Sheng Y, Carpenter J S, Elomba C D, Alwine J S, Yue M, Chen C X, Tisdale J E
School of Nursing, Indiana University, Indianapolis, IN, USA.
College of Pharmacy, Purdue University, West Lafayette, IN, USA.
Climacteric. 2022 Apr;25(2):128-140. doi: 10.1080/13697137.2021.1948006. Epub 2021 Aug 4.
This systematic review provides an overview of the effects of menopausal symptom treatment options on palpitations, defined as feelings of missed or exaggerated heart beats, reported by perimenopausal and postmenopausal women. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searches were conducted in PubMed, CINAHL and PsycINFO to identify articles meeting pre-specified inclusion criteria. Of 670 unique articles identified, 37 were included in the review. Treatments included drug therapies and non-drug therapies. Palpitations were studied as an outcome in 89% of articles and as an adverse effect in 11%. Articles provided mostly level II/III evidence due to their design and/or small sample sizes. Based on available evidence, no therapies can be fully recommended for clinical practice. Only some hormonal agents (e.g. estradiol) can be recommended with caution based on some positive evidence for reducing palpitation prevalence or severity. However, other drug therapies (e.g. moxonidine, atenolol), dietary supplementary treatments (e.g. isoflavones, , sage), cognitive-behavioral intervention and auricular acupressure cannot be recommended given the existing evidence. Additional well-designed randomized controlled treatment trials focusing on palpitations during the menopause transition as an inclusion criteria and outcome are needed to advance the field.
本系统评价概述了围绝经期和绝经后女性报告的绝经症状治疗方案对心悸（定义为心跳漏跳或心跳加剧的感觉）的影响。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，在PubMed、CINAHL和PsycINFO中进行检索，以识别符合预先指定纳入标准的文章。在识别出的670篇独特文章中，有37篇被纳入该评价。治疗方法包括药物治疗和非药物治疗。89%的文章将心悸作为研究结果，11%的文章将其作为不良反应进行研究。由于文章的设计和/或样本量较小，大多提供的是II/III级证据。根据现有证据，没有哪种治疗方法可被完全推荐用于临床实践。基于一些关于降低心悸发生率或严重程度的阳性证据，仅可谨慎推荐某些激素制剂（如雌二醇）。然而，鉴于现有证据，其他药物治疗（如莫索尼定、阿替洛尔）、饮食补充治疗（如异黄酮、鼠尾草）、认知行为干预和耳穴按压均不可推荐。需要开展更多设计良好的以绝经过渡期间心悸为纳入标准和研究结果的随机对照治疗试验，以推动该领域的发展。
