Jing-Jing Wei, Ming-Jun Zhu, Yong-Xia Wang, Bin L I, Guang-Cao Peng, Xin-Lu Wang, Rui Y U
Henan University of Chinese Medicine Zhengzhou 450000, China.
the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450000, China.
Zhongguo Zhong Yao Za Zhi. 2020 Oct;45(19):4756-4765. doi: 10.19540/j.cnki.cjcmm.20200302.505.
To systematically evaluate the efficacy and safety of Xinmailong Injection in the treatment of coronary heart disease complicated with heart failure. Seven databases,namely CNKI, VIP,WanFang,SinoMed,PubMed,EMbase,Cochrane Library, were retrieved by computer for collecting the randomized controlled trials about Xinmailong Injection in the treatment of coronary heart disease complicated with heart failure. The literatures were screened out, data was extracted, and the methodological quality evaluation was conducted by 2 researchers independently according to inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis and corresponding description analysis. A total of 19 studies involving 1 922 patients were included, including 967 cases in the trial group and 955 cases in the control group. All the clinical studies showed a low quality. Meta-analysis results showed that Xinmailong Injection combined with conventional treatment could better reduce the BNP level(SMD=-3.34, 95%CI[-4.06,-2.63]) in patients of coronary heart disease complicated with heart failure or NT-proBNP level, improve the cardiac function(RR=1.23,95%CI[1.18,1.29]) and LVEF(MD=6.85,95%CI[4.93,8.76]),increase 6 MWT(MD=24.34, 95%CI[16.05, 32.64]) and VEGF(MD=26.39,95%CI[24.30,28.49]),and decreased LVEDD(MD=-4.06, 95%CI[-6.33,-1.80]). And subgroup analysis suggested that the course of treatment may be related to the increase of LVEF. This study found that Xinmailong Injection for coronary heart disease complicated with heart failure can further alleviate clinical symptoms and relevant indicators, with no serious adverse reaction. However, it still needs the support of well-designed multicenter, double-blind and high-quality clinical trials.
系统评价心脉隆注射液治疗冠心病合并心力衰竭的有效性和安全性。通过计算机检索中国知网（CNKI）、维普（VIP）、万方、中国生物医学文献数据库（SinoMed）、PubMed、EMbase、Cochrane图书馆7个数据库，收集心脉隆注射液治疗冠心病合并心力衰竭的随机对照试验。对文献进行筛选、数据提取，由2名研究人员根据纳入和排除标准独立进行方法学质量评价。采用RevMan 5.3软件进行Meta分析及相应的描述性分析。共纳入19项研究，涉及1922例患者，试验组967例，对照组955例。所有临床研究质量均较低。Meta分析结果显示，心脉隆注射液联合常规治疗能更好地降低冠心病合并心力衰竭患者的脑钠肽（BNP）水平（标准化均数差[SMD]=-3.34，95%可信区间[CI][-4.06，-2.63]）或N末端脑钠肽前体（NT-proBNP）水平，改善心功能（相对危险度[RR]=1.23，95%CI[1.18，1.29]）和左心室射血分数（LVEF）（平均差[MD]=6.85,95%CI[4.93,8.76]）,增加6分钟步行试验距离（6 MWT）（MD=24.34,95%CI[16.05,32.64]）及血管内皮生长因子（VEGF）（MD=26.39,95%CI[24.30,28.49]），并减小左心室舒张末期内径（LVEDD）（MD=-4.06,95%CI[-6.33,-1.80]）。亚组分析提示，疗程可能与LVEF升高有关。本研究发现，心脉隆注射液用于治疗冠心病合并心力衰竭可进一步缓解临床症状及相关指标，且无严重不良反应。然而，仍需要设计良好的多中心、双盲、高质量临床试验予以支持。
