Objective:To evaluate the efficacy and safety of Wenxin Keli for premature beats in structurally normal heart systematically.Methods:Eight databases at home and abroad were searched to collect randomized controlled tr...Objective:To evaluate the efficacy and safety of Wenxin Keli for premature beats in structurally normal heart systematically.Methods:Eight databases at home and abroad were searched to collect randomized controlled trials of Wenxin Keli for premature beats without cardiac diseases.The included literatures were systematically evaluated with Cochrane Handbook 5.1 evaluation criteria and tools,and Meta analysis was performed with software RevMan5.3.Results:A total of 13 randomized controlled trials with 1278 subjects were included.The exprimental group used Wenxin Keli alone while the control group used antiarrhythmic medicine.The Meta analysis results showed that the total effective rate(RR=1.06,95%CI[0.97,1.16],P=0.23)and clinical symptom effective rate(RR=1.16,95%CI[0.94,1.44],P=0.18)of Wenxin Keli on idiopathic premature beats was not significantly different from western medicine group.The subgroup analysis of total effective rate showed that Wenxin Keli had no significant difference with metoprolol(RR=1.04,95%CI[0.95,1.15],P=0.41),bisoprolol(RR=1.32,95%CI[0.85,2.05],P=0.22)and propanone(RR=1.07,95%CI[0.90,1.26],P=0.44).ECG changes showed that the PR intervals(MD=-12.57,95%CI[-16.15,-8.99],P<0.00001)and QTc intervals(MD=-8.09,95%CI[-15.52,-0.65],P=0.03)in the western medicine group were prolonged significantly more than those of Wenxin Keli.In terms of safety,the incidence of adverse reactions of Wenxin Keli was significantly less than that of western medicine group(RR=0.32,95%CI[0.19,0.54],P<0.0001).Conclusion:The efficacy of Wenxin Keli in the treatment of premature beats with structurally normal heart is accurate,and there are no serious adverse reactions.However,because of the low quality of the included papers,which affected the reliability of the conclusions,high-quality clinical research is needed to further demonstrate.展开更多
目的:对稳心颗粒治疗心房颤动(房颤)的有效性及安全性进行全面系统的评价。方法:电子检索PubMed、Web of Science、Cochrane Library等外文数据库及中国知识基础设施工程(CNKI)、万方数据知识服务平台(Wan Fang Data)、维普期刊资源整...目的:对稳心颗粒治疗心房颤动(房颤)的有效性及安全性进行全面系统的评价。方法:电子检索PubMed、Web of Science、Cochrane Library等外文数据库及中国知识基础设施工程(CNKI)、万方数据知识服务平台(Wan Fang Data)、维普期刊资源整合服务平台(VIP)、中国生物医学文献服务系统(SinoMed)等中文数据库,时间截至2018年10月1日。按照Cochrane手册推荐的质量评价标准对纳入研究进行质量学评价,采用Rev Man 5.3软件进行数据分析,采用Stata 14软件Begg检验进行发表偏倚分析。结果:共纳入24篇随机对照试验(RCTs),涉及到2246名房颤患者。结果显示,稳心颗粒单用或者联合西药治疗在控制快速心室率(MD=-7.14,95%CI:-8.42--5.87),降低房颤发作次数和持续时间,缩短窦律转复时间(MD=-3.04,95%CI:-3.47--2.61),增加窦律转复率(RR=1.19,95%CI:1.09-1.29),减少房颤复发率(RR=0.28,95%CI:0.13-0.59),提高左室射血分数(LVEF)(MD=3.44,95%CI:0.87-6.01),改善左心室舒张末内径(LVEDD)(MD=-2.47,95%CI:-2.86--2.08),降低左心房内径(LAd)(MD=-0.91,95%CI:-1.58--0.25),减少P波离散度(Pd)(MD=-4.04,95%CI:-4.15--3.93)等方面效果优于空白对照、安慰剂或单用西药治疗。稳心颗粒联合小剂量胺碘酮在改善P波最大时限(Pmax)优于单用常规剂量胺碘酮治疗(MD=-8.25,95%CI:-10.33--6.17),而稳心颗粒联合常规剂量胺碘酮治疗效果更优(MD=-13.10,95%CI:-13.65--12.55)。与对照组相比,联合治疗组不良反应发生更少,且Begg检验未发现发表偏倚。结论:稳心颗粒单用或者联合西药在房颤治疗中有良好疗效,但仍需要高质量证据予以验证。展开更多
基金National Natural Science Foundation of China(No.81774128)National key Research and development program(No.2019YFC1708404)。
文摘Objective:To evaluate the efficacy and safety of Wenxin Keli for premature beats in structurally normal heart systematically.Methods:Eight databases at home and abroad were searched to collect randomized controlled trials of Wenxin Keli for premature beats without cardiac diseases.The included literatures were systematically evaluated with Cochrane Handbook 5.1 evaluation criteria and tools,and Meta analysis was performed with software RevMan5.3.Results:A total of 13 randomized controlled trials with 1278 subjects were included.The exprimental group used Wenxin Keli alone while the control group used antiarrhythmic medicine.The Meta analysis results showed that the total effective rate(RR=1.06,95%CI[0.97,1.16],P=0.23)and clinical symptom effective rate(RR=1.16,95%CI[0.94,1.44],P=0.18)of Wenxin Keli on idiopathic premature beats was not significantly different from western medicine group.The subgroup analysis of total effective rate showed that Wenxin Keli had no significant difference with metoprolol(RR=1.04,95%CI[0.95,1.15],P=0.41),bisoprolol(RR=1.32,95%CI[0.85,2.05],P=0.22)and propanone(RR=1.07,95%CI[0.90,1.26],P=0.44).ECG changes showed that the PR intervals(MD=-12.57,95%CI[-16.15,-8.99],P<0.00001)and QTc intervals(MD=-8.09,95%CI[-15.52,-0.65],P=0.03)in the western medicine group were prolonged significantly more than those of Wenxin Keli.In terms of safety,the incidence of adverse reactions of Wenxin Keli was significantly less than that of western medicine group(RR=0.32,95%CI[0.19,0.54],P<0.0001).Conclusion:The efficacy of Wenxin Keli in the treatment of premature beats with structurally normal heart is accurate,and there are no serious adverse reactions.However,because of the low quality of the included papers,which affected the reliability of the conclusions,high-quality clinical research is needed to further demonstrate.
文摘目的:对稳心颗粒治疗心房颤动(房颤)的有效性及安全性进行全面系统的评价。方法:电子检索PubMed、Web of Science、Cochrane Library等外文数据库及中国知识基础设施工程(CNKI)、万方数据知识服务平台(Wan Fang Data)、维普期刊资源整合服务平台(VIP)、中国生物医学文献服务系统(SinoMed)等中文数据库,时间截至2018年10月1日。按照Cochrane手册推荐的质量评价标准对纳入研究进行质量学评价,采用Rev Man 5.3软件进行数据分析,采用Stata 14软件Begg检验进行发表偏倚分析。结果:共纳入24篇随机对照试验(RCTs),涉及到2246名房颤患者。结果显示,稳心颗粒单用或者联合西药治疗在控制快速心室率(MD=-7.14,95%CI:-8.42--5.87),降低房颤发作次数和持续时间,缩短窦律转复时间(MD=-3.04,95%CI:-3.47--2.61),增加窦律转复率(RR=1.19,95%CI:1.09-1.29),减少房颤复发率(RR=0.28,95%CI:0.13-0.59),提高左室射血分数(LVEF)(MD=3.44,95%CI:0.87-6.01),改善左心室舒张末内径(LVEDD)(MD=-2.47,95%CI:-2.86--2.08),降低左心房内径(LAd)(MD=-0.91,95%CI:-1.58--0.25),减少P波离散度(Pd)(MD=-4.04,95%CI:-4.15--3.93)等方面效果优于空白对照、安慰剂或单用西药治疗。稳心颗粒联合小剂量胺碘酮在改善P波最大时限(Pmax)优于单用常规剂量胺碘酮治疗(MD=-8.25,95%CI:-10.33--6.17),而稳心颗粒联合常规剂量胺碘酮治疗效果更优(MD=-13.10,95%CI:-13.65--12.55)。与对照组相比,联合治疗组不良反应发生更少,且Begg检验未发现发表偏倚。结论:稳心颗粒单用或者联合西药在房颤治疗中有良好疗效,但仍需要高质量证据予以验证。
