稳心颗粒联合美托洛尔治疗冠心病合并室性心律失常的系统评价

Wenxin Keli combined with metoprolol in the treatment of CHD-induced ventricular arrhythmias: a systematic review and meta-analysis

目的对稳心颗粒联合美托洛尔治疗冠心病合并室性心律失常的随机对照试验(RCT)质量进行调查,并评估其疗效和安全性。方法计算机检索PubMed、Cochrane图书馆临床试验注册数据库、EMBASE、CNKI万方数据库中相关文献(检索时限均为建库至2013年9月10日),筛选出稳心颗粒联合美托洛尔治疗冠心病室性心律失常的RCT,GRADEprofiler3.6软件进行证据质量评级,RevMan5.2软件进行Meta分析。结果共检索得潜在相关文献142篇,筛选后纳入34个研究,共计2 981例患者。Meta分析结果显示:两组总有效率的数据差异有统计学意义[91.65%vs 70.75%,OR 4.67,95%CI(3.76,5.79),P<0.000 01];联合用药组比对照组不良反应更少[6.33%vs 12.36%,OR=0.48,95%CI(0.33,0.69),P<0.000 1]。结论联合应用稳心颗粒与美托洛尔治疗冠心病合并室性心律失常比单独使用美托洛尔疗效更显著,且不良反应较少。

Objective To evaluate the safety and efficacy of combined treatment of Wenxin Keli and metoprolol in treating ventricular arrhythmias induced by coronary heart disease （CHD）. Methods Articles were searched from Pub Med, Cochrane Central Register of Controlled Trials, EMBASE, CNKI, Wan-Fang database （from the time of database＇s initial construction to September 10, 2013） to screen qualified RCTs. GRADEprofiler3.6 and RevMan5.2 were employed in literature quality evaluation and statistic analysis. Results Of 142 related articles, 34 RCTs （2981 patients） were qualified and included. The results of meta analysis were as follows： the difference of overall response rate between two groups was statistically significant [91.65% vs 70.75%, OR 4.67, 95%CI （3.76, 5.79）, P〈0.01]; The group of combined treatment showed a lower rate of adverse events than control group [6.33%vs12.36%, OR=0.48, 95%CI（0.33, 0.69）, P〈0.01]. Conclusion Combined treatment ofWenxin Keli and Metoprolol is more effective and causing less adverse events than only use metoprolol for treating CHD-induced ventricular arrhythmias.