摘要
目的系统评价心脉隆注射液治疗蒽环类药物诱导的心脏毒性的作用。方法计算机检索中国知网(CNKI)、万方数据知识服务平台(Wanfang)、维普中文期刊(VIP)、PubMed、Embase、the Cochrane Library中、英文数据库中从建库起至2020年7月有关心脉隆注射液治疗蒽环类药物心脏毒性的随机对照试验。2位研究者按照纳入、排除标准进行文献筛选和资料提取。运用RevMan 5.3软件对结局指标进行Meta分析,采用TSA v0.9软件对心电图异常率进行试验序贯分析。结果共纳入研究8项,涉及对象660例,其中试验组330例,对照组330例。Meta分析结果显示,试验组在提高左心室射血分数(LVEF)[MD=4.95,95%CI(3.44,6.45),P<0.00001],提高二尖瓣环舒张早期与心房收缩期峰值速度比率(E/A)[MD=0.28,95%CI(0.09,0.46),P=0.003],缩小左心室收缩末期内径(LVESD)[MD=-0.51,95%CI(-0.74,-0.29),P<0.00001]、左心室舒张末期内径(LVEDD)[MD=-0.50,95%CI(-0.62,-0.37),P<0.00001],减少心电图异常率[RR=0.28,95%CI(0.20,0.40),P<0.00001],降低肌钙蛋白I(cTnI)[SMD=-2.62,95%CI(-3.55,-1.69),P<0.00001]方面均优于对照组。心脉隆注射液治疗未增加药物不良反应发生率。试验序贯分析显示心脉隆注射液对蒽环类药物诱导的心脏毒性的心电图异常率的疗效明确。结论心脉隆注射液对蒽环类药物化疗患者有心脏保护作用,可改善其产生的心脏毒性。
Objective To systematically evaluate the effect of Xinmailong injection in the treatment of cardiotoxicity induced by anthracycline chemotherapy.Methods Randomized controlled trials of Xinmailong injection to treat cardiotoxicity induced by anthracycline were searched through databases,such as CNKI,Wanfang,VIP,PubMed,Embase,the Cochrane Library,etc.The search time was from the establishment of the database to July2020.Two researchers independently searched the literature strictly in accordance with the criteria for screening,and conducted screening and data extraction.Meta analysis was performed by using RevMan 5.3 software,sequential analysis of the abnormal rate of electrocardiogram was carried out by using TSA v0.9 software.Results Eight studies that met the criteria were included,with a total sample size of 660 cases,including 330 cases in the experimental group and 330 cases in the control group.Meta analysis results showed that compared with the control group,the left ventricular ejection fraction(LVEF)in the experimental group increased[MD=4.95,95%CI(3.44,6.45),P<0.00001],improve the ratio of the peak velocity of the mitral valve ring during the early diastole to the atrial systole(E/A)increased[MD=0.28,95%CI(0.09,0.46),P=0.003],the left ventricular end systolic diameter(LVESD)[MD=-0.51,95%CI(-0.74,-0.29),P<0.00001],left ventricular end-diastolic diameter(LVEDD)[MD=-0.50,95%CI(-0.62,-0.37),P<0.00001]and the abnormal rate of electrocardiogram[RR=0.28,95%CI(0.20,0.40),P<0.00001]were reduced,troponin I(cTnI)decreased[SMD=-2.62,95%CI(-3.55,-1.69),P<0.00001].Adding Xinmailong injection did not increase the incidence of adverse reactions.The sequential analysis of the test showed that Xinmailong injection has a clear curative effect on the abnormal rate of electrocardiogram in patients with anthracycline-induced cardiotoxicity.Conclusion Xinmailonginjection has a cardioprotective effect on anthracycline chemotherapy patients and can improve the cardiotoxicity induced by anthracycline.
作者
马腾
朱明军
王永霞
李彬
郑超楠
贾梦楠
于丽
常鑫迪
MA Teng;ZHU Mingjun;WANG Yongxia;LI Bin;ZHENG Chaonan;JIA Mengnan;YU Li;CHANG Xindi(Henan University of Chinese Medicine,Zhengzhou 450046 Henan,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003 Henan,China)
出处
《中药新药与临床药理》
CAS
CSCD
北大核心
2021年第6期886-893,共8页
Traditional Chinese Drug Research and Clinical Pharmacology
基金
国家重点研发计划重点专项课题(2019YFC1710000,2019YFC1710003)
国家中医药管理局中医药循证能力建设项目(2019XZZXXXG003)
河南省高校科技创新团队支持计划(13IRTSTHN012)
河南省中医药科学研究专项课题(2018JDZX009)
河南省中原千人计划-中原名医项目(豫财行[2020]140号)。
作者简介
马腾,男,硕士研究生,研究方向:中医药对心血管疾病的预防和治疗,Email:mateng621@163.com;通信作者:朱明军,男,博士,教授,博士研究生导师,研究方向:中医药防治心血管疾病的临床和基础研究。Email:zhumingjun317@163.com。
