中药治疗心律失常合并焦虑抑郁的有效性及安全性的Meta分析

Meta-analysis of efficacy and safety of traditional Chinese medicine in the treatment of arrhythmia combined with anxiety and depression

目的:系统评价中药治疗心律失常合并焦虑抑郁的有效性与安全性。方法:计算机检索中文数据库(CNKI、Wanfang、VIP)及英文数据库(PubMed、Cochorane Library),时间截止至2020年9月。筛选所有公开发表的关于中药治疗心律失常合并焦虑抑郁的临床随机对照实验研究,应用Cochrane协作网提供的风险评估工具(ROB)进行文献质量评价,采用Revman 5.3软件进行meta分析。结果:共纳入17项研究,总计1773例患者,实验组采用中药联合常规西药治疗,总计888例;对照组采用单纯常规西药治疗,总计885例。Meta分析结果显示:与对照组(西药)相比,实验组(中药联合西药)可有效提高中医证候疗效[RR=1.28(1.19,1.39)],降低心律失常的发作次数[RR=1.29(1.21,1.36)],降低焦虑[RR=−1.44(−2.09,−0.78)]、抑郁量表评分[RR=−0.94(−1.34,−0.53)],差异均具有统计学意义(P<0.05)。结论:中药治疗心律失常合并焦虑抑郁具有显著临床效果,不良反应较轻微,优于单独使用西药治疗,但仍需更多严谨的高质量临床随机对照试验来进一步验证。

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine(TCM)in the treatment of arrhythmia combined with anxiety and depression by meta analysis.Methods:Chinese and foreign medical literature databases such as CNKI,Wanfang,VIP,PubMed and Cochorane Library were searched until September 2020.All the published clinical randomized controlled trials on the treatment of arrhythmia combined with anxiety and depression with TCM were collected and screened.The risk assessment tools provided by Cochrane were used to evaluate the quality of the studies,and meta analysis was carried out by Revman 5.3 software.Result:A total of 17 studies were included,with 1773 cases,including the experimental group using TCM combined with Western medicine therapy(n=888),and the control group using conventional Western medicine treatment(n=885).The results of meta analysis showed that compared with the control group(Western medicine),the experimental group significantly improved the curative effect of TCM syndrome[RR=1.28(1.19,1.39)],decreased the number of arrhythmia attack[RR=1.29(1.21,1.36)],the score of anxiety[RR=−1.44(−2.09,−0.78)]and depression scale[RR=−0.94(−1.34,−0.53)]with statistically significant differences.Con-clusion:TCM has significant clinical effects in the treatment of arrhythmia combined with anxiety and depression,with mild adverse reaction,which is better than Western medicine used alone.However,more high-quality clinical randomized controlled trials are needed for further verification.