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| Effect of acute heart failure with Shenfu Injection: a Meta-analysis and GRADE evaluation |
| Hits 1587 Download times 924 Received:October 13, 2020 |
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| DOI
10.11656/j.issn.1673-9043.2021.01.14 |
| Key Words
Shenfu Injection;acute heart failure;meta-analysis;GRADE evaluation |
| Author Name | Affiliation | E-mail | | ZHAO Ting | Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China | | | CAO Yawen | Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China | | | LIU Yu | Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China | | | WANG Xianliang | Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China | | | BI Yingfei | Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China | | | MAO Jingyuan | Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China | jymao@126.com | | WANG Shuai | Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China | |
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| Abstract
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| [Objective] To Analysis the clinical efficacy and safety of Shenfu Injection on acute heart failure,further evaluate the evidence level,and to provide reference for the rational clinical applicate of Shenfu injection in clinical practice.[Methods] ollected randomized controlled trials(RCT) of the combined western medicine routine of the Shenfu injections (treatment group) compared to the western medical routine (control group) for the treatment of acute heart failure in the databases of CBM,CNKI,VIP,WANFANG DATA,PubMed,Embase,The Cochrane Library. Two researchers independently carried out literature screening and extracted the relevant data,the quality evaluation were carried out by ROB scale,meta-analysis were carried out by RevMan 5.3 software,and the quality of evidence was graded using the GRADE system.[Results] The total number of included literatures was 43,which were randomized controlled trails,with 3 193 patients. According tometa-analysis,Shenfu injection combined with western medicine routine treatment improve cardiac function (NYHA)[RR=1.25,95%CI(1.19,1.31),P<0.01] or (Killip)[RR=1.38,95%CI(1.24,1.53),P<0.01]),reduce BNP[MD=-266.83,95%CI(-337.73,-195.93),P<0.01] or NT-proBNP[MD=-965.00,95%CI(-1 900.74,-29.26),P=0.04],improve LVEF[MD=6.35,95%CI(4.91,7.80),P<0.01],improve quality of life[MD=-20.34,95%CI(-32.80,-7.88),P<0.01],improve TCM syndrome[MD=-1.60, 95%CI(-2.59,-0.61),P<0.01],the curative effect is better than the conventional treatment of western medicine. Reduce urine volume[MD=-35.95,95%CI(-137.11,65.21),P=0.49],reduce re-hospitalization rate of heart failure[RR=0.50,95%CI(0.05,5.23),P=0.56] the curative effect is equivalent to Western medicine treatment. And No significant adverse reactions were found in all studies. According the GRADE,TCM syndrome score is medium quality evidence,Killip cardiac function grade improvement rate,urine volume and heart failure re-hospitalization rate are low quality evidence,NYHA cardiac function grade improvement rate,BNP,NT-proBNP,LVEF,minnesota living with heart failure questionnaire (MLHFQ) score,safety are very low quality evidence.[Conclusion] The curative efficacy of treatment of acute heart failure in the combination of Shenfu Injections and Western medicine is better than the treatment of Western medicine,the safety is good,and due to the low quality of the included research,the exact conclusion needs more high-quality research to be further verified. |
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