Keywords
Septic cardiomyopathy
Effectiveness
Safety
Meta-analysis
Submitted : 2021-12-21
Accepted : 2022-01-05
Published : 2022-01-20
Abstract
Objective: To evaluate the efficacy and safety of Shenfu injection in the treatment of septic cardiomyopathy. Methods: Literatures on Shenfu injection for the treatment of sepsis published from the establishment of each database to December 31, 2020, were searched by computer; Cochrane risk-of-bias tool was used for evaluating the quality of literatures, and Review Manager 5.4 software was used for meta-analysis. Results: Twenty random controlled trials (RCTs) were included, with a total of 1,179 patients; the meta-analysis showed that the routine treatment of Western medicine combined with Shenfu injection can reduce the 28-day mortality, the length of hospital stay, cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic peptide (NT-proBNP) as well as improve the left ventricular ejection fraction (LVEF) with low incidence of adverse reactions. Conclusion: Western medicine combined with Shenfu injection can further reduce myocardial injury in patients with sepsis and improve cardiac function as well as the prognosis of patients with septic cardiomyopathy.
References
Frencken JF, Donker DW, Spitoni C, et al., 2018, Myocardial Injury in Patients With Sepsis and Its Association with Long-Term Outcome. Circ Cardiovasc Qual Outcomes, 11(2): e004040.
Zheng Z, Ma H, Zhang X, et al., 2017, Enhanced Glycolytic Metabolism Contributes to Cardiac Dysfunction in Polymicrobial Sepsis. J Infect Dis, 215(9): 1396-1406.
Rumery K, Yunus F, Frishman WH, 2020, Myocardial Depression in Sepsis: Beneficial Adaptation or Sequelae that Requires Treatment?. Cardiol Rev, 28(5): 256-261.
Yang L, Yue J, Luo Y, et al., 2018, Research Progress of Shenfu Injection in the Treatment of Myocardial inhibition in Sepsis. Chinese Medicine Modern Distance Education of China, 16(5): 149-151.
Zou H, Zhou Qi, Zhou C, et al., 2012, Protective Effect of Shenfu Injection on Myocardial Injury in Patients with Sepsis. China Medical Herald, 9(13): 77-78, 87.
Luo Y, Zhao F, Chen W, et al., 2018, Clinical Study of Shenfu Injection on Myocardial Injury in Patients with Sepsis. Journal of Emergency in Traditional Chinese Medicine, 27(11): 1930-1932.
Higgins JPT, Thomas J, Chandler J, et al., (eds) 2021, Cochrane Handbook for Systematic Reviews of Interventions Version 6.2. Cochrane. www.training.cochrane.org/handbook (updated on February 2021).
Zhou X, Lin M, Yu Y, 2015, Influence of Shenfu Injection on Hemorheology and Prognosis of Patients with Severe Sepsis. Chongqing Medicine, 44(36): 5157-5159.
Yao S, 2015, Effects of Shenfu Injection on Systemic Circulation, Oxygen Metabolism and Prognosis in Patients with Septic Shock. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 25(24): 23-25.
Xiao Y, Li Y, Wang G, et al., 2017, Clinical Observation of Shenfu Injection in Treatment of Septic Shock Patients. Journal of Emergency in Traditional Chinese Medicine, 26(9): 1665-1667.
Wu X, Wu H, Guan Y, et al., 2012, Effect of Shenfu Injection on Early Plasma NT-proBNP in Patients with Sepsis. Journal of Emergency in Traditional Chinese Medicine, 21(12): 2035-2036.
Wang L, Qi H, Zhang W, et al., 2018, Effects of Shenfu Injection on D-Lactic Acid and Inflammatory Factors in Patients with Severe Sepsis. Journal of Clinical Emergency, 19(1): 17-20.
Tao L, 2019, Clinical Observation of Fuzheng Guben Method in the Treatment of Sepsis. Journal of Guangzhou University of Traditional Chinese Medicine, 36(10): 1535-1539.
Song X, Shen Y, Yuan Z, 2015, Effects of Shenfu Injection on Serum Troponin I, N-Terminal Pro-brain Natriuretic Peptide Levels and Cardiac Index in Patients with Sepsis. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 44: 151-152.
Liu T, Lv B, Huang R, et al., 2014, Effect of Shenfu Injection on Cardiac Function inPatients with Septic Myocardial Injury. Shandong Medical Journal, 000(026): 69-71.
Liu M, 2015, Clinical Observation of Shenfu Injection on Myocardial Injury in Sepsis. Guangzhou University of Chinese Medicine.
Liu M, Ye B, Shi X, 2017, Efficacy Analysis of Shenfu Injection in Patients with Aeptic Shock. Journal of Imaging Research and Medical Applications, 1: 171-173.
Lin M, Pan S, Zeng W, et al., 2014, Effects of Shenfu Injection on Cardiac Function and Plasma NT-proBNP in Patients with Sepsis Myocardial Injury. Modern Practical Medicine, 26(10): 1265-1266.
Li J, 2012, Clinical Study of Shenfu Injection in the Treatment of Septic Shock. Zhejiang University.
Jiang R, Lei S, Wang L, et al., 2009, Effect of Shenfu Injection on Tissue Oxygen Metabolism in Patients with Severe Sepsis. China Journal of Traditional Chinese Medicine and Pharmacy, 24(7): 965-967.
Huang X, 2016, Evaluation of Hemodynamic Effect and Prognosis of Shenfu Injection in Patients with Septic Shock by PiCCO. Guangzhou University of Chinese Medicine.
Geng F, Yu L, Zhang Y, 2019, Influence of Shenfu Injection on Inflammatory Factors and Clinical Prognosis of Patients with Sepsis. Chinese Traditional Patent Medicine, 41(1): 228-230.
Feng H, Li W, 2014, Protective Effect of Shenfu Injection on Myocardial Injury in Patients with Sepsis. Hebei Medical Journal, 2014(18): 2764-2765.
Cui Y, Dai L, 2016, Effect of Shenfu Injection on Septic Shock and Hemodynamics. Modern Journal of Integrated Traditional Chinese and Western Medicine, 25(19): 2120-2122.
Shen Q, Zhang Z, 2017, Effects of Shenfu Injection on Plasma BNP and Inflammatory Factors in Patients with Sepsis Myocardial Injury. Journal of Emergency in Traditional Chinese Medicine, 26(1): 184-185, 188.
Poveda-Jaramillo R, 2021, Heart Dysfunction in Sepsis. J Cardiothorac Vasc Anesth, 35(1): 298-309.
Habimana R, Choi I, Cho HJ, et al., 2020, Sepsis-Induced Cardiac Dysfunction: A Review of Pathophysiology. Acute Crit Care, 35(2): 57-66.
Zeng L, Zhao Y, Jiang C, et al., 2017, Analysis of Clinical Diagnostic Bounds of Myocardial Injury Markers in the Diagnosis of Acute Myocardial Infarction. International Journal of Laboratory Medicine, 38(6): 826-828.
Maisel AS, Krishnaswamy P, Nowak RM, et al., 2022, Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure. N Engl J Med, 347(3): 161-167.
Gong H, Luo X, 2010, Application Progress of BNP and NT-proBNP in Heart Failure. Journal of Military Surgeonin in Southwest China, 12(1): 99-101.
Zhang S, Wu B, 2001, Study on Positive Inotropic Effect of Aconitine Combined with Potassium Channel Agonist on Isolated Rat Heart. Chinese Pharmacological Bulletin, 17(5): 570-572.
Jiang J, Zhang S, Ji D, 2012, Handbook of Common New Drugs, Shanxi Science and Technology Press Co., Ltd., Jinan, 2000-2009.
Yang W, Li P, Mi H, et al., 2018, Protective Effects of Shenfu Injection on Acute Pancreatitis in Rats. Chinese Journal of Experimental Traditional Chinese Medicine, 24(7): 159-164.
Duncan DJ, Hopkins PM, Harrison SM, 2007, Negative Inotropic Effects of Tumour Necrosis Factor-Alpha and Interleukin-1? are Ameliorated by Alfentanil in Rat Ventricular Myocytes. Br J Pharmacol, 150(6): 720-726.
Yu Y, Wang S, 2013, Effect of Shenfu Injection on Mitochondrial and Inner Membrane Injury of Hypertrophic Cardiomyocytes. Chinese Materia Medica Pharmacology and Clinical, 29(4): 19-21.
Xin Y, Wu Y, Gu Y, et al., 2010, Experimental Study of Shenfu Injection on Myocardial Apoptosis Induced by Ischemia/Reperfusion Injury in Rats. Journal of Cardiopulmonary and Vascular Diseases, 29(3): 229-232.