复方丹参滴丸联合胺碘酮治疗心律失常效果的Met a分析

Meta analysis of Compound Danshen Dripping Pills combined with Amiodarone in the treatment of arrhythmia

目的对复方丹参滴丸联合胺碘酮治疗心律失常的临床效果和安全性进行系统评价。方法检索Cochrane Library、中国生物医学文献光盘数据库(CBM)、Clinicaltrials.gov、PubMed、Embase、Medline、CNKI、万方数据库、维普全文电子期刊(VIP),收集从建库至2018年9月关于复方丹参滴丸联合胺碘酮治疗心律失常的临床随机对照试验,依据纳入及排除标准由2名研究员独立完成检索与文献的资料提取,采用RevMan5.3软件进行Meta分析。结果最终纳入13篇研究文献,共涉及1178例受试者其中590例患者采用复方丹参滴丸联合胺碘酮治疗,588例患者采用胺碘酮治疗。复方丹参滴丸联合胺碘酮与单纯应用胺碘酮治疗心律失常比较,其临床疗效[RR=1.21,95%CI(1.16,1.27),P <0.00 001]更好,且室性早搏[MD=-178.09,95%CI(-201.94,-154.25),P <0.00 001]、房性早搏[MD=-119.14,95%CI(-134.21,-104.06),P <0.00 001]、交界性早搏[MD=-54.88,95%CI(-68.61,-41.59),P <0.00 001]次数均减少,不良反应发生率更低[RR=0.28,95%CI(0.13,0.60),P <0.00 001],差异有统计学意义(P <0.05)。结论与单用胺碘酮比较,应用复方丹参滴丸联合胺碘酮治疗心律失常的临床效果更加显著,安全性更高。但由于纳入的文献质量普遍偏低,上述结论仍需更多高质量的随机对照实验作为论据加以证实。

Objective To systematically evaluate the clinical efficacy and safety of Compound Danshen Dropping Pills combined with Amiodarone in the treatment of arrhythmia.Methods Cochrane Library,CBM,Clinicaltrials.gov,PubMed,Embase,Medline,CNKI,Wanfang database,VIP full-text electronic journals(VIP)were searched by computer,and randomized controlled trials of Compound Danshen Dropping Pills combined with Amiodarone in the treatment of arrhythmia were collected from the database to September 2018.Randomized controlled trials of arrhythmias were performed by two researchers independently according to inclusion and exclusion criteria.Meta analysis was performed by RevMan 5.3 software.Results Finally,13 studies were included,involving 1178 subjects including 590 patients of Compound Danshen Dripping Pills combined with Amiodarone trenatment and 588 patients of Amiodarone treatment.Compared with Amiodarone alone,Compound Danshen Dripping Pills combined with Amiodarone has better clinical efficacy[RR=1.21,95%CI(1.16,1.27),P<0.00 001]and ventricular premature beats[MD=-178.09,95%CI(-201.94,-154.25),P<0.00 001],atrial premature beats[MD=-119.14,95%CI(-134.21,-104.06),P<0.00 001],borderline.Sexual premature beats[MD=-54.88,95%CI(-68.61,-41.59),P<0.00 001]frequency were reduced,the incidence of adverse reactions was lower[RR=0.28,95%CI(0.13,0.60),P<0.00 001],the difference was statistically significant(P<0.05).Conclusion Compared with Amiodarone alone,Compound Danshen Dropping Pills combined with Amiodarone has more significant clinical effect and higher safety in the treatment of arrhythmia.However,due to the low quality of the included literature,the above conclusions still need to be supported by more high quality randomized controlled trials.