Meta-analysis of efficacy and safety of the treatment of Shengmai Injection for viral myocarditis

CAI Yin-he; WEN Jun-mao; Lu Ke; WU Wei

doi:10.3969/j.issn.1674-4055.2017.06.02

Abstract：Objective To systematically review the clinical effect and safety of Shengmai Injection combined with western medicine in the treatment of viral myocarditis (VMC).Method Databases as PubMed, Embase, Cochrane library, CNKI, VIP, Wanfang data and CBM were searched in order to collect randomized clinical trials (RCTs) on the effectiveness and safety of Shengmai Injection combined with western medicine in the treatment of VMC. Two researchers independently screened literatures according to the inclusion and exclusion criteria, and evaluated the methodological quality of included studies. We carried out meta-analysis and TSA analysis by using RevMan 5.3 version and TSA v0.9 respectively, and GRADEpro was used to evaluate the quality of evidence. Result 14 RCTs including 1492 cases were included eventually. The analysis shows that: ①the total effective rate of Shengmai Injection (SMI) + supportive therapy was superior to those of pure supportive therapy (RR=1.11, 95%CI: 1.02 to 1.20,P<0.05); ②the same as the total effective rate of SMI + symptomatic treatment versus pure symptomatic treatment (RR=1.23, 95%CI: 1.17 to 1.30,P<0.00001); ③the levels of Creatine phosphokinase (CK, MD=-66.31, 95%CI: -110.38 to -22.23,P=0.003), creatine kinase isoenzyme (CK-MB,MD=-12.91, 95%CI:-14.91 to -10.90,P<0.00001), lactate dehydrogenase (LDH,MD=-64.11, 95%CI: -107.07 to -21.15,P=0.003), and aspartate aminotransferase (AST,MD=-11.85, 95%CI: -14.15 to -9.55,P<0.00001) were lower with SMI combined with western medicine than with western medicine controls. Result of TSA analysis showed that SMI combined with western medicine were effectively for VMC treatment, and could lower CK, CK-MB and AST, but the effecton LDH was unclear.Conclusion Shengmai injection combined with Western medicine in the treatment of viral myocarditis has a certain effect. However, the quality of existing research is low and the number is too small, which required more high-quality, multi-center randomized double-blind clinical trials for further validation.