目的:丹参酮IIA磺酸钠(STS)注射液已被广泛用作肺心病的辅助治疗。然而,到目前为止,尚未对STS注射液的疗效进行系统评估。因此,本研究探讨了STS注射液作为PHD辅助治疗的疗效.
方法:从中国科技期刊数据库筛选随机对照试验(RCT),中国国家知识基础设施,万方数据库,PubMed,中医学,谷歌学者,Medline,中国生物医学文献数据库,科克伦图书馆,截至2024年1月20日的Embase和中国科学引文数据库。文献检索,数据收集和质量评估由两名研究者独立进行.提取的数据用RevMan5.4和STATA14.0进行分析。基于方法学质量,STS注射液的剂量,对照组措施和干预时间,进行敏感性分析和亚组分析.
结果:本研究纳入了19项RCTs,共1739例患者。结果表明,作为辅助治疗,STS注射液联合西药治疗PHD疗效优于单纯西药治疗,提高临床有效率(RR=1.22;95%CI,1.17~1.27;p<0.001),氧分压(MD=10.16;95%CI,5.07至15.24;p<0.001),左心室射血分数(MD=8.66;95%CI,6.14~11.18;p<0.001)和每搏输出量(MD=13.10;95%CI,11.83~14.38;p<0.001),同时降低低切血黏度(MD=-1.16;95%CI,-1.57至-0.74;p<0.001),高剪切血液粘度(MD=-0.64;95%CI,-0.86至-0.42;p<0.001),血浆粘度(MD=-0.23;95%CI,-0.30至-0.17;p<0.001),血细胞比容(MD=-8.52;95%CI,-11.06至-5.98;p<0.001),纤维蛋白原(MD=-0.62;95%CI,-0.87至-0.37;p<0.001)和二氧化碳分压(MD=-8.56;95%CI,-12.09至-5.02;p<0.001)。
结论:STS注射液作为辅助治疗似乎比单纯西药治疗PHD更有效。然而,由于纳入的RCT质量低,需要更精心设计的随机对照试验来验证STS注射的疗效.
OBJECTIVE: Sodium tanshinone IIA sulfonate (STS) injection has been widely used as adjunctive therapy for pulmonary heart disease (PHD) in China. Nevertheless, the efficacy of STS injection has not been systematically evaluated so far. Hence, the efficacy of STS injection as adjunctive therapy for PHD was explored in this study.
METHODS: Randomized controlled trials (RCTs) were screened from China Science and Technology Journal Database, China National Knowledge Infrastructure, Wanfang Database, PubMed, Sino-Med, Google Scholar, Medline, Chinese Biomedical Literature Database, Cochrane Library, Embase and Chinese Science Citation Database until 20 January 2024. Literature searching, data collection and quality assessment were independently performed by two investigators. The extracted data was analyzed with RevMan 5.4 and STATA 14.0. Basing on the methodological quality, dosage of STS injection, control group measures and intervention time, sensitivity analysis and subgroup analysis were performed.
RESULTS: 19 RCTs with 1739 patients were included in this study. Results showed that as adjunctive therapy, STS injection combined with Western medicine showed better therapeutic efficacy than Western medicine alone for PHD by increasing the clinical effective rate (RR = 1.22; 95% CI, 1.17 to 1.27; p < 0.001), partial pressure of oxygen (MD = 10.16; 95% CI, 5.07 to 15.24; p < 0.001), left ventricular ejection fraction (MD = 8.66; 95% CI, 6.14 to 11.18; p < 0.001) and stroke volume (MD = 13.10; 95% CI, 11.83 to 14.38; p < 0.001), meanwhile decreasing the low shear blood viscosity (MD = -1.16; 95% CI, -1.57 to -0.74; p < 0.001), high shear blood viscosity (MD = -0.64; 95% CI, -0.86 to -0.42; p < 0.001), plasma viscosity (MD = -0.23; 95% CI, -0.30 to -0.17; p < 0.001), hematokrit (MD = -8.52; 95% CI, -11.06 to -5.98; p < 0.001), fibrinogen (MD = -0.62; 95% CI, -0.87 to -0.37; p < 0.001) and partial pressure of carbon dioxide (MD = -8.56; 95% CI, -12.09 to -5.02; p < 0.001).
CONCLUSIONS: STS injection as adjunctive therapy seemed to be more effective than Western medicine alone for PHD. However, due to low quality of the included RCTs, more well-designed RCTs were necessary to verify the efficacy of STS injection.