血必净注射液治疗脓毒症性急性肾损伤的临床疗效评价

doi:10.5246/jcps.2025.12.085

中国药学(英文版) ›› 2025, Vol. 34 ›› Issue (12): 1126-1143.DOI: 10.5246/jcps.2025.12.085

血必净注射液治疗脓毒症性急性肾损伤的临床疗效评价

李雅静¹^,²^,^#, 陈腾飞³^,⁴^,^#, 严长宏², 白雅雯¹, 严昊阳⁵, 刘清泉¹^,³^,⁴^,^*()

^1. 内蒙古医科大学中医学院, 内蒙古呼和浩特 010110
^2. 包头市中心医院中医科, 内蒙古包头 014040
^3. 首都医科大学附属北京中医医院, 北京 100700
^4. 北京市中医药研究所, 北京 100700
^5. 湖南中医药大学中医学院, 湖南长沙 410208

收稿日期:2025-08-24 修回日期:2025-09-11 接受日期:2025-09-27 出版日期:2025-12-31 发布日期:2025-12-31
通讯作者: 刘清泉

Xuebijing injection for sepsis-associated acute kidney injury treatment: a systematic review and meta-analysis

Yajing Li¹^,²^,^#, Tengfei Chen³^,⁴^,^#, Changhong Yan², Yawen Bai¹, Haoyang Yan⁵, Qingquan Liu¹^,³^,⁴^,^*()

¹ Traditional Chinese Medicine College, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia, China
² Department of Traditional Chinese Medicine, Baotou Central Hospital, Baotou 014040, Inner Mongolia, China
³ Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100700, China
⁴ Beijing Institute of Traditional Chinese Medicine, Beijing 100700, China
⁵ College of Traditional Chinese Medicine, Hunan University of Traditional Chinese Medicine, Changsha 410208, Hunan, China

Received:2025-08-24 Revised:2025-09-11 Accepted:2025-09-27 Online:2025-12-31 Published:2025-12-31
Contact: Qingquan Liu
About author:
^# Yajing Li and Tengfei Chen contributed equally to this work.
Supported by:
The Natural Science Foundation of Joint Research Project of the China Association of Chinese Medicine (Grant No. 2024-LHGG-YSBZ2004).

摘要/Abstract

摘要：

本研究旨在基于Meta分析评价血必净注射液联合CRRT治疗脓毒症所致急性肾损伤(Sepsis-associated acute kidney injury, SA-AKI)的临床疗效。在国内外数据库检索血必净注射液联合CRRT治疗SA-AKI的临床随机对照试验(randomized controlled trials, RCTs), 根据纳入和排除标准, 确定纳入的文献, 运用RevMan5.4软件对文献进行质量评估及Meta分析。共纳入20项试验, 1695例患者。结果显示, 与单纯CRRT治疗相比, 联合血必净注射液组的血清肌酐[SMD = –1.50, 95% CI (–1.89, –1.12)]、尿素氮[SMD = –1.61, 95% CI (–2.32, –0.90)]、血清胱抑素C [MD = –0.60, 95% CI (–1.05, –0.14)]; Acute Physiology And Chronic Health Evaluation Ⅱ评分(APACHE Ⅱ评分) [MD = –3.57, 95% CI (–4.73, –2.41)]、Sequential Organ Failure Assessment评分(SOFA评分)[MD = –2.46, 95% CI (–3.00, –1.92)]; 炎症指标: C反应蛋白(CRP) [SMD = –2.26, 95% CI (–2.82, –1.69)]、肿瘤坏死因子(TNF-α) [SMD = –2.45, 95% CI (–3.11, –1.79)]、白细胞介素-6 (IL-6) [SMD = –2.40, 95% CI (–3.01, –1.78)]; 免疫功能指标: CD3 [SMD = 2.79, 95% CI (1.41, 4.18)]、CD4 [SMD = 1.09, 95% CI (0.63, 1.55)]; 凝血功能指标: PT [SMD = –1.70, 95% CI (–2.46, –0.94), P < 0.0001]、APTT [SMD = –1.04, 95% CI (–1.25, –0.83), P < 0.00001]、Fib [SMD = 2.32, 95% CI (1.43, 3.21), P < 0.00001]; 死亡率[OR = 0.52, 95% CI (0.33, 0.83), P = 0.006] 均有统计学意义(P < 0.05)。脓毒症急性肾损伤在CRRT治疗的基础上联合血必净注射液治疗对肾功能的恢复、炎性因子的消除、免疫功能的改善、凝血功能的控制、死亡率的降低上明显优于单纯CRRT治疗。但由于试验整体质量不高, 仍需更多大样本、多中心、双盲的随机对照试验进一步支持。

关键词: 血必净注射液, CRRT, 脓毒症, 急性肾损伤, Meta分析

Abstract:

Sepsis-associated acute kidney injury (SA-AKI) represents a leading contributor to the elevated mortality observed in sepsis patients. In the present study, we conducted a comprehensive meta-analysis to assess the clinical effectiveness of continuous renal replacement therapy (CRRT) in combination with Xuebijing injection for the treatment of SA-AKI. A systematic search was performed across major databases, including CNKI, VIP, Sinomed, WanFang, PubMed, and the Cochrane Library, covering publications up to January 2025. Quality assessment and statistical analyses were carried out using RevMan 5.4. The pooled results demonstrated that the adjunctive use of Xuebijing injection with CRRT, as compared to CRRT alone, yielded significantly better outcomes. Specifically, this combined therapy was associated with enhanced recovery of renal function, more effective clearance of inflammatory mediators, improved immune modulation, better regulation of coagulation parameters, and a marked reduction in mortality among SA-AKI patients.

Key words: Xuebijing injection, CRRT, Sepsis, Acute kidney injury, Meta-analysis

Supporting:

李雅静, 陈腾飞, 严长宏, 白雅雯, 严昊阳, 刘清泉. 血必净注射液治疗脓毒症性急性肾损伤的临床疗效评价[J]. 中国药学(英文版), 2025, 34(12): 1126-1143.

Yajing Li, Tengfei Chen, Changhong Yan, Yawen Bai, Haoyang Yan, Qingquan Liu. Xuebijing injection for sepsis-associated acute kidney injury treatment: a systematic review and meta-analysis[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(12): 1126-1143.

图/表 18

Figure 1. Flowchart of studies screening.

Table 1. General information on the included literature.

Figure 2. Risk of bias assessment diagram.

Figure 3. Forest plot for Scr meta-analysis.

Figure 4. Forest plot for urea nitrogen meta-analysis.

Figure 5. Forest plot for serum Cys-C meta-analysis.

Figure 6. Forest plot for APACHE II score meta-analysis.

Figure 7. Forest plot for SOFA score meta-analysis.

Figure 8. Forest plot for CRP meta-analysis.

Figure 9. Forest plot for TNF-α meta-analysis.

Figure 10. Forest plot for IL-6 meta-analysis.

Figure 11. Forest plot for CD3 meta-analysis.

Figure 12. Forest plot for CD4 meta-analysis.

Figure 13. Forest plot for PT meta-analysis.

Figure 14. Forest plot for APTT meta-analysis.

Figure 15. Forest plot for Fib meta-analysis.

Figure 16. Forest plot for mortality meta-analysis.

Figure 17. Funnel plots for publication bias and sensitivity analysis of the main outcome.

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血必净注射液治疗脓毒症性急性肾损伤的临床疗效评价

Xuebijing injection for sepsis-associated acute kidney injury treatment: a systematic review and meta-analysis

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