JIANG Zhi-xiong,ZHU Zhi-de*,QI Xiang,et al.Meta-analysis on Chinese Materia Medica Combined with Meglumine Adenosine Cyclphosphate in the Treatment of Viral Myocarditis[J].Chinese Journal of Library and Information Science for Traditional Chinese Medicine,2021,45(5):13-18.[doi:10.3969/j.issn.2095-5707.2021.05.003]
中药联合环磷腺苷葡胺治疗病毒性心肌炎的Meta分析
- Title:
- Meta-analysis on Chinese Materia Medica Combined with Meglumine Adenosine Cyclphosphate in the Treatment of Viral Myocarditis
- 文章编号:
- 2095-5707(2021)05-0013-06
- Keywords:
- meglumine adenosine cyclphosphate; Chinese materia medica; viral myocarditis; Meta-analysis
- 分类号:
- R2-05
- 文献标志码:
- A
- 摘要:
- 目的 系统评价中药联合环磷腺苷葡胺治疗病毒性心肌炎的疗效。方法 计算机检索中国知识资源总库（CNKI）、中国学术期刊数据库（万方数据）、中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）、PubMed、Cochrane Library、Embase数据库建库至2021年4月10日的中药联合环磷腺苷葡胺治疗病毒性心肌炎的随机对照试验（RCT），由2名研究人员独立筛选文献、提取资料并评价纳入文献的质量，采用RevMan 5.3、Stata/SE 12.0软件进行统计分析。结果 共纳入7个RCT，涉及患者749例，其中试验组377例，对照组372例。Meta分析结果显示：试验组总有效率（RR＝1.35，95%CI[1.25，1.45]，P＜0.01）、肌酸激酶同工酶（MD＝-5.00，95%CI[-6.41，-3.59]，P＜0.01）、乳酸脱氢酶（MD＝-16.66，95%CI[-28.13，-5.19]，P＜0.01）、脑钠肽（MD＝-264.19，95%CI[-287.73，-240.64]，P＜0.01）、C反应蛋白（MD＝-4.87，95%CI[-5.76，-3.98]，P＜0.01）等均优于对照组。结论 中药联合环磷腺苷葡胺治疗病毒性心肌炎临床疗效优于常规疗法，鉴于纳入的文献样本量有限，因此需要更多高质量、多中心、大样本的RCT进一步验证。
- Abstract:
- Objective To systematically analyze the efficacy of Chinese materia medica combined with meglumine adenosine cyclphosphate in the treatment of viral myocarditis. Methods Randomized controlled trials (RCTs) of Chinese materia medica combined with meglumine adenosine cyclphosphate in the treatment of viral myocarditis were retrieved from CNKI, VIP, Wanfang, PubMed, CBM, Cochrane Library and Embase from establishment to 10th, April, 2021. After two researchers independently selected the literature, extracted data and evaluated the quality of methodology included in the study, Meta-analysis was carried out by using RevMan 5.3 and Stata/SE12.0 software. Results Seven RCTs were included, including 749 patients. Among them, 377 patients were in experimental group and 372 patients were in control group. The Meta-analysis results showed the total effective rate in the experimental group (RR=1.35, 95%CI [1.25, 1.45], P<0.01), the level of MB isoenzyme of creatine kinase (MD=-5.00, 95%CI [-6.41, -3.59], P<0.01), the level of lactate dehydrogenase (MD=-16.66, 95%CI [-28.1, -5.19], P<0.01), the level of plasma brain natriuretic peptide (MD=-264.19, 95%CI [-287.73, -240.64], P<0.01), and the level of C-reactive protein (MD=-4.87, 95%CI [-5.76, -3.98], P<0.01), which were all better than those of the control group. Conclusion Chinese materia medica combined with meglumine adenosine cyclphosphate in the treatment of viral myocarditis show better efficacy compared with routine therapy. However, in view of the limited sample size of the included literature, more high-quality, multi-center, large-sample RCTs are needed for further verification.
参考文献/References:
[1] 中华中医药学会心血管病分会.国际中医临床实践指南?病毒性心肌炎[J].中国实验方剂学杂志,2020,26(18):91-97.
[2] 卢志强,黄克钧,王珂,等.急性病毒性心肌炎的临床特点及影响因素分析[J].中华医院感染学杂志,2019,29(22):3423-3426.
[3] Martins D S, Ait-Ali L, Khraiche D, et al. Evolution of acute myocarditis in a pediatric population: an MRI based study[J]. Int J Cardiol, 2021(329):226-233.
[4] Caforio A L P, Marcolongo R, Baritussio A, et al. Myocarditis in systemic immune-mediated diseases[M]// Caforio A L P. Myocarditis: pathogenesis, diagnosis and treatment. Cham: Springer, 2020:195-221.
[5] 赵述强,李翔宇.病毒性心肌炎中西医防治的研究进展[J].中西医结合心脑血管病杂志,2016,14(18):2115-2118.
[6] ZHENG Q, ZHUANG Z, WANG Z H, et al. Clinical and preclinical systematic review of astragalus membranaceus for viral myocarditis[J]. Oxid Med Cell Longev, 2020(2020): 1560353.
[7] 牛锋,姚惠辉,曹甦.黄芪注射液联合大量丙种球蛋白治疗小儿急性重症病毒性心肌炎的效果观察[J].中国医药导报,2019,16(23):69-72.
[8] 唐淑洁,钱九光,赵旭伟,等.环磷腺苷葡胺治疗急性心肌梗死的临床观察[J].中国药房,2017,28(23):3274-3276.
[9] 孙婧,党亚南,张霄娜.芪冬颐心口服液联合环磷腺苷葡胺对病毒性心肌炎患者心肌酶谱、细胞免疫功能及血浆心钠素水平的影响[J].现代中西医结合杂志,2019,28(26):2925-2928.
[10] 中华医学会儿科学分会心血管学组,中华儿科杂志编辑委员会.病毒性心肌炎诊断标准(修订草案)[J].中国实用儿科杂志,2000(5):315.
[11] 孙传兴.临床疾病诊断依据治愈好转标准[M].2版.北京:人民军医出版社,1998:134-135.
[12] 王书云.环磷腺苷葡胺和银翘散治疗小儿病毒性心肌炎的效果分析[J].世界中医药,2016,11(6):1816-1817.
[13] 周舸.环磷腺苷葡胺与参麦注射液治疗小儿病毒性心肌炎的疗效分析[J].中国医药科学,2011,1(19):94,96.
[14] 杨顺昱.黄芪注射液合用环磷腺苷葡胺治疗急性病毒性心肌炎的疗效观察[J].广西医学,2008,30(5):649-651.
[15] 陈志娟.黄芪注射液联合环磷腺苷葡胺注射液治疗急性心肌炎90例疗效观察[J].广西医学,2009,31(8):1126-1127.
[16] 骆书辉.环磷腺苷葡胺和参麦注射液治疗小儿病毒性心肌炎的临床价值[J].中国医药指南,2012,10(20):48-49.
[17] 郑俊晨,李林娟,高波,等.心欣舒胶囊联合环磷腺苷葡胺治疗病毒性心肌炎的临床研究[J].现代药物与临床,2016,31(9):1365-1368.
[18] 郑铎,郭文娟,赵雪莲,等.益气养阴解毒方联合环磷腺苷葡胺注射液治疗病毒性心肌炎35例[J].河南中医,2020,40(4):581-584.
[19] Olejniczak M, Schwartz M, Webber E, et al. Viral myocarditis-incidence, diagnosis and management[J]. J Cardiothorac Vasc Anesth, 2020,34(6):1591-1601.
[20] Razzano D, Fallon J T. Myocarditis: somethings old and something new[J]. Cardiovascular Pathology, 2020(44):107155.
[21] 赵雯雯,豆兴茹,黄春燕,等.异甘草酸镁注射液与注射用环磷腺苷葡胺配伍的稳定性[J].医药导报,2019,38(10):1331-1334.
[22] XIN M, FENG J, HAO Y, et al. Cyclic adenosine monophosphate in acute ischemic stroke: some to update, more to explore[J]. J Neurol Sci, 2020(413):116775.
[23] LIAO J, XIE J, LIN D, et al. Meglumine cyclic adenylate improves neurological function following acute spinal cord injury in rats[J]. Molecular Medicine Reports, 2014,10(3):1225-1230.
[24] LIU W, CHEN J L, LIU H, et al. Effects of meglumine cyclic adenylate pretreatment on systemic inflammatory response syndrome induced by lipopolysaccharide in rats[J]. J Huazhong Univ Sci Technolog Med Sci, 2017,37(3):332-336.
[25] Veremeyko T, Yung A, Dukhinova M, et al. Cyclic AMP pathway suppress autoimmune neuroinflammation by inhibiting functions of encephalitogenic CD4 T cells and enhancing M2 macrophage polarization at the site of inflammation[J]. Front Immunol, 2018(9):50.
[26] Mohan M L, Nagatomo Y, Saha P P, et al. The IgG3 subclass of β1-adrenergic receptor autoantibodies is an endogenous biaser of β1AR signaling[J]. Mol Biol Cell, 2021,32(7):622-633.
[27] 莫海燕,冯旭霞.参芪扶正注射液联合环磷腺苷葡胺治疗慢性心力衰竭的临床观察[J].中国实验方剂学杂志,2015,21(1):178-181.
[28] 李宁宁,朱莹莹,邓丽萍.卡托普利联合注射用环磷腺苷葡胺对病毒性心肌炎患儿心电图及血清肌钙蛋白Ⅰ水平的影响[J].医药论坛杂志,2019,40(2):172-174.
[29] 李雪,时圣明,赵余庆.人参及其皂苷和人参方剂防治病毒性疾病的研究进展[J].中草药,2020,51(9):2379-2389.
[30] 高文静,侯敏,王攀,等.外泌体作为中药新活性成分的研究进展[J].世界科学技术－中医药现代化,2019,21(9):1869-1876.
[31] 尹春园,刘建勋,王敏,等.基于国家专利数据库中药复方治疗心肌炎的规律研究[J].中华中医药杂志,2019,34(8):3717-3721.
[32] 石哲玮,刘胜新,詹嘉琛,等.汉黄芩苷对柯萨奇B3病毒诱导的病毒性心肌炎小鼠炎症反应的影响[J].中国病理生理杂志,2020,36(3):427-432.
[33] 崔宏,胡思源.中成药治疗病毒性心肌炎的临床研究进展[J].天津药学,2018,30(2):72-75.
[34] 唐瑜,刘杰,丁鹏,等.动态心电图联合BNP、CK-MB在急性上呼吸道感染并发病毒性心肌炎诊断中的应用价值[J].中国循证心血管医学杂志,2020,12(11):1374-1377,1382.
相似文献/References:
[1]李哲,常暖*,李黎.中药院内制剂政策历史、现状及对策[J].中国中医药图书情报杂志,2014,38(1):38.[doi:10.3969/j.issn.2095-5707.2014.01.012]
Li Zhe,Chang Nuan*,Li Li.The Policy History, Present Situation and Countermeasures of Chinese Medicine Hospital Preparations[J].Chinese Journal of Library and Information Science for Traditional Chinese Medicine,2014,38(5):38.[doi:10.3969/j.issn.2095-5707.2014.01.012]
[2]史磊,曹思思.基于利水功效组群药物的中药药性规律研究[J].中国中医药图书情报杂志,2014,38(4):10.[doi:10.3969/j.issn.2095-5707.2014.04.003]
Shi Lei,Cao Sisi.A Study on Regularity of the Property of Chinese Materia Medica Based on Group Drugs with Diuretic Efficacy[J].Chinese Journal of Library and Information Science for Traditional Chinese Medicine,2014,38(5):10.[doi:10.3969/j.issn.2095-5707.2014.04.003]
[3]林敏华,吴昊,曾华敏,等.中药提取物及有效成分防治非酒精性脂肪性肝病的作用机制研究进展[J].中国中医药图书情报杂志,2020,44(1):72.[doi:10.3969/j.issn.2095-5707.2020.01.017]
LIN Min-hua,WU Hao,ZENG Hua-min,et al.Research Progress in Mechanism of Action of Chinese Materia Medica Extracts and Active Components for Prevention and Treatment of Nonalcoholic Fatty Liver Disease[J].Chinese Journal of Library and Information Science for Traditional Chinese Medicine,2020,44(5):72.[doi:10.3969/j.issn.2095-5707.2020.01.017]
[4]黄凯文,刘芳.岭南医家江勒卿与《药物学注释》[J].中国中医药图书情报杂志,2020,44(4):48.[doi:10.3969/j.issn.2095-5707.2020.04.012]
HUANG Kai-wen,LIU Fang.Lingnan Doctor Jiang Le-qing and Yao Wu Xue Zhu Shi[J].Chinese Journal of Library and Information Science for Traditional Chinese Medicine,2020,44(5):48.[doi:10.3969/j.issn.2095-5707.2020.04.012]
[5]郝雨培,崔妍彧,赵若楠,等.中药治疗子宫肌瘤的作用机制研究进展[J].中国中医药图书情报杂志,2021,45(4):69.[doi:10.3969/j.issn.2095-5707.2021.04.017]
HAO Yu-pei,CUI Yan-yu,ZHAO Ruo-nan,et al.Research Progress in Mechanism of Chinese Materia Medica in the Treatment of Uterine Leiomyoma[J].Chinese Journal of Library and Information Science for Traditional Chinese Medicine,2021,45(5):69.[doi:10.3969/j.issn.2095-5707.2021.04.017]
备注/Memo
收稿日期：2021-04-15
更新日期/Last Update:
2021-09-07