Hu Hai-Yin, Ji Zhao-Chen, Yu Dan-Dan, Yang Feng-Wen, Wang Hui, Zheng Wen-Ke, Zhang Jun-Hua
Evidence Based Medicine Center, Tianjin University of Traditional Chinese Medicine Tianjin 300193, China.
Institue of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100049, China.
Zhongguo Zhong Yao Za Zhi. 2020 Mar;45(5):1149-1158. doi: 10.19540/j.cnki.cjcmm.20190802.501.
To assess the clinical efficacy of Chinese patent medicine for bradyarrhythmia(BA) by using network Meta-analysis method. Relevant randomized controlled trials(RCTs) of Chinese patent medicine for BA were retrieved from China National Knowledge Infrastructure(CNKI), WanFang Database, VIP database, SinoMed, PubMed and Cochrane Library. The retrieval time ranged from the commencement of each database to February 2019. We completed the literature screening and data extraction according to the pre-determined inclusion and exclusion criteria. The quality of inclusion studies was assessed using the bias risk assessment tool recommended by the Cochrane Handbook of Systematic Review 5.3. The data were analyzed by WinBUGS, and STATA software was used for plotting. Finally, 46 RCTs were included, involving 4 Chinese patent medicines and 3 306 patients. According to the network Meta-analysis, the total effective rate in alleviating BA symptoms had 7 direct comparisons and 3 indirect comparisons. The efficacy of the 4 Chinese patent medicines combined with routine therapy was superior to that of routine therapy, with statistically significant differences. The order of the four Chinese patent medicines by efficacy was as follows: Shenxian Shengmai Oral Liquid>Shensong Yangxin Capsules>Xinbao Pills>Ningxinbao Capsules. The average heart rate had 7 direct comparisons and 3 indirect comparisons. The efficacy of Shenxian Shengmai Oral Liquid and Shensong Yangxin Capsules combined with routine therapy was superior to that of routine therapy, with statistically significant differences. The order of the four Chinese patent medicines by efficacy was as follows: Shenxian Shengmai Oral Liquid>Shensong Yangxin Capsules>Xinbao Pills>Ningxinbao Capsules. The results showed that the Chinese patent medicines combined with routine therapy were effective in the treatment of BA. Due to the differences in the quantity and quality of the included studies on different Chinese patent medicines, the sequencing results of Chinese patent medicines need to be further verified.
采用网状Meta分析方法评估中成药治疗缓慢性心律失常(BA)的临床疗效。从中国知网(CNKI)、万方数据库、维普数据库、中国生物医学文献数据库、PubMed及考克兰图书馆检索有关中成药治疗BA的随机对照试验(RCT)。检索时间从各数据库建库至2019年2月。根据预先设定的纳入与排除标准完成文献筛选与数据提取。采用考克兰系统评价手册5.3推荐的偏倚风险评估工具评估纳入研究的质量。数据采用WinBUGS软件进行分析,用STATA软件绘图。最终纳入46项RCT,涉及4种中成药及3 306例患者。根据网状Meta分析,缓解BA症状的总有效率有7个直接比较和3个间接比较。4种中成药联合常规治疗的疗效优于常规治疗,差异有统计学意义。4种中成药疗效排序为:参仙升脉口服液>参松养心胶囊>心宝丸>宁心宝胶囊。平均心率有7个直接比较和3个间接比较。参仙升脉口服液和参松养心胶囊联合常规治疗的疗效优于常规治疗,差异有统计学意义。4种中成药疗效排序为:参仙升脉口服液>参松养心胶囊>心宝丸>宁心宝胶囊。结果显示,中成药联合常规治疗对BA有效。由于不同中成药纳入研究的数量和质量存在差异,中成药的排序结果尚需进一步验证。