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参附注射液治疗心力衰竭系统评价的批判性综述。

A Critical Overview of Systematic Reviews of Shenfu Injection for Heart Failure.

机构信息

The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province 510120, China.

The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province 255014, China.

出版信息

Cardiovasc Ther. 2021 Mar 6;2021:8816590. doi: 10.1155/2021/8816590. eCollection 2021.


DOI:10.1155/2021/8816590
PMID:33777184
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7960068/
Abstract

OBJECTIVES: Shenfu Injection (SFI) was widely used in the treatment of heart failure (HF) in China. A plethora of systematic reviews/meta-analyses (SRs/MAs) has been conducted in this research area, although with scattered results. The purpose of this overview was to conduct a comprehensive review to summarize and critically evaluate the existing evidence. METHODS: Digital databases were searched for SRs/MAs up to January 28, 2021. Two authors independently screened the reviews and assessed the methodological quality of included SRs/MAs using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2). Quality of evidence for outcomes evaluated within the reviews was appraised with the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE). RESULTS: Thirteen SRs/MAs met the inclusion criteria. Based on AMSTAR-2, the quality of all SRs/MAs was critically low, because all of them have more than one critical domains that were unmet. Based on GRADE, the evidence quality of 24 outcome measures was low or very low, 27 outcome measures was moderate, and none outcome measure was high. Descriptive analysis showed that SFI was an effective and safe method for HF. CONCLUSIONS: The use of SFI for the treatment of HF may be clinically effective and safe. However, this conclusion must be interpreted cautiously due to the generally low methodological quality and low evidence quality of the included SRs/MAs. More rigorously designed SRs/MAs and RCTs with high methodological quality are necessary for further proof.

摘要

目的:参附注射液(SFI)在中国被广泛用于心力衰竭(HF)的治疗。虽然结果参差不齐,但该研究领域已经进行了大量的系统评价/荟萃分析(SRs/MAs)。本综述的目的是进行全面的综述,以总结和批判性评估现有证据。

方法:截至 2021 年 1 月 28 日,对 SRs/MAs 进行了数字数据库检索。两名作者独立筛选综述,并使用评估系统评价方法学质量 2 版(AMSTAR-2)评估纳入的 SRs/MAs 的方法学质量。使用推荐评估、发展和评估分级(GRADE)评估综述中评估的结局的证据质量。

结果:符合纳入标准的有 13 项 SRs/MAs。根据 AMSTAR-2,所有 SRs/MAs 的质量均为批判性低,因为它们都有一个以上未满足的关键领域。根据 GRADE,24 个结局指标的证据质量为低或极低,27 个结局指标为中等,没有结局指标为高。描述性分析表明,SFI 是治疗 HF 的有效且安全的方法。

结论:SFI 用于 HF 的治疗可能在临床上有效且安全。但是,由于纳入的 SRs/MAs 的方法学质量普遍较低且证据质量较低,因此必须谨慎解释此结论。需要更严格设计的 SRs/MAs 和具有高方法学质量的 RCT 来进一步证明。

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[6]
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[7]
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[8]
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Evid Based Complement Alternat Med. 2021-10-25

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