Systemic evaluation and Meta-analysis of Wenxin Keli in treatment of idiopathic premature beats in randomized controlled trails

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.

Clinical Efficacy of Ningxin Tongluo Decoction(宁心通络汤)Combined with Dapagliflozin on Patients of Type 2 Diabetes Mellitus Complicated with Ventricular Premature Beats

Objective:To explore the clinical efficacy of Ningxin Tongluo Decoction(宁心通络汤)combined with Dapagliflozin in the treatment of type 2 diabetes mellitus complicated with ventricular premature beats.Methods:Ninety-two patients with type 2 diabetes mellitus complicated with ventricular premature beats in our hospital were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with routine Western medicine,and the observation group was treated with Ningxin Tongluo Decoction on the basis of the control group.The clinical efficacy of the two groups before and after treatment,TCM syndrome score,blood glucose levels[fasting blood glucose(GLU),glycosylated hemoglobin(Hb A1c)],glucose metabolism levels[fasting insulin(FINS),insulin resistance index(HOMA-IR)],the number of ventricular premature beats detected by 24-hour ambulatory electrocardiogram,heart rate turbulence(HRT)[initial oscillation(TO),oscillation slope(TS)],and heart rate variability(HRV)standard deviation of two normal R-R intervals(SDNN),standard deviation of average normal R-R intervals every 5 minutes(SDANN)and root mean square of adjacent normal R-R intervals(RMSSD)were observed.Results:After treatment,the total effective rate of the observation group was 89.13%,significantly higher than that of the control group(73.91%),and the difference was statistically significant(P<0.05).Both groups could reduce TCM syndrome score,blood glucose level,glucose metabolism level,reduce the number of ventricular premature beats,improve HRT and HRV levels,and the observation group was superior to the control group,and the difference was statistically significant(P<0.05).Conclusion:Ningxin Tongluo Decoction combined with Dapagliflozin is effective in treating type 2 diabetes mellitus patients with ventricular premature beats.It can reduce blood glucose level,improve HRV and HRT,improve autonomic nerve function and exert antiarrhythmic effect.

An introduction of the experience in treating Ventricular premature beat with stasis heat

Ventricular premature beat,a kind of arrhythmia,is one of common diseases which not only decreases the quality of life but also has the danger of death.The pathogenesis in Traditional Chinese Medicine is that the injury of heart and kidney is the essence and the block of solid evil such as phlegm and blood stasis is the manifestation.The teacher,Li Yuan,has worked in clinic for decades and considered that the important pathogenesis of the VP beat is“heat transformed from Yang”,which cannot be ignored as it is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.