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小檗碱治疗室性期前收缩的疗效和安全性:一项随机对照试验的荟萃分析和系统评价。

Efficacy and safety of berberine for premature ventricular contractions: a meta-analysis and systematic review of randomized controlled trials.

机构信息

Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, PR China.

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Science, Beijing, PR China.

出版信息

Pharm Biol. 2023 Dec;61(1):1474-1483. doi: 10.1080/13880209.2023.2248167. Epub 2023 Oct 19.

Abstract

CONTEXT

Berberine is a potential drug that can effectively treat cardiovascular diseases, including premature ventricular contractions (PVCs).

OBJECTIVE

This study was conducted to assess the efficacy and safety of berberine for PVCs.

METHODS

The literature was searched using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang, and Chinese Biomedical Literature Database (CBM) for randomized controlled trials (RCTs) from inception to October 1, 2022. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to assess the quality of evidence.

RESULTS

Ten RCTs with 896 participants were included in the meta-analysis. The results showed that compared to antiarrhythmic drugs (AD), berberine (BE) combined with AD had a higher effective rate (RR = 1.26; 95% CI:1.12, 1.42;  = 0.0001) with no significant incidence of adverse reactions (RR = 0.93; 95% CI:0.33, 2.57;  = 0.88), and BE alone had no significant difference in effective rate (RR = 0.91; 95% CI:0.77, 1.07;  = 0.23), and a lower incidence of adverse reactions (RR = 0.38; 95% CI:0.15, 0.97;  = 0.04) and recurrence rate (RR = 0.40; 95% CI:0.18, 0.88;  = 0.02).

CONCLUSIONS

The results suggest that BE is an effective and safe adjunctive method for PVCs. In addition, BE is recommended for patients with PVCs who had severe adverse reactions after administrating AD as an alternative therapy.

摘要

背景

小檗碱是一种有潜力的药物,可有效治疗心血管疾病,包括室性早搏(PVCs)。

目的

本研究旨在评估小檗碱治疗 PVCs 的疗效和安全性。

方法

检索PubMed、Cochrane 图书馆、Embase、中国知网(CNKI)、中国科技期刊数据库(VIP)、万方和中国生物医学文献数据库(CBM),从建库至 2022 年 10 月 1 日,获取随机对照试验(RCT)的文献。采用修订后的 Cochrane 偏倚风险工具评估偏倚风险,并采用推荐评估、制定与评价(GRADE)系统评估证据质量。

结果

纳入 10 项 RCT,共 896 名参与者。Meta 分析结果显示,与抗心律失常药物(AD)相比,小檗碱(BE)联合 AD 的有效率更高(RR=1.26;95%CI:1.12,1.42; = 0.0001),不良反应发生率无显著差异(RR=0.93;95%CI:0.33,2.57; = 0.88);而 BE 单药治疗的有效率无显著差异(RR=0.91;95%CI:0.77,1.07; = 0.23),但不良反应发生率和复发率更低(RR=0.38;95%CI:0.15,0.97; = 0.04;RR=0.40;95%CI:0.18,0.88; = 0.02)。

结论

结果提示 BE 是治疗 PVCs 的有效且安全的辅助方法。此外,对于因 AD 治疗而出现严重不良反应的 PVCs 患者,BE 可作为替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e984/10588516/3a3437d602dd/IPHB_A_2248167_F0001_C.jpg

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