Meta - Analysis Of Clinical Efficacy Of Shenmai Injection In The Treatment Of Cardiogenic Shock

Purpose:We evaluate Shenmai Injection clinical efficacy of the treatment of cardiogenic shock by evidence-based medicine method.Material and method:We retrieved three electronic databases such as CNKI, VIP and Wanfang databases. Collect randomized or quasi-randomized controlled trials which Shenmai Injection combination western medicine as the experimental group treat cardiogenic shock, observing clinical efficacy. Evaluate the quality of literature by the Jadad score and the Cochrane Handbook. Enter the extracted data into Revman5.3 software for analysis.Results: The analysis included a total of 10 documents, are low-quality literature. A total of 629 cases, including 325 patients in test group(Shenmai injection combined with western medicine), and 304 patients in the control group(western medicine). Meta-analysis: Reducing mortality: the experimental group than the control group,(RR = 0.44, 95% CI [0.26,0.74], Z = 3.06, P = 0.002); Improving systolic blood pressure level: the experimental group than the control group,(MD = 12.64,95% CI [4.10,21.18], Z = 2.90, P = 0.004); Improving diastolic blood pressure level: the experimental group than the control group,(MD = 5.19,95% CI [0.55,9.84], Z = 2.19, P = 0.03); Reducing heart rate level: the experimental group than the control group,(MD =-10.74, 95% CI [-18.00,-3.48], Z = 2.90, P = 0.004); Reduction in dopamine withdrawal time: the experimental group than the control group,(MD =-69.46,95% CI [-74.48,-64.44], Z = 27.12, P <0.00001); Improvement rate of heart function(Killip classification): the experimental group than the control group,(RR = 1.39, 95% CI [1.10,1.77], Z = 2.75, P = 0.006); Improvement of left ventricular ejection fraction: experimental group than the control group,(MD = 7.68,95% CI [6.26,9.09], Z = 10.63, P <0.00001); Shrinking left ventricular end-systolic volume: the experimental group than the control group,(MD =-9.51,95% CI [-10.95,-8.07], Z = 12.95, P <0.00001); Shrinking left ventricular end-diastolic volume: the experimental group and the control group, no difference,(MD =-0.45,95% CI [-7.07,6.18], Z = 0.13, P = 0.90); Improvement rate of symptom: the experimental group than the control group,(RR = 1.16, 95% CI [1.02,1.31], Z = 2.22, P = 0.03); No record of serious adverse reactions.Conclusion: Shenmai Injection in treatment of cardiogenic shock can reduce mortality and improve systolic and diastolic blood pressure, reduce heart rate and improve heart function(Killip classification), improve the left ventricular ejection fraction, reduced left ventricular end-systolic volume, and improve symptom relief rate, the existing information is not suggestive of serious adverse events. We need to improve the quality of randomized controlled trials to further verification.