DOI QR코드

DOI QR Code

승모판의 인공판막 치환술후 삼부주사액의 심근보호효과에 관한 체계적 문헌고찰 및 메타분석

Myocardial Protective Effects of Shenfu Injection after Mitral Valve Replacement Surgery; A Systematic Review and Meta Analysis.

  • 신봉진 (부산대학교 한의학전문대학원) ;
  • 김지호 (부산대학교 한의학전문대학원) ;
  • 안무혁 (부산대학교 한의학전문대학원) ;
  • 권정남 (부산대학교 한의학전문대학원)
  • Bong-Jin Shin (Pusan National University School of Korean Medicine) ;
  • Ji-Ho Kim (Pusan National University School of Korean Medicine) ;
  • Mu-Hyeok Ahn (Pusan National University School of Korean Medicine) ;
  • Jung-Nam Kwon (Pusan National University School of Korean Medicine)
  • 투고 : 2022.02.11
  • 심사 : 2022.07.15
  • 발행 : 2022.09.01

초록

Objectives: The purpose of this study was to evaluate the effects of shenfu injection on myocardial protective effects after mitral valve replacement surgery. Methods: We searched four international databases (PUBMED, Embase, Web of Science and CNKI) and three domestic electronic databases (OASIS, RISS and NDSL) for relevant studies. We used following keywords 'shenfu', 'valve replacement', 'mitral valve' at PUBMED, Embase and Web of Science; '二尖瓣', '参附注射液', '瓣膜' at CNKI and '이첨판', '판막', '삼부' at domestic databases. The search range included randomized controlled trials. When appropriate, meta-analyses were performed. Results: Seven randomized controlled trials were selected. All studies used Shenfu injection after mitral valve replacement surgery. We analyzed myocardial damage, cardiac function, patients' recovery rate, with various evaluation indicators. We also used meta-analysis for CK-MB, cTnI, MDA and voluntary recovery of heartbeat. CK-MB was analyzed in two subgroups: 8 hours and 24 hours after surgery. Std was -2.34(95% CI -4.10, -0.58) for 8 hours and -1.95(95% CI -4.79 to 0.88) for 24 hours. 8 hours showed statistically significant difference. cTnI appeared significant decrease with Std of -2.13(95% CI -2.60, -1.66). MDA showed significant decrease with Std of -0.95(95% CI -1.43 to -0.47). Voluntary recovery of heartbeat significantly increased with the odd ratio of 4.34(95% CI 1.76, 10.70). Conclusions: We suggest that Shenfu injection after Mitral valve replacement surgery may have significant myocardial protective effects in terms of reducing myocardial damages, reactive oxygen species, increasing cardiac function and patients' recovery after surgery. However, the evidence is limited, further research is required.

키워드

과제정보

이 과제는 부산대학교 기본연구지원사업(2년)에 의하여 연구되었음.

참고문헌

  1. Kim, M. S., Cho, S. J., Park, S. J., Cho, S. W., Choi, S. H., Kim, H. S., ... & Park, S. W. (2019). Frequency and clinical associating factors of valvular heart disease in asymptomatic Korean adults. Scientific reports, 9(1), 1-8.  https://doi.org/10.1038/s41598-018-37186-2
  2. Kil A. R., Shin Y. S. (2020). Relationship between Warfarin Related Knowledge, Self Efficacy and Medication Adherence of Patient with Prosthetic Heart Valve Replacement. 21(1), 584-592. 
  3. Book publishing Jungdam Editorial department steps to internal Medicine 3. Seoul: JDB: 2013 p.243-6. 
  4. Kim J. H., Jung S. H., Kim N. H., Jung J. H., Soh J. E., Lee S. J., ... & Hwang H. K. (2002). A Case Report on the Inflation Failure of Distal Portion of Inoue Balloon during Percutaneous Mitral Valvuloplasty in a Patient with Rheumatic Mitral Stenosis. Korean Circulation Journal 32(10), 906-910.  https://doi.org/10.4070/kcj.2002.32.10.906
  5. Shin D. K., Kim M. H., Cho J. K. & Kim K. S. (1996). Evaluation of the Surgical Treatment for Mitral Stenosis. The Korean journal of thoracic and cardiovascular surgery, 29(10). 1095-1101. 
  6. Asmar BE, Perrier P, Couetil J, Carpentier A. (1991). Failures in reconstructive mitral valve surgery. J Med Liban. 39:7-11. 
  7. Zheng C. (2004). Cardioprotection of Shenfu on the Ischemia-Reperfusion Injury In Mitral Valve Repalcement with Cardiopulmonary Bypass and Its Effect on Postoperative Fatigue Syndrome. 重庆医科大学. 
  8. Cho H. J., Lee J. W., Jung S. H., Je H. G., Choo S. J., Song H. & Chung C. H. (2008). Midterm Results of the Bioprosthesis in Mitral Position. Journal of Chest Surgery, 41(695-702). 
  9. Kim H. Z., Lim S. H., Park S. W., Kim N. S. & Lee M. K. (2007). Iatrogenic Aortic Dissection Following Mitral Valve Replacement - A case report -. Korean Journal of Anesthesiology, 53(4), 524-527.  https://doi.org/10.4097/kjae.2007.53.4.524
  10. Kim S. H., Kim C. S., Lee N. J., Gil N. S., Lee J. H., Yoon S. Z. ... & Bahk J. H. (2008). Left Ventricular Rupture immediately after Mitral Valve Replacement -A case report-. Korean Journal of Anesthesiology; 54(3), 363-365.  https://doi.org/10.4097/kjae.2008.54.3.363
  11. Na K. J., Kim S. H. & Kim G. H. (1995). Clinical Results of Mitral Valve Replacement. The Korean journal of thoracic and cardiovascular surgery. 28(12). 1113-1121. 
  12. Shin HR, Kim CH, Chu HM et al. (2020). A Case Report of a Mitral Stenosis Patient Treated with Korean Medicine. J Int Korean Med. 41(3), 457-466.  https://doi.org/10.22246/jikm.2020.41.3.457
  13. Ryu HC, Seo CH, Kim IG et al. (2005). Clinical Report of Cerebral Infarction Patient with Mitral Regurgitation. Korean J Oriental Physiology & Pathology. 19(4), 1082-1087. 
  14. Wang, Y. Y., Li, Y. Y., Li, L., Yang, D. L., Zhou, K., & Li, Y. H. (2018). Protective Effects of Shenfu Injection against Myocardial Ischemia-Reperfusion Injury via Activation of eNOS in Rats. Biological & pharmaceutical bulletin, 41(9), 1406-1413.  https://doi.org/10.1248/bpb.b18-00212
  15. Song W. T., Cheng F. F., Xu L. Lin C. R., & Liu J. X. (2012). Chinese medicine shenfu injection for heart failure: A systematic review and meta-analysis. Evid Based Complement Alternat Med. 2012(713149. 10.1155/2012/713149 
  16. Qing Y., Dong L. & Wei T. (2006). Effects of Shenfu injection on perioperative myocardial enzymes and hemodynamics in patients with mitral valve replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery. 04). 284-285. 
  17. Li K., Zheng S. Y. & Chen Z. Y. (2009). Study of protective effect of Shen-fu injection on myocardial ischemia-reperfusion injury in mitral valve replacement. Practical Geriatrics. 23(01). 30-34. 
  18. Zheng C. D. & Min S. (2009). Effect of Shenfu injection in improving fatigue syndrome after open heart surgery. Journal of Clinical and Experimental Medicine. 8(07). 110-111. 
  19. WANG Fang-jun, CHEN Bing, TU Fa-ping, YANG Guang, QIN Jiao, HE Hong-xia (2010). Effects of shenfu injection on recovery of heartbeat in patients undergoing mitral valve replacement surgery. Chinese Journal of Experimental Traditional Medical Formulae (04).170-173. doi: 10.13422/j.cnki.syfjx.2010.04.064. 
  20. Wu J., Mo S., Luo Y. Guo Y. Ding Y. Yang X. & Wei Y. (2018). Myocardial Protection of Shenfu Injection and Non-invasive Limb Ischemic Preconditioning in Mitral Valve Replacement. Chinese Journal of Integrative Medicine on Cardio-/Cerebrovascular Disease. 16(05). 574-576. 
  21. Song Z. B., Sun D., Ma Y. F., Wei L. J. & Wang Y. S. (2020). Effects of Shenfu Injection on Postoperative Assisted Respiration and Serum s ICAM-1, CK-MB and cTnI in Patients Undergoing Mitral Valve Replacemen with Cardiopulmonary Bypass. Chinese Journal of Rational Drug Use. 17(05). 52-55. 
  22. Feng Y. (2020). To evaluate the perioperative myocardial protective effect of different doses of Shenfu injection (SFI) in patients undergoing mitral valve replacement (MVR) with cardiopulmonary bypass. Journal of North Pharmacy. 17(04). 82-83. 
  23. Iliodromitis, E. K. Lazou, A. & Kremastinos, D. T. (2007). Ischemic preconditioning: Protection against myocardial necrosis and apoptosis. Vascular health and risk management. 3(5). 629-637. 
  24. Shin H. R., Kim C. H., Chu H. M., Lee Y. U. Kim K. H., Won J. H. & Song B. K. (2020) A Case Report of a Mitral Stenosis Patient Treated with Korean Medicine. Korean J. Orient. Int. Med. 41(3), 457-466.27)  https://doi.org/10.22246/jikm.2020.41.3.457
  25. Jeong G. S., Jeon J. C., Kam C. W. & Park DI. (2001). One case treated cerebral Infarction with rheumatic mitral stenosis. Korean Journal of Internal Medicine, 22(3), 463-9. 
  26. Nationwide college of Korean Medicine Faculty Council of Cardiology Internal Medicine. (2016) Cardiovascular and Neurological Medicine in Korean MedicineI, II. Seoul: Wooripub. p.119-44,275,178-9,196,370 
  27. Ryu H. C., Seo C. H., Kim I. G., Choi C. W., Lee Y. S., Kim J. S. & Kim H. C. (2005). Clinical Report of Cerebral Infarction Patient with Mitral Regurgitation. Journal of Physiology & Pathology in Korean Medicine. 19, 1082-1087. 
  28. Wei W. K. & Mo S. Q. (2005) Clinical Observation on Chinese Herbal Medicine in Preventing the Attack of Rheumatic Feverin Patients with Chronic Rheumatic Valvular Heart Disease, Journal of Guangzhou university of traditional chinese medicine, 22(3), 167-9. 
  29. Chen Y. M. (2008). Yiyuan Qiangxin Decoction in the Treatment of 56 Cases of Rheumatic Heart Valve Disease with Heart Failure. Chinese medicine modern distance education of China ;6(1):46-7. 
  30. Jeong D. Y., Lee B. K., Hong J. W. & An W. G. Study of Membrane Potential Analysis According to Applying Doksam-tang to a Human Heart Failure Model. Herbal Formula Science [Internet]. 2015 Jun 30;23(1):121-31. Available from: https://doi.org/10.14374/HFS.2015.23.1.121 
  31. Beijing College of Traditional Chinese Medicine. (1983). Practical Chinese Medicine. Beijing: Beijing Press, 744,747 
  32. Song W. T., Cheng F. F., Xu L., Lin C. R. & Liu J. X. (2012). Chinese Medicine Shenfu Injection for Heart Failure: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 1741-4288 
  33. Zhao F. & The second people's Hospital of Chengdu. (2021) Clinical study of Shenfu Injection combined with mechanical ventilation in treatment of severe asthma with type II respiratory failure. Journal of Hubei University of Chinese Medicine, 30-3338 
  34. Yu S. (2021). Study on the "dose-effect-toxicity" relationship of Shenfu injection on Gemcitabine combined with cisplatin in the treatment of advanced lung cancer. Contemporary Medicine, 172-173 
  35. Seo S. P. (2002). Serum Cardiac Markers. KOREAN JOURNAL OF INSURANCE, 21, 11-18 
  36. Lee J. H. & Choi Y. C. (2016). Rhabdomyolysis. Korean Journal of Neuromuscular Disorders, 8(1), 22-27. 
  37. Yoon Y. S., Kang H. S., Choue C. W., Kim K. S., Song J. S. & Bae J. H. (1998). The Significance of Serum Cardiac Troponin I Concentration in the Patients with Acute Myocardial Infarction. Korean Circulation Journal, 28(10), 1717-1726.  https://doi.org/10.4070/kcj.1998.28.10.1717
  38. Kim M. W., Seo S. W., Kim S. G. & Kwon Y. J. (1986). Serum Myoglobin in the Early Phase of Acute Myocardial Infarction. Korean Circulation Journal, 16(3), 373-378.  https://doi.org/10.4070/kcj.1986.16.3.373
  39. Kim E. Y. (2011). Pharmacotherapy in Critical Care for Adults. J. Kor. Soc. Health-Syst. Pharm., 285(2), 169. 
  40. Heo J. H., Jeong C. H., Jang J. M., Kim W. S., Jang W. I. & Lee Y. S. (2003). Relationship of Hemodynamic Changes during Off-Pump Coronary Bypass Grafting and Their Effects on Postoperative Outcome. Journal of Chest Surgery, 36(8), 576-582. 
  41. Kim Y. K., Lee D. H., Jin S. H., Lee W. G. & Song K. E. (2006). Relationships among Oxidative Stress Markers, Lifestyle Factors and Biochemical Findings. Annals of Laboratory Medicine, 26(5), 343-350  https://doi.org/10.3343/kjlm.2006.26.5.343
  42. Witkowska, A. M. & Borawska, M. H. (2004). Soluble intercellular adhesion molecule-1 (sicam-1): An overview. Eur Cytokine Netw. 15(2). 91-98.