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中国11种常用改善冠心病心律失常治疗策略的临床疗效与安全性:一项网状Meta分析

The Clinical Efficacy and Safety of 11 Commonly Used Treatment Strategies Improving Arrhythmia of CHD in China: A Network Meta-Analysis.

作者信息

Wang Tao, Li Wei, Huang Qianqian, Yuan Chuqiao, Qu Liping, Xiao Xiaohe, Zou Wenjun

机构信息

College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

The Fifth Medical Center of PLA General Hospital, Beijing, China.

出版信息

Front Pharmacol. 2021 Sep 20;12:741716. doi: 10.3389/fphar.2021.741716. eCollection 2021.

Abstract

Arrhythmia which as a common complication of CHD, has a high incidence. At present, more and more anti-arrhythmic drugs are used in clinical practice. However, which drug has the best efficacy and high safety is still unknown. Therefore, we decided to use NMA to solve this problem. We searched CNKI, Wanfang database, VIP database, Pubmed, Embase and Cochrane libraries, and collected all RCTs of arrhythmia of CHD, and used RevMan (5.3) and Stata (13.0) to carry out this NMA. The primary outcome indicator of this study is efficiency; the secondary outcome indicator is the incidence of adverse reactions. A total of 134 RCTs, 13,951 patients, and 11 treatment strategies were included in this NMA. The results show that all treatment strategies can effectively improve the arrhythmia of patients. Among them, PMA+AM, AM+AT, AM+WG have higher effective rates, and PMA+AM, WG+ME, SC+ME have better safety. The effectiveness and safety of the treatment strategies which combined TCM and chemical drugs, are significantly better than that of using chemical drugs alone. The treatment strategy of combination of multiple drugs usually has higher efficiency and safety. PMA+AM seems to be the most recommended treatment strategy. In addition, the rational combination of TCM and chemical drugs may provide potential benefit. : https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021229693.

摘要

心律失常作为冠心病的常见并发症,发病率较高。目前,临床实践中使用的抗心律失常药物越来越多。然而,哪种药物疗效最佳且安全性高仍不清楚。因此,我们决定使用网络 Meta 分析来解决这个问题。我们检索了中国知网、万方数据库、维普数据库、PubMed、Embase 和考克兰图书馆,收集了所有冠心病心律失常的随机对照试验,并使用 RevMan(5.3 版)和 Stata(13.0 版)进行此项网络 Meta 分析。本研究的主要结局指标是疗效;次要结局指标是不良反应的发生率。此项网络 Meta 分析共纳入 134 项随机对照试验、13951 例患者和 11 种治疗策略。结果表明,所有治疗策略均可有效改善患者的心律失常。其中,普罗帕酮 + 胺碘酮、胺碘酮 + 阿替洛尔、胺碘酮 + 稳心颗粒有效率较高,普罗帕酮 + 胺碘酮、稳心颗粒 + 美托洛尔、参松养心胶囊 + 美托洛尔安全性较好。中西医结合的治疗策略的有效性和安全性明显优于单纯使用化学药物。多种药物联合的治疗策略通常具有更高的有效性和安全性。普罗帕酮 + 胺碘酮似乎是最推荐的治疗策略。此外,中西医合理联用可能会带来潜在益处。:https://www.crd.york.ac.uk/PROSPERO/,标识符 CRD42021229693 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f5/8488134/a964bc2d52d9/fphar-12-741716-g001.jpg

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