稳心颗粒联合酒石酸美托洛尔治疗室性早搏的疗效与安全性：一项系统评价与Meta分析
Efficacy and safety of Wenxin Keli combined with metoprolol tartrate in the treatment of premature ventricular contractions: A systematic review and meta-analysis.
作者信息
Huang Ping, Luo Yining, Chen Jiaxue, Xu Jingke, Shi Yuanshu, Chen Guoren, Ma Ping
机构信息
School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
出版信息
Front Cardiovasc Med. 2022 Jul 29;9:952657. doi: 10.3389/fcvm.2022.952657. eCollection 2022.
BACKGROUND
Wenxin Keli (WXKL) has good clinical value in the treatment of premature ventricular contractions, but there is insufficient evidence to support it. This study evaluates the efficacy and safety of WXKL combined with metoprolol tartrate in the treatment of ventricular premature beats (VPCs).
METHODS
We searched seven databases to identify randomized controlled trials (RCTs) for this study. Two reviewers independently screened and extracted the data. The Cochrane Manual criteria were used for methodological quality assessment. Meta-analyses were performed using Review Manager 5.4.1 software. Risk ratios (RR) were used for effect sizes for dichotomous data, demonstrated in effect sizes and 95% confidence intervals (CIs).
RESULTS
A total of 11 RCTs of WXKL combined with metoprolol tartrate in the treatment of premature ventricular contractions were included in this study. Meta-analysis showed that WXKL combined with metoprolol tartrate (treatment group) was more effective than metoprolol tartrate (control group) in improving premature ventricular contractions (RR = 1.32, 95% CI: [1.24, 1.40], < 0.00001); significantly improved the rate of premature ventricular contractions (RR = 1.32, 95% CI: [1.23, 1.41], < 0.00001); there was no difference in adverse drug reactions compared with the control group (RR = 0.61, 95% CI: [0.35, 0.1.05], = 0.08), but the number of adverse reactions ( = 18) was less than that of the control group ( = 32), and the severity was lower than that of the control group. The included studies only mentioned randomization and did not describe the generation of random sequences in detail.
CONCLUSION
This study found that Wenxin Keli combined with metoprolol tartrate in the treatment of premature ventricular contractions increased the efficacy of the drug, reduced the occurrence of adverse reactions, and reduced the severity of adverse reactions. Due to the quality limitations of the included studies, more high-quality RCTs are needed in the future to provide more evidence for longer-term analyses.
背景
稳心颗粒在治疗室性早搏方面具有良好的临床价值，但支持证据不足。本研究评估稳心颗粒联合酒石酸美托洛尔治疗室性早搏（VPCs）的疗效和安全性。
方法
我们检索了七个数据库以确定本研究的随机对照试验（RCTs）。两名研究者独立筛选并提取数据。采用Cochrane手册标准进行方法学质量评估。使用Review Manager 5.4.1软件进行荟萃分析。风险比（RR）用于二分类数据的效应量，以效应量和95%置信区间（CIs）表示。
结果
本研究共纳入11项稳心颗粒联合酒石酸美托洛尔治疗室性早搏的RCTs。荟萃分析表明，稳心颗粒联合酒石酸美托洛尔（治疗组）在改善室性早搏方面比酒石酸美托洛尔（对照组）更有效（RR = 1.32，95% CI：[1.24, 1.40]，P < 0.00001）；显著提高了室性早搏的控制率（RR = 1.32，95% CI：[1.23, 1.41]，P < 0.00001）；与对照组相比，药物不良反应无差异（RR = 0.61，95% CI：[0.35, 1.05]，P = 0.08），但不良反应发生例数（n = 18）少于对照组（n = 32），且严重程度低于对照组。纳入研究仅提及随机化，未详细描述随机序列的产生。
结论
本研究发现，稳心颗粒联合酒石酸美托洛尔治疗室性早搏可提高药物疗效，减少不良反应的发生，并降低不良反应的严重程度。由于纳入研究的质量限制，未来需要更多高质量的RCTs为长期分析提供更多证据。
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