目的:本研究旨在评价7种中药注射液(CMI)联合常规治疗对重症肺炎(SP)的疗效及安全性。方法:计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)数据库、PubMed、EMbase、Cochrane Library和Web of Science数据库,检索时间均从建库至2022年1月1日。由2名研究人员独立进行文献的搜集,按照Cochrane风险评估工具进行质量评价,应用Stata17.0进行网状Meta分析。结果:纳入54篇,共4 011例患者,涉及7种中药注射液。网状Meta分析结果显示:在主要结局指标方面,提高临床有效率疗效在联合西医常规治疗的基础上痰热清注射液+西医常规>醒脑静注射液+西医常规>血必净注射液+西医常规>喜炎平注射液+西医常规>热毒宁注射液+西医常规>参麦注射液+西医常规>参附注射液+西医常规>西医常规;降低病死率方面,参麦注射液+西医常规>血必净注射液+西医常规>热毒宁注射液+西医常规>醒脑静注射液+西医常规>西医常规;在次要结局指标方面,热毒宁注射液、痰热清注射液联合西医治疗在减少住ICU时间(d)、总住院时间(d)、降低CPIS评分及APACHE评分方面疗效显著,无明显不良反应。结论:在西医常规治疗基础上联合上述7种中药注射液均可提高临床疗效,且安全性较好。其中血必净注射液、参麦注射液及痰热清注射液联合西医治疗在提高临床有效率及降低病死率方面有一定优势,但由于本研究的文献质量总体不高,未来希望有更多高质量、多中心的随机对照试验对本研究结果加以验证。
本文通过查阅中国知网(CNKI)、PubMed及相关参考书目,对目前心血管疾病常用中药注射液及其涉及中药有效组分的相关文献进行归纳及分析。文章所载中药注射液有川芎嗪注射液、丹参酮IIA磺酸钠注射液等5种中药注射液,其主要成分多数源自单味中药;中药中有效组分被提取作为中药注射液主要成分是趋势,占比80%;以上中药注射液不仅仅适用于某个中医证型,在相关心血管疾病中多有应用;涉及中药有丹参、川芎等,有效组分类型有皂苷和黄酮类等;多具有保护缺血再灌注损伤、抗炎、抗氧化、抗血栓形成等药理作用。本文为防治心血管疾病提供依据。China Knowledge Network (CNKI), PubMed and relevant bibliographies were consulted to summarize and analyze the current commonly-used traditional Chinese medicine injections (TCMIs) for cardiovascular diseases and their related literature involving the active components of traditional Chinese medicines. In this paper, there are 5 types of TCMIs, including ligustrazine injection, tanshinone IIA sodium sulfonate injection etc. The majority are derived from single-flavored Chinese medicines. It is a trend that the effective components of Chinese medicines are extracted to be the main ingredients of Chinese medicine injections, which accounts for 80% of the total. The above Chinese medicine injections are not only applicable to a certain TCM type, but also to the relevant cardiovascular diseases, in which they can be used in a variety of ways. Involving Chinese medicines such as Salvia miltiorrhiza and Rhizoma Ligustici Chuanxiong, etc., and the types of active components include saponins and flavonoids, etc. Most of them have the pharmacological effects of protection against ischemia-reperfusion injury, anti-inflammation, antioxidation and anti-thrombosis. This article can provide the basis of prevention and treatment of cardiovascular diseases.
