中医药治疗冠心病室性早搏的系统评价

Systematic Review of Traditional Chinese Medicine for Ventricular Premature Complexes in Coronary Artery Disease

目的评价中医药治疗冠心病室性早搏的有效性及安全性。方法计算机检索了PubMed、Cochrane图书馆临床试验注册数据库,中国生物医学文献数据库(Web版)、中文生物医学期刊数据库(Web版)CMCC、VIP中文科技期刊数据库(Web版)、CNKI中国期刊全文数据库(Web版)、万方数据库,筛选出中医药治疗冠心病室性早搏的随机对照试验(RCT)或半随机对照试验。用Jadad评分对纳入研究的质量进行评价,RevMan5.1.4软件进行Meta分析。结果共收集中医药治疗冠心病室性早搏文献486篇,经过初筛和严格评价,纳入研究14个,共1 560例,治疗组901例,对照组659例。纳入研究的Jadad评分≥3分。对14项研究的临床疗效有效率合并效应量的检验,PP分析结果:RR(random)=1.25,95%CI[1.13,1.37],有统计学意义(P<0.0001);ITT分析结果:RR(fixed)=1.26,95%CI[1.17,1.36],有统计学意义(P<0.0001)。结论根据当前研究提示,中医药治疗冠心病室性早搏可能是有效的,但尚需更多高质量研究以增加证据的强度。

Objective To assess the effectiveness and safety of traditional Chinese medicine（TCM） in the treatment of ventricular premature complexes（VPC） in coronary artery disease（CAD）.Methods We searched the literature associated with randomized controlled trials（RCT） or quasi-RCT of TCM in treating CAD patients with VPC from PubMed（update to Feb 2011）,Chinese Biology Medicine disc For Internet（CBM Web）（update to Feb 2011）,Chinese Medical Current Content（CMCC）（update to Feb 2011）,VIP Chinese science and Technology Periodical Database（update to Feb 2011）,CNKI China Journal Full-text Database（update to Feb 2011）,and Wan Fang Database（update to Feb 2011）.Quality of them was evaluated by the method-Jadad Score,and statistical analysis was performed using the Cochrane Collaboration＇s Rev Man 5.1.4 software.Results 14 trials involving 1 560 VPC patients（901 patients in the treated group and 659 patients in the control group）.All the included were greater than or equal to score three（Jadad Score）.Per-protocol analysis showed RR（random）=1.25,95%CI[1.13,1.37]（P0.000 1）;and Intention-To-Treat analysis showed RR（fixed）=1.26,95%CI[1.17,1.36]（P0.000 1）.Conclusion According to the present evidence,TCM in the treatment of VPC in CAD is effective.But more well designed randomized controlled trials are required.