Abstract：
Based on the network Meta-analysis, the efficacy and safety of different traditional Chinese medicine(TCM) injections in the treatment of chronic pulmonary heart disease(CPHD) were systematically evaluated. CNKI, Wanfang, VIP, SinoMed, Web of Science, PubMed, EMbase, and Cochrane Library were searched to collect randomized controlled trial(RCT) of TCM injection in the treatment of CPHD from inception to October 1, 2023. The quality of the included studies was evaluated by the bias risk assessment tool recommended by the Cochrane systematic evaluation manual version 5.3. Stata 17.0 and RevMan 5.4 software were used for statistical analysis of the data. Finally, 103 RCTs were included, involving 9 332 patients and 13 kinds of TCM injections. Network Meta-analysis yielded the following results.(1)In terms of improving the total clinical effective rate, the top three intervention measures in SUCRA ranking are Shuxuetong Injection + conventional western medicine>Ligustrazine Injection + conventional western medicine>Xinmailong Injection + conventional western medicine.(2)In terms of reducing pulmonary artery pressure, the top three intervention measures in SUCRA ranking are Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine>Ligustrazine Injection + conventional western medicine>Shenmai Injection + conventional western medicine.(3)In terms of improving left ventricular ejection fraction(LVEF), the top three intervention measures in SUCRA ranking are Xinmailong Injection + conventional western medicine>Danhong Injection + conventional western medicine>Ginkgo Damo Injection + conventional western medicine.(4) In terms of reducing brain natriuretic peptide(BNP), the top three intervention measures in SUCRA ranking are Xinmailong Injection + conventional wes-tern medicine>Ginkgo Damo Injection + conventional western medicine>Danhong Injection + conventional western medicine.(5) In terms of increasing arterial oxygen partial pressure(PaO_2) and reducing arterial carbon dioxide partial pressure(PaCO_2), the top three intervention measures in SUCRA ranking are Shenxiong Glucose Injection + conventional western medicine>Shenmai Injection + conventional western medicine>Shenfu Injection + conventional western medicine.(6) In terms of improving arterial oxygen saturation(SaO_2), the top three intervention measures in SUCRA ranking are Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine>Xinmailong Injection + conventional western medicine>Shenmai Injection + conventional western medicine.(7) In terms of increasing the percentage of forced expiratory volume in the first second(FEV_1%), the top three intervention measures in SUCRA ranking are Shenfu Injection + conventional western medicine>Tanshinone Sodium Ⅱ_A Sulfonate Injection + conventional western medicine>Shenmai Injection + conventional western medicine.(8) In terms of increasing the proportion of forced expiratory volume to forced vital capacity in the first second(FEV_1/FVC), the top three intervention measures in SUCRA ranking are Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine>Shuxuetong Injection + conventional western medicine>Danhong Injection + conventional western medicine.(9) In terms of safety, neither the experimental group nor the control group experienced any serious adverse drug reactions during the treatment period. In summary, combining TCM injection with conventional western medicine treatment can improve the comprehensive efficacy of treating CPHD, reduce pulmonary artery pressure, and improve cardiopulmonary function and arterial blood gas levels. However, due to the limitations of the quality and quantity of research methodology included, the above conclusions need to be further validated by more well-designed and high-quality RCT.
摘要：
基于网络元分析，系统评价不同中药注射剂治疗慢性肺源性心脏病的疗效和安全性。CNKI,万方,VIP,SinoMed,WebofScience,PubMed,EMBase,和Cochrane图书馆被搜索以收集从开始到2023年10月1日的中药注射剂治疗CPHD的随机对照试验(RCT)。纳入研究的质量通过Cochrane系统评估手册5.3版推荐的偏倚风险评估工具进行评估。采用Stata17.0和RevMan5.4软件对数据进行统计分析。最后,包括103项RCT，涉及9332例患者和13种中药注射剂。网络Meta分析得出以下结果。(1)在提高临床总有效率方面,SUCRA排名前三的干预措施是疏血通注射液+常规西药>川芎嗪注射液+常规西药>心脉隆注射液+常规西药。（2）在降低肺动脉压方面，SUCRA排名前三的干预措施是丹参川芎嗪注射液+常规西药>川芎嗪注射液+常规西药>参麦注射液+常规西药。(3)在改善左心室射血分数(LVEF)方面,SUCRA排名前三的干预措施是心脉隆注射液+常规西药>丹红注射液+常规西药>银杏达莫注射液+常规西药。（4）在降低脑钠肽（BNP）方面，SUCRA排名前三位的干预措施是心脉隆注射液+常规西药>银杏达莫注射液+常规西药>丹红注射液+常规西药。(5)在提高动脉氧分压(PaO_2)和降低动脉二氧化碳分压(PaCO_2)方面,SUCRA排名前三的干预措施是参芎葡萄糖注射液+常规西药>参麦注射液+常规西药>参附注射液+常规西药。(6)在提高动脉血氧饱和度(SaO_2)方面,SUCRA排名前三的干预措施是丹参川芎嗪注射液+常规西药>心脉隆注射液+常规西药>参麦注射液+常规西药。（7）在增加第一秒用力呼气量的百分比（FEV_1％）方面，SUCRA排名前三位的干预措施是参附注射液+常规西药>丹参酮ⅡA磺酸钠注射液+常规西药>参麦注射液+常规西药。（8）在增加第一秒用力呼气量与用力肺活量的比例（FEV_1/FVC）方面，SUCRA排名前三的干预措施是丹参川芎嗪注射液+常规西药>疏血通注射液+常规西药>丹红注射液+常规西药。（9）在安全方面，试验组和对照组在治疗期间均未出现严重的药物不良反应。总之,中药注射剂与常规西药治疗相结合,可提高CPHD的综合疗效。降低肺动脉压,改善心肺功能和动脉血气水平。然而,由于研究方法的质量和数量的限制，以上结论需要通过更精心设计和高质量的RCT进一步验证。
