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血必净注射液能否降低重症肺炎患者的死亡率?一项系统评价与Meta分析

Could Xuebijing Injection Reduce the Mortality of Severe Pneumonia Patients? A Systematic Review and Meta-Analysis.

作者信息

Wang Juan, Zhu Jia, Guo Jie, Wang Qian

机构信息

Department of Intensive Medicine, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210012, China.

Postgraduate College, Nanjing University of Chinese Medicine, Nanjing 210023, China.

出版信息

Evid Based Complement Alternat Med. 2020 Aug 28;2020:9605793. doi: 10.1155/2020/9605793. eCollection 2020.

Abstract

METHODS

Databases including PubMed, Cochrane Library, Web of Science, Embase, CNKI, WanFang, and VIP were searched, from inception to February 2020, to identify randomized controlled trials (RCTs) about XBJ combined with western medicine treatment in treating severe pneumonia. Literature screening, data extraction, and methodological quality assessment were carried out by two researchers back-to-back. RevMan 5.3 software was used for statistical analysis.

RESULTS

A total of 21 articles involving 2072 patients were included. The meta-analysis showed that treatment combined with XBJ has better efficiency compared with western medicine treatment alone. It could also decrease 28-day mortality; shorten the length of intensive care unit (ICU) stay time and mechanical ventilation time; and reduce the levels of C-reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC), tumor necrosis factor- (TNF-), interleukin-6 (IL-6), and D-dimer in the serum of patients. The incidence of adverse reactions did not increase significantly.

CONCLUSION

XBJ combined with western medicine treatment has significant clinical efficacy and no obvious adverse reactions. A dose of 100 ml bid is recommended to reduce 28-day mortality. The conclusion needs to be further verified with larger-sample size and higher-quality RCTs.

摘要

方法

检索包括PubMed、Cochrane图书馆、Web of Science、Embase、中国知网(CNKI)、万方和维普等数据库,检索时间从建库至2020年2月,以识别关于血必净(XBJ)联合西医治疗重症肺炎的随机对照试验(RCT)。由两名研究人员背对背进行文献筛选、数据提取和方法学质量评估。使用RevMan 5.3软件进行统计分析。

结果

共纳入21篇文章,涉及2072例患者。荟萃分析表明,与单纯西医治疗相比,联合血必净治疗具有更高的有效率。它还可以降低28天死亡率;缩短重症监护病房(ICU)住院时间和机械通气时间;降低患者血清中C反应蛋白(CRP)、降钙素原(PCT)、白细胞(WBC)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和D-二聚体的水平。不良反应发生率未显著增加。

结论

血必净联合西医治疗具有显著的临床疗效且无明显不良反应。建议剂量为100 ml,每日两次,以降低28天死亡率。该结论需要通过更大样本量和更高质量的RCT进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b44/7474780/36ecaed9a74e/ECAM2020-9605793.001.jpg

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