麻黄细辛附子汤加减治疗缓慢性心律失常有效性和安全性的Meta分析

A Meta-analysis of effectiveness and safety about Mahuang Xixin Fuzi decoction in treating bradycardia arrhythmia

[目的]系统评价麻黄细辛附子汤加减治疗缓慢性心律失常的有效性与安全性。[方法]计算机与手工检索相结合的方法,全面检索2000年1月—2017年4月公开发表的关于麻黄细辛附子汤加减治疗缓慢性心律失常的临床随机对照试验,根据纳排标准筛选,并提取数据,通过Revman5.3软件进行分析。[结果]共纳入研究19篇,患者1 530例;在综合疗效方面,麻黄细辛附子汤加减组疗效优于对照组,RR=1.30,95%CI[1.23,1.38](P<0.000 01);治疗后基础心率比较,麻黄细辛附子汤加减组优于对照组,MD7.87,95%CI[6.47,9.26](P<0.000 01);治疗后最慢心率比较,麻黄细辛附子汤加减组优于对照组,MD6.45,95%CI[4.72,8.18](P<0.000 01);治疗后平均心率比较:麻黄细辛附子汤加减组优于对照组,MD7.20,95%CI[6.23,8.16](P<0.000 01);治疗后静息心率比较,麻黄细辛附子汤加减组优于对照组,MD8.03,95%CI[6.52,9.54](P<0.000 01);治疗后中医证候改善比较:麻黄细辛附子汤加减组优于对照组,RR=1.47,95%CI[0.94,2.30](P<0.10);不良反应方面,共6篇文献提到均未发生严重肝肾功能不良反应。[结论]麻黄细辛附子汤加减对缓慢性心律失常在临床疗效、改善心率方面有一定作用,且具有一定安全性。

[Objective] A systematic review of the effectiveness and safety about Mahuang Xixin Fuzi decoction treating bradycardia arrhythmia. [Methods] By using the computer retrieval and manual search,we can retrieve clinical randomized controlled trials about Mahuang Xixin Fuzi decoction treating bradycardia arrhythmia from 2000 Jan. to 2017 Apr.. According to the Inclusion criteria and exclusion criteria, we screen literature and extract data, and data analyzed by Revman 5.3. [Results] Totally 19 RCTs were included with1 530 cases. The data showed that Mahuang Xixin Fuzi decoction group can improve the effectiveness of patients [RR=1.30, 95%CI（1.23,1.38）, P〈0.00001]. Comparison of basal heart rate after treatment： compared with the control group, the treatment group has statistical difference [MD7.87, 95%CI（6.47, 9.26）, P〈0.000 01]. Comparison of the slowest heart rate after treatment, compared with the control group,the treatment group has statistical difference [MD 6.45, 95%CI（4.72,8.18）, P〈0.000 01]. Comparison of mean heart rate after treatment,compared with the control group, the treatment group has statistical difference [MD7.20, 95%CI（6.23, 8.16）, P〈0.000 01]. Comparison of resting heart rate after treatment, compared with the control group, the treatment group has statistical difference, [MD 8.03, 95% CI（6.52, 9.54）, P〈0.000 01]. Comparison of TCM syndromes improvement after treatment, compared with the control group, compared with the control group, the treatment group has statistical difference [ RR=1.47, 95% CI（0.94, 2.30）, P〈0.10]. The adverse events between treatment group and control group did not occur. [Conclusion] Mahuang Xixin Fuzi decoction has certain effects on the clinical efficacy and heart rate in the treatment of bradycardia arrhythmia, and also has certain safety.