稳心颗粒联合美托洛尔治疗冠心病心律失常有效性及安全性的系统评价  

Efficacy and Safety of Wenxin Granule Combined with Metoprolol in the Treatment of Arrhythmia of Coronary Heart Disease:a Meta-analysis

作　　者：曹新福 李享[1] 刘红旭[1] 周明学[1,2] 周琦[1] CAO Xinfu;LI Xiang;LIU Hongxu;ZHOU Mingxue;ZHOU Qi(Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]北京市中医研究所

出　　处：《中西医结合心脑血管病杂志》2021年第1期14-23,共10页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：北京市医院管理局重点医学专业发展计划(No.ZYLX201817);北京市医院管理局青年人才培养“青苗计划”(No.QML20181002)。

摘　　要：目的系统评价稳心颗粒联合美托洛尔治疗冠心病心律失常的有效性及安全性。方法通过计算机检索中国知网、万方数据库、维普信息资源系统、PubMed、Web of Science及Cochrane Library等数据库,时间为建库至2019年6月,收集有关稳心颗粒联合美托洛尔治疗冠心病心律失常的临床随机对照试验。由两位评价员对纳入的研究进行资料提取和质量评价,并采用RevMan 5.3软件进行统计学分析。结果纳入的32篇研究共3383例病人。Meta分析结果显示,稳心颗粒联合美托洛尔治疗冠心病心律失常在临床总有效率[RR=1.21,95%CI(1.18,1.25),P<0.00001]、室性期前收缩次数[SMD=-4.40,95%CI(-5.64,-3.17),P<0.00001]、房性期前收缩次数[SMD=-4.27,95%CI(-5.78,-2.77),P<0.00001]、ST段压低程度[MD=-0.36,95%CI(-0.41,-0.31),P<0.00001]、ST段压低持续时间[MD=-0.73,95%CI(-0.82,-0.65),P<0.00001]、不良反应发生率[RR=0.69,95%CI(0.55,0.87),P=0.002]方面,均优于单用美托洛尔,差异均有统计学意义。结论当前证据表明,与单用美托洛尔比较,稳心颗粒联合美托洛尔治疗冠心病心律失常,可提高临床疗效,并且安全性更佳。Objective To systematically evaluate the efficacy and safety of Wenxin Granules combined with Metoprolol for the treatment of coronary heart disease(CHD)arrhythmia.Methods CNKI,VIP,WangFang,PubMed,Web of Science,and the Cochrane Library were retrieved by computer for randomized clinical trials(RCT)of Wenxin Granules combined with metoprolol vs metoprolol alone for the treatment of CHD arrhythmia from inception to June 2019.Data extract and quality evaluation were performed by two individual reviewers,and the Meta-analysis was carried out by RevMan 5.3 software.Results A total of 32 RCT were included,involving 3383 cases.The Meta-analysis results showed that the effects of Wenxin Granules combined with metoprolol(trial group)were superior to those of metoprolol alone(control group)in the total effective rate[RR=1.21,95%CI(1.18,1.25),P<0.00001],the number of ventricualr premature contraction[SMD=-4.40,95%CI(-5.64,-3.17),P<0.00001],the number of atrial premature contraction[SMD=-4.27,95%CI(-5.78,-2.77),P<0.00001],ST segment depression[MD=-0.36,95%CI(-0.41,-0.31),P<0.00001],ST segment duration[MD=-0.73,95%CI(-0.82,-0.65),P<0.00001],and the incidence of adverse reaction[RR=0.69,95%CI(0.55,0.87),P=0.002].Conclusion Wenxin Granules combined with metoprolol is more effective and safe in the treatment of CHD arrhythmia than metoprolol alone.

关 键 词：冠心病 心律失常 稳心颗粒 美托洛尔 室性期前收缩 房性期前收缩 ST段压低 系统评价 

分 类 号：R54[医药卫生—心血管疾病]