Li Zunjiang, Fan Ye, Huang Chunxia, Liu Quanle, Huang Manhua, Chen Baijian, Peng Zhe, Zhu Wei, Ding Banghan
The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Cardiovasc Med. 2022 Jul 25;9:934598. doi: 10.3389/fcvm.2022.934598. eCollection 2022.
This study aimed to assess the adjunctive efficacy and safety of Puerarin injection (PI) on acute heart failure (AHF) based on a systematic review and meta-analysis.
Nine databases were searched from March 1990 to March 2022 to identify randomized controlled trials (RCTs) related to the adjunctive treatment of PI for AHF. The Cochrane collaboration tool was used to assess the risk of bias in the included studies. Meta-analysis and subgroup and sensitivity analyses were conducted by RevMan 5.3 software. The evidence's certainty was evaluated by grading recommendations assessment, development, and evaluation (GRADE) methods.
A total of 8 studies were included with a total of 614 patients with AHF. The meta-analysis demonstrated that adjunctive treatment with PI on AHF was superior to conventional medicine alone. It increased the total effective rate (RR = 1.38; 95% CI, 1.22-1.55; < 0.001) and improved left ventricular ejection fraction [SMD = 0.85; 95% CI (0.62, 1.09); < 0.001]. Regarding safety, a total of 11.9% (23/194) adverse reactions were observed in the PI group and 9.8% (19/194) adverse reactions in the control group, and there were no significant differences in the incident rate of adverse events between both groups [RR = 1.16; 95% CI (0.66-2.05); = 0.061]. The outcomes' evidentiary quality was assessed as "moderate."
PI had an adjunctive effect on AHF combined with conventional medicine, and it seemed to be safe and more effective than the conventional medical treatment alone for improving the total clinical effective rate and left ventricular ejection fraction. But further well-designed RCTs are required to confirm the efficacy and safety of XBP in treating AHF due to the poor methodological quality of the included RCTs.
[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=327636], identifier [CRD42022327636].
本研究旨在通过系统评价和荟萃分析评估葛根素注射液（PI）对急性心力衰竭（AHF）的辅助疗效和安全性。
检索1990年3月至2022年3月的九个数据库，以确定与PI辅助治疗AHF相关的随机对照试验（RCT）。使用Cochrane协作工具评估纳入研究的偏倚风险。通过RevMan 5.3软件进行荟萃分析以及亚组和敏感性分析。采用推荐分级评估、制定与评价（GRADE）方法评估证据的确定性。
共纳入8项研究，总计614例AHF患者。荟萃分析表明，PI辅助治疗AHF优于单纯使用传统药物。它提高了总有效率（RR = 1.38；95%CI，1.22 - 1.55；P < 0.001），并改善了左心室射血分数[SMD = 0.85；95%CI（0.62，1.09）；P < 0.001]。在安全性方面，PI组共观察到11.9%（23/194）的不良反应，对照组为9.8%（19/194），两组不良事件发生率无显著差异[RR = 1.16；95%CI（0.66 - 2.05）；P = 0.061]。结果的证据质量被评估为“中等”。
PI联合传统药物对AHF有辅助作用，在提高总临床有效率和左心室射血分数方面似乎比单纯传统药物治疗更安全、更有效。但由于纳入的RCT方法学质量较差，需要进一步设计良好的RCT来证实PI治疗AHF的疗效和安全性。
[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=327636]，标识符[CRD42022327636]
