参松养心胶囊治疗阵发性心房颤动的Meta分析

Shensong Yangxin Capsule in the Treatment of Paroxysmal Atrial Fibrillation:A Meta-analysis

目的系统评价参松养心胶囊治疗阵发性心房颤动的疗效及安全性。方法计算机检索电子数据库CNKI、万方、维普、CBM、Cochrane Library、Pubmed和EMbase,所有数据库检索时间为建库日起至2015年6月8日。纳入比较参松养心胶囊与常规西药对照治疗阵发性心房颤动的随机对照临床试验,由两名研究者按照Cochrane Handbook 5.1.0标准独立进行文献质量评价、提取数据并交叉核对,使用RevMan5.3软件进行Meta分析。结果共纳入8个研究,合计600例阵发性心房颤动病人。所有纳入文献质量普遍较低。Meta分析结果显示:参松养心+常规治疗较单纯常规治疗可显著改善阵发性心房颤动病人的心房颤动发作频率[SMD=-1.34,95%CI(-1.98,-0.69),P<0.000 1],参松养心+常规治疗较单纯常规治疗可显著改善阵发性心房颤动病人的生活质量[SMD=3.6,95%CI(2.39,4.81),P<0.000 01],参松养心+常规治疗较单纯常规治疗可显著改善阵发性心房颤动病人的运动耐量[SMD=1.55,95%CI(0.95,2.15),P<0.000 01],参松养心+常规治疗与单纯常规治疗在不良反应方面无统计学意义,未改善常规治疗阵发性心房颤动病人不良反应[RR=0.65,95%CI(0.19,2.18),P=0.49]。结论参松养心胶囊联合常规西药治疗可显著改善阵发性心房颤动病人的生活质量、运动耐量及心房颤动发作频率、P波离散度,但由于所纳入的研究质量较低,仍需进一步多中心、大样本的随机双盲对照试验进行验证。

Objective To assess the efficacy and safety of Shensong Yangxin capsule（SYC）in the treatment of paroxysmal atrial fibrillation（PAF）.Methods We searched electronic databases CNKI,Wanfang,VIP,CBM,Cochrane Library,Pubmed and EMbase,all database retrieval time was building a database date until June 8,2015.Randomly assigned comparison SYC and conventional medicine control in patients with PAF controlled clinical trials were induded,the two researchers conducted an independent quality assessment in accordance with Cochrane Handbook 5.1.0standard,extract data and cross-checking.Meta-analysis was used RevMan5.3 software.Results A total of eight studies,600 cases of patients with PAF were included.The included studies had generally low quality.Meta-analysis showed that SYC plus conventional therapy compared with conventional therapy alone could improve the frequency of atrial fibrillation in patients with PAF[SMD=-1.34,95% CI（-1.98,-0.69）,P〈0.00 01.SYC plus conventional therapy compared with conventional therapy alone could significantly improve the quality of life in patients with PAF[SMD=3.6,95%CI 2.39,4.81],P〈0.000 01].SYC plus conventional therapy compared with conventional therapy alone could significantly improve exercise tolerance in patients with paroxysmal atrial fibrillation amount[SMD = 1.55,95% CI（0.95,2.15）,P〈0.000 01].SYC plus conventional treatment with conventional therapy alone did not improve the adverse events in conventional treatment of PAF [RR = 0.65,95% CI（0.19,2.18）,P =0.49].Conclusion SYC and conventional western medicine treatment can significantly improve the quality of life in patients with PAF,exercise tolerance and frequency of atrial fibrillation,and P wave dispersion.The included studies has generally low quality.It remains to more,and large sample randomized controlled trials for validation.