胺碘酮联合稳心颗粒治疗心力衰竭合并心律失常的有效性及安全性Meta分析

Meta-analysis of efficacy and safety of amiodarone combined with Wenxin granules in the treatment of heart failure complicated with arrhythmia

目的系统分析胺碘酮联合稳心颗粒治疗心力衰竭合并心律失常的有效性及安全性。方法检索知网、万方、维普等数据库,检索词:胺碘酮联合稳心颗粒、心力衰竭合并心律失常等,年限为建库至2020年10月,搜集胺碘酮联合稳心颗粒治疗心力衰竭合并心律失常有效性及安全性的相关文献,采用Cochrance协作网提供的ReviewManager 5.3软件对纳入文献进行偏倚风险评估及Meta分析。结果检索共获得文献223篇,根据文献的纳入标准和排除标准,最终共纳入7篇文献,624例患者;3项研究分配隐藏、选择性报告研究结果为高偏倚风险,对研究者和受试者实施盲法,对结局指标评价实施盲法及其他偏移为偏倚风险不确定,随机序列的产生、结果数据的完整性为低偏倚风险;4项研究随机序列的产生、分配隐藏、选择性报告研究结果为高偏倚风险,对研究者和受试者实施盲法、对结局指标评价实施盲法及其他偏移为偏倚风险不确定,结果数据的完整性为低偏倚风险;纳入7个研究,异质性检验结果显示异质性较小(I^(2)=0%),固定效应模型Meta分析结果显示,研究组心力衰竭合并心律失常的临床疗效优于对照组[OR=6.02,95%CI(3.42,10.61),P<0.01];2项研究报道了不良反应,异质性检验结果显示异质性较小(I^(2)=0%),固定效应模型Meta分析结果显示,研究组不良反应发生率低于对照组[OR=6.02,95%CI(0.05,0.89),P=0.03]。结论胺碘酮联合稳心颗粒治疗心力衰竭合并心律失常临床疗效显著,且可有效降低不良反应的发生率,有效性和安全性均较高。

Objective To systematically evaluate the efficacy and safety of amiodarone combined with Wenxin granules in the treatment of heart failure complicated with arrhythmia.Methods Searched the databases such as Zhiwang,Wanfang and Weipu,the key words:amiodarone combined with Wenxin granules,heart failure with arrhythmia,etc,collected the relevant studies on the efficacy and safety of amiodarone combined with Wenxin granules in the treatment of heart failure complicated with arrhythmia,evaluated the risk of bias of each document by using the ReviewManager 5.3 software provided by Cochrance collaboration network,and analysed the data included in the literature.Results A total of 223 literatures were retrieved,according to the inclusion and exclusion criteria of the literature,a total of seven literatures and 624 patients were finally included;Three studies,the results of the assignment of concealment and selective reporting were high risk of bias,blindness for researchers and subjects,blindness for outcome indicators,and other biases were uncertain,the generation of random sequence and the integrity of result data were low risk of bias;Four studies,random sequence generation,allocation concealment,selective reporting of research results were high risk of bias,blindness for researchers and subjects,blindness for outcome indicators,and other biases were uncertain,results data integrity was low risk of bias;Seven studies were included,and the heterogeneity test results showed that the heterogeneity was small(I^(2)=0%),the fixed-effects model Meta-analysis results showed that the clinical efficacy of heart failure complicated with arrhythmia in the study group was better than the control group[OR=6.02,95%CI(3.42,10.61),P<0.01];Two studies reported adverse reactions,and the heterogeneity test results showed that the heterogeneity was small(I^(2)=0%),the fixed-effect model Meta analysis showed that the incidence of adverse reactions in the study group was lower than that in the control group[OR=6.02,95%CI(0.05,0.89),P=0.03].Conclusion Amiodarone combined with Wenxin granules has significant clinical efficacy in the treatment of heart failure complicated with arrhythmia,and can effectively reduce the incidence of adverse reactions,with high efficacy and safety.