心可舒联合ARB类降压药治疗高血压所致心律失常有效性及安全性Meta分析

The Effectiveness and Safety of Xinkeshu Combined with ARB Antihypertensive Drugs in the Treatment of Arrhythmia Caused by Hypertension:A Meta Analysis

目的:利用Meta分析方法,探讨心可舒治疗高血压所致心律失常的有效性及安全性。方法:检索数据库The Cochrane Library、PubMed、Web of Science、ProQuest、Embase、中国生物医学文摘数据库、中国知网、维普、万方等数据库,设置检索时间为自建库起至2021年6月。根据论文查重、题名摘要筛选、文章内容筛选获取最终文献,统计学分析采用Rev Man 5.4软件。结果:最终纳入7项随机对照试验,共计765例患者,Meta分析结果:心可舒联合ARB类降压药在改善临床疗效(OR=6.45,95%CI[2.93,14.20],P<0.00001)、降低收缩压(MD=-4.64,95%CI[-9.09,-0.18],P=0.04)、降低舒张压(MD=-5.38,95%CI[-10.40,-0.36],P=0.04)、降低房性早搏发生的有效性(OR=5.99,95%CI[3.39,10.58],P<0.00001)、降低室性早搏发生的有效性(OR=7.33,95%CI[3.88,13.86],P<0.00001)方面的作用优于单纯使用ARB类降压药组;在降低心房纤颤发生的有效性(OR=1.88,95%CI[0.77,4.62],P=0.17)、不良反应发生率(OR=1.06,95%CI[0.57,1.95],P=0.86)方面差异无统计学意义,各研究显示未发生肝肾功能异常。结论:应用心可舒联合ARB类降压药治疗高血压所致心律失常的疗效明确,推荐临床应用。

Objective:Meta analysis method was used to systematically evaluate the effectiveness and safety of Xinkeshu in treating arrhythmia caused by hypertension.Methods:Search the databases The Cochrane Library,PubMed,Web of Science,ProQuest,Embase,China Biomedical Abstracts Database,CNKI,WEIPU and WANFANG,and the setting time is from the beginning of the database construction to June 2021.The final literature was obtained according to the duplicate check,title abstract screening,and article content screening,and the statistical analysis was performed with Rev Man 5.4.Results:A total of 765patients were included in 7randomized controlled trials.Meta-analysis results showed that Xinkeshu combined with ARB antihypertensive drugs improved clinical efficacy(OR=6.45,95%CI[2.93,14.20],P<0.00001),decreased systolic blood pressure(MD=-4.64,95%CI[-9.09,-0.18],P=0.04),decreased diastolic blood pressure(MD=-5.38,95%CI[-10.40,-0.36],P=0.04),decreased the effectiveness of premature atrial contractions(OR=5.99,95%CI[3.39,10.58],P<0.00001),decreased the effectiveness of premature ventricular beats(OR=7.33,95%CI[3.88,13.86],P<0.00001),which was better than that of the pure ARB antihypertensive drugs group.There was no statistically significant difference in decreased effectiveness of atrial fibrillation(OR=1.88,95%CI[0.77,4.62],P=0.17)and in the incidence of adverse reactions(OR=1.06,95%CI[0.57,1.95],P=0.86),and studies have shown no abnormal liver and kidney function.Conclusion:The therapeutic effect of Xinkeshu combined with ARB antihypertensive drugs on arrhythmia caused by hypertension is clear,and clinical application is recommended.