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稳心颗粒与抗心律失常药物治疗心房颤动的疗效:一项Meta分析

[Curative effect of Wenxin Granule and antiarrhythmic drugs in the treatment of atrial fibrillation:a Meta-analysis].

作者信息

Wang Zhao-Bo, Zhao Yu-Juan, Zhou Fan-Chao, Zhu Yu-Han, Liu Lei, Feng Cong, Chen Zi-Long

机构信息

Heilongjiang University of Chinese Medicine Harbin 150040, China.

the Second Hospital of Harbin Harbin 150056, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2019 Jun;44(11):2379-2389. doi: 10.19540/j.cnki.cjcmm.20190308.001.

Abstract

To evaluate the efficiency and safety between Wenxin Granule and antiarrhythmic drugs in the treatment of atrial fibrillation(AF). A total of 8 major electronic databases(CNKI, WanFang, VIP, CBM, Cochrane Library, Web of Science, PubMed, EMbase) were retrieved since the establishment of the database to January 10, 2019. Two reviewers extracted data, and assessed the methodological quality of the included studies. The Meta-analysis was made by RevMan 5.3 software. Finally, 42 studies involving 4 657 patients were included. The results of Meta-analysis showed that compared with antiarrhythmic drug, the combined administration with Wenxin Granule and antiarrhythmic drug had a better clinical efficiency(OR=3.37, 95%CI[2.69,4.22],I2=0%,P<0.000 01)and efficacy on cardioversion(OR=2.32,95%CI[1.67,3.22],I2=0%,P<0.000 01), with reduction in P_d(MD=-5.48,95%CI [-7.32,-3.64],I2=0%,P<0.000 01)and P_(max)(MD=-9.91,95%CI[-12.86,-6.95],I2=0%,P<0.000 01). The comparison between the combined application with Wenxin Granule and the single application of amiodarone showed a clinical efficiency(OR=2.89,95%CI[1.96,4.26],I2=44%,P<0.000 01),and efficacy on sinus rhythm maintenance(OR=2.58,95%CI[1.82,3.66],I2=3%,P<0.000 01). The comparison between the combined application with Wenxin Granule and the single application of amiodarone showed a clinical efficiency(OR=0.88,95%CI[0.53,1.46],I~2=0%,P=0.63). The combined treatment with Wenxin Granule has a better clinical efficiency in AF better than amiodarone, with no evidence for more benefits from the single administration with Wenxin Granules.

摘要

评估稳心颗粒与抗心律失常药物治疗心房颤动(AF)的有效性和安全性。自各数据库建立至2019年1月10日,共检索了8个主要电子数据库(中国知网、万方、维普、中国生物医学文献数据库、考克兰图书馆、科学引文索引、医学期刊数据库、荷兰医学文摘数据库)。两名评价员提取数据,并评估纳入研究的方法学质量。采用RevMan 5.3软件进行Meta分析。最终,纳入42项研究,涉及4657例患者。Meta分析结果显示,与抗心律失常药物相比,稳心颗粒联合抗心律失常药物具有更好的临床疗效(OR = 3.37,95%CI[2.69,4.22],I² = 0%,P < 0.000 01)及复律疗效(OR = 2.32,95%CI[1.67,3.22],I² = 0%,P < 0.000 01),P_d降低(MD = -5.48,95%CI[-7.32,-3.64],I² = 0%,P < 0.000 01),P_max降低(MD = -9.91,95%CI[-12.86,-6.95],I² = 0%,P < 0.000 01)。稳心颗粒联合用药与胺碘酮单药治疗相比,具有临床疗效(OR = 2.89,95%CI[1.96,4.26],I² = 44%,P < 0.000 01)及维持窦性心律疗效(OR = 2.58,95%CI[1.82,3.66],I² = 3%,P < 0.000 01)。稳心颗粒联合用药与普罗帕酮单药治疗相比,临床疗效(OR = 0.88,95%CI[0.53,1.46],I² = 0%,P = 0.63)。稳心颗粒联合治疗AF的临床疗效优于胺碘酮,未发现稳心颗粒单药治疗有更多益处。

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