参附注射液对低血压血流动力学影响荟萃分析

发布时间：2018-05-06 15:11

本文选题：参附注射液 + 低血压　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:评价中成药参附注射液对低血压患者血流动力学影响,为应用参附注射液防治低血压提供循证医学的证据。材料与方法:以“参附注射液”为主检索词联合“低血压”或“休克”或“泵衰”或“血流动力学”或“厥脱”或“厥证”或“脱证”或“眩晕”分别进行中文文献全面检索建库至2016年12月在国内各中文期刊发表的有关参附注射液防治低血压的随机对照试验的研究文献。文献纳入标准:(1)研究类型:以参附注射液防治低血压为主要研究目的的随机对照实验。(2)研究对象:低血压患者:收缩压90mmHg、舒张压60mmHg或原有基础血压降低30mmHg。(3)干预措施:实验组采用参附注射液,或参附注射液加上原有疾病的基础治疗,对照组采用西药,或原有疾病的基础治疗(空白)作对照。(4)研究对象至少纳入30位患者。(5)有研究指标的原始数据。用Jadad评分量表对文献的质量进行评分,用RevMan5.3统计软件对纳入研究进行荟萃分析。结果:1.参附注射液组总有效率高于对照组,其差异具有统计学意义[OR=3.59,95%CI(2.56,5.05),总效应Z=7.39,P0.00001]。2.参附注射液组患者收缩压值高于对照组,与空白组对比其差异具有统计学意义[MD=14.74,95%CI(7.21,22.27),总效应Z=3.84,P=0.00010.05],与西药组对比其差异不具有统计学意义[MD=0.82,95%CI(-8.78,10.42),总效应Z=0.17,P=0.870.05]。3.参附注射液组患者舒张压值高于对照组,与空白组对比其差异具有统计学意义[MD=9.45,95%CI(6.32,12.57),总效应Z=5.93,P0.00001],与西药组对比其差异不具有统计学意义[MD=1.83,95%CI(-0.52,4.17),总效应Z=1.53,P=0.130.05]。4.参附注射液组患者平均动脉压值高于对照组,与空白组对比其差异具有统计学意义(P0.00001),与西药组对比其差异不具有统计学意义(P=0.210.05)。5.参附注射液组患者中心静脉压值高于对照组,与空白组对比其差异具有统计学意义(P0.00001),与西药组对比其差异不具有统计学意义(P=0.05)。6.参附注射液组患者心率低于对照组,与空白组对比其差异具有统计学意义[MD=-12.14,95%CI(-15.81,-8.48),总效应Z=6.49,P0.00001],与西药组对比其差异不具有统计学意义[MD=-3.67,95%CI(-37.98,30.63),总效应Z=0.21,P=0.830.05]。7.参附注射液组患者尿量多于对照组,与空白组对比其差异具有统计学意义(P0.00001),与西药组对比其差异不具有统计学意义(P=0.05)。8.参附注射液组患者左室射血分数高于对照组,与空白组对比其差异具有统计学意义(P0.00001),与西药组对比其差异不具有统计学意义(P=0.430.05)9.参附注射液组患者左室舒张末期内径小于对照组,与空白组对比其差异具有统计学意义(P0.00001),与西药组对比其差异不具有统计学意义(P=0.540.05)。10.参附注射液组患者血管活性药物使用量小于对照组,与空白组对比其差异具有统计学意义(P0.00001),与西药组对比其差异具有统计学意义(P0.0001)。11.参附注射液组患者乳酸水平低于对照组,与空白组对比其差异具有统计学意义(P0.0001),与西药组对比其差异不具有统计学意义(P=0.380.05)。12.参附注射液组患者心律失常发生率低于对照组,与空白组对比其差异不具有统计学意义(P=0.110.05),与西药组对比其差异具有统计学意义(P=0.00050.05)。结论:参附注射液可以安全有效地提高低血压患者血压水平,包括收缩压和舒张压以及平均动脉压、中心静脉压,提高患者左室射血分数,增加患者尿量,同时可以降低患者心率、心律失常发生率、乳酸水平,减小左室舒张末期内径,但作用不优于西药;在血管活性药物使用方面,参附注射液可以减少其用量且作用优于西药。
[Abstract]:Objective: To evaluate the hemodynamic effects of Shenfu Injection on hypotension in patients with hypotension and to provide evidence-based medicine for the application of Shenfu Injection in preventing hypotension. Materials and methods: "Shenfu Injection" was used as the main retrieval word combined with "hypotension" or "shock" or "pump failure" or "hemodynamics" or "syncope" or "syncope". A comprehensive retrieval of Chinese literature from Chinese literature to the Chinese Periodicals in December 2016 on the randomized controlled trials of Shenfu Injection on the prevention and treatment of hypotension in Chinese periodicals. The documents are included in the standard: (1) the study type: the randomised study of the main purpose of the study on the prevention and treatment of hypotension by the injection of annotation. Control experiment. (2) subjects: the patients with hypotension: systolic pressure 90mmHg, diastolic pressure 60mmHg or original basic blood pressure decrease 30mmHg. (3) intervention measures: the experimental group adopted Shenfu injection, or Shenfu Injection plus the basic treatment of the original disease, the control group used western medicine, or the basic treatment of the original disease (blank) as the control. (4) object to the study object to the control group. There were 30 patients. (5) the original data of the study index. The quality of the literature was scored by the Jadad scale, and the RevMan5.3 statistical software was used to carry out a meta-analysis on the inclusion study. Results: the total effective rate of the 1. Shenfu injection group was higher than the control group, the difference was statistically significant [OR=3.59,95%CI (2.56,5.05), the total effect Z=7.39, P0.00001 The systolic pressure of].2. Shenfu injection group was higher than that of the control group. Compared with the blank group, the difference was statistically significant [MD=14.74,95%CI (7.21,22.27), total effect Z=3.84, P=0.00010.05], compared with western medicine group, the difference was not statistically significant [MD=0.82,95%CI (-8.78,10.42), total effect Z=0.17, P=0.870.05].3. Shenfu injection group patients Shu. The difference of tension was higher than that of the control group, and the difference was statistically significant [MD=9.45,95%CI (6.32,12.57), the total effect was Z=5.93, P0.00001], and the difference was not statistically significant [MD=1.83,95%CI (-0.52,4.17), the total effect Z=1.53, and the average arterial pressure of the patients with P=0.130.05].4. Shenfu injection was higher than that of the control group, and the value of the total effect was higher than the control group, and the difference between the group and the empty group was higher than the control group. The difference of the white group was statistically significant (P0.00001). Compared with the western medicine group, the difference was not statistically significant (P=0.210.05) the central venous pressure of the patients in the.5. Shenfu injection group was higher than the control group, and the difference was statistically significant (P0.00001) compared with the blank group (P0.00001), and the difference was not statistically significant (P=0.05).6. compared with the western medicine group (P=0.05). The heart rate of the Shenfu injection group was lower than that of the control group. Compared with the blank group, the difference was statistically significant [MD=-12.14,95%CI (-15.81, -8.48), the total effect Z=6.49, P0.00001], compared with the western medicine group, the difference was not statistically significant [MD=-3.67,95%CI (-37.98,30.63), the total effect Z=0.21, and the patients in the P=0.830.05].7. Shenfu injection group had more urine volume than the control group. Compared with the control group, the difference was statistically significant (P0.00001). Compared with the western medicine group, the difference was not statistically significant (P=0.05) the left ventricular ejection fraction of the.8. Shenfu injection group was higher than that of the control group, and the difference was statistically significant (P0.00001) compared with the blank group (P0.00001), and the difference was not statistically significant compared with the western medicine group. (P=0.430.05) the left ventricular end diastolic diameter of the 9. Shenfu injection group was less than the control group. Compared with the blank group, the difference was statistically significant (P0.00001). The difference was not statistically significant (P=0.540.05) compared with the western medicine group (P=0.540.05) the use of vascular living drugs in the.10. Shenfu injection group was less than that of the control group, and the difference was compared with the blank group. Statistical significance (P0.00001), compared with the western medicine group, the difference was statistically significant (P0.0001).11. Shenfu injection group was lower than the control group, compared with the blank group, the difference was statistically significant (P0.0001), compared with the western medicine group, the difference was not statistically significant (P=0.380.05).12. Shenfu injection group patients heart. The incidence of arrhythmia was lower than that of the control group. Compared with the blank group, the difference was not statistically significant (P=0.110.05). Compared with the western medicine group, the difference was statistically significant (P=0.00050.05). Conclusion: Shenfu injection can improve the blood pressure level of the hypotension patients safely and effectively, including systolic and diastolic pressure, and the mean arterial pressure and central vein. Pressure, increase the left ventricular ejection fraction, increase the urine volume of patients, and reduce the heart rate, arrhythmia incidence, lactic acid level, reduce the left ventricular end diastolic diameter, but the effect is not better than western medicine; in the use of vasoactive drugs, Shenfu injection can reduce its dosage and effect better than Western medicine.

【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

【参考文献】