled trials (RCTs) and quasi-RCTs were included and the Cochrane Collaboration's RevMan 5.1 was used for data analysis.

RESULT

  1. Fifty studies were included for efficacy analysis, in which, only 1 study was true RCT, all of studies did not mention allocation concealment, blind and information of loss to follow-up. The fatality rate during hospitalization (OR 0.43, 95% CI [0.31-0.60]), incidence of heart failure (OR 0.49, 95% CI [0.34-0.70]), incidence of shock (OR 0.53, 95% CI[0.30-0.93]) and incidence of re-infarction (OR 0.16, 95% CI [0.03-0.77]) in Shenmai injection plus conventional treatment group was lower than that in the conventional treatment group, while the rate of recanalization (OR 1.24, 95% CI [0.90-1.71]) was similar between the two groups. 2) For safety analysis, we did not found serious adverse drug reaction/adverse events (ADR/AE) of Shenmai injection for AMI.

CONCLUSION

The currently available evidence showed that Shenmai injection plus conventional treatment group may decrease the fatality rate during hospitalization, the incidence of cardiac failure, shock and re-infarction. However, these findings should be carefully interpreted due to the low methodological quality and small sample size of trials. Although serious ADR/AE was did not report of Shenmai injection, the post-marketing safety evaluation is need to be performed.

摘要

目的

评估参麦注射液治疗急性心肌梗死(AMI)的有效性和安全性。

方法

从Cochrane图书馆、Medline、EMbase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库和维普数据库中检索参麦治疗AMI的所有临床研究。对于参麦的疗效分析,纳入随机对照试验(RCT)和半随机对照试验(quasi-RCT),并使用Cochrane协作网的RevMan 5.1进行数据分析。

结果

1)纳入50项研究进行疗效分析,其中只有1项为真正的RCT,所有研究均未提及分配隐藏、盲法和失访信息。参麦注射液加常规治疗组的住院病死率(OR=0.43,95%可信区间[0.31-0.60])、心力衰竭发生率(OR=0.49,95%可信区间[0.34-0.70])、休克发生率(OR=0.53,95%可信区间[0.30-0.93])和再梗死发生率(OR=0.16,95%可信区间[0.03-0.77])低于常规治疗组,而两组的再通率(OR=1.24,95%可信区间[0.90-1.71])相似。2)对于安全性分析,未发现参麦注射液治疗AMI的严重药物不良反应/不良事件(ADR/AE)。

结论

现有证据表明,参麦注射液加常规治疗组可能降低住院病死率、心力衰竭、休克和再梗死的发生率。然而,由于试验的方法学质量低和样本量小,这些结果应谨慎解读。虽然未报道参麦注射液的严重ADR/AE,但仍需要进行上市后安全性评估。

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