口服中成药联合抗心律失常药治疗阵发型房颤有效性和安全性的贝叶斯网状Meta分析

A Bayesian Network Meta-Analysis:Efficacy and Safety of Oral Chinese Patent Medicine inTreatment of Paroxysmal Atrial Fibrillation

目的对3种中成药治疗阵发性房颤有效性及安全性的差异进行系统评价。方法首先对Pubmed、CBM、CNKI、万方、维普等中英文数据库进行检索,检索时间限制为建库至2021年10月,检索中成药治疗阵发性房颤的随机对照试验的文献,2名研究人员独立提取文献资料并进行质量评价,应用ADDIS 16.1和Stata 15.1软件进行贝叶斯网状Meta分析。结果共纳入31篇符合纳入标准文献,包括3种中成药,6种用药方案,共计2514例受试患者。总有效率效果排名前3的用药方案:参松养心胶囊联合抗心律失常药物>稳心颗粒联合抗心律失常药物>养心定悸胶囊联合抗心律失常药物,降低不良反应发生率方面排名前3的用药方案:参松养心胶囊联合抗心律失常药>养心定悸胶囊联合抗心律失常药物>稳心颗粒联合抗心律失常药物。结论参松养心胶囊联合抗心律失常药治疗阵发性房颤患者的有效率及安全性最好,该结论仍需更多高质量随机对照试验研究验证。

Objective The differences in the effectiveness and safety of 3 kinds of Chinese patent medicines in the treatment of paroxysmal atrial fibrillation were systematically evaluated.Methods First,the Chinese and English databases such as Pubmed,CBM,CNKI,Wanfang and Weipu were searched.The search time was limited to the establishment of the database until October 2021,and the randomized controlled trials of Chinese patent medicines in the treatment of paroxysmal atrial fibrillation were searched.2 researchers independently extracted the literature data and conducted quality evaluation,and ADDIS 16.1 and Stata 15.1 software were used to conduct Bayesian network Meta-analysis.Results A total of 31 documents meeting the inclusion criteria were included,including 3 Chinese patent medicines,6 medication plansand a total of 2514 patients.Statistical analysis results showed the top 3 medication regimens with total effective rate were ShensongYangxin Capsules(参松养心胶囊)combined with antiarrhythmic drugs>Wenxin Granules(稳心颗粒)combined with antiarrhythmic drugs>Yangxin Dingji Capsules(养心定悸胶囊)combined with antiarrhythmic drugs.The top 3 medication regimens in terms of reducing the incidence of adverse reactions were Shensong Yangxin Capsules combined with antiarrhythmic drugs>Yangxin Dingji Capsules combined with antiarrhythmic drugs>Wenxin Granules combined with antiarrhythmic drugs.Conclusion Shensong Yangxin Capsules combined with antiarrhythmic drugs have the best efficiency and safety in the treatment of patients with paroxysmal atrial fibrillation.This conclusionneeds more high-quality randomized controlled trials to verify.