益气活血法治疗气虚血瘀型心房颤动临床疗效和安全性的Meta分析  

Clinical Efficacy and Safety of Supplementing Qi and Activating Blood Circulation in the Treatment of Atrial Fibrillation with Qi Deficiency and Blood Stasis:a Meta-analysis

作　　者：甘洁文[1] 金宇[1] 殷惠军[2] 马民[3] 张淼 GAN Jiewen;JIN Yu;YIN Huijun;MA Min;ZHANG Miao(Shenzhen Second People′s Hospital,Shenzhen 518000,Guangdong,China)

机构地区：[1]深圳市第二人民医院,广东深圳518000 [2]中国中医科学院西苑医院 [3]暨南大学,广州510632

出　　处：《中西医结合心脑血管病杂志》2021年第15期2516-2523,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：深圳医疗卫生三名工程(No.SZSM201612049)。

摘　　要：目的系统评价益气活血法治疗气虚血瘀型心房颤动的有效性和安全性。方法计算机检索PubMed、EMbase、the Cochrane Library、Web of SCI、中国知网(CNKI)、万方数据资源系统(WanFang Data)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)等数据库,纳入益气活血中药合常规西药对比常规西药治疗心房颤动的临床随机对照试验(RCT)研究。由两位评价者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,应用RevMan 5.3软件进行Meta分析。结果纳入17项RCT,共计1358例病人,Meta分析结果显示试验组在改善临床总有效率[RR=1.29,95%CI(1.20,1.39),P<0.05]、心电图疗效[RR=1.15,95%CI(1.02,1.28),P<0.05]、中医证候疗效[RR=1.27,95%CI(1.02,1.58),P<0.05]、中医证候积分[SMD=-1.80,95%CI(-2.82,0.77),P<0.05]、不良反应发生率[RR=0.40,95%CI(0.22,0.71),P<0.05]、血浆凝血酶原时间[SMD=2.99,95%CI(1.45,4.53),P<0.05]、活化部分凝血活酶时间[SMD=1.30,95%CI(0.67,1.94),P<0.05]及血浆纤维蛋白原[SMD=-2.70,95%CI(-4.21,-1.19),P<0.05]方面均优于对照组。结论现有证据表明,在常规治疗基础上加上益气活血方药联合治疗心房颤动疗效更好,不良反应更少。Objective To systematically evaluate the clinical efficacy and safety of supplementing qi and activating blood circulation in the treatment of atrial fibrillation with qi deficiency and blood stasis.Methods The randomized controlled trials(RCT)for the treatment of atrial fibrillation with traditional Chinese medicine alone by supplementing qi,activating blood circulation and conventional western medicine compared with conventional western medicine were were collected from PubMed,Embase,The Cochrane Library,Web of SCI,China National Knowledge Infrastructure(CNKI),Wanfang Data Resource System Data,Chinese science and technology periodical database(VIP),Chinese Biomedical Literature Service System(SinoMed).Two researchers independently screened the literatures,extracted data,and evaluated the methodological quality.Rev Man 5.3 software was used for Meta-analysis.Results A total of 17 literatures were included,involving 1358 patients.The result of Meta-analysis showed that the clinical efficacy[RR=1.29,95%CI(1.20,1.39),P<0.05],electrocardiogram efficacy[RR=1.15,95%CI(1.02,1.28),P<0.05],and traditional Chinese medicine syndromes efficacy[RR=1.27,95%CI(1.02,1.58),P<0.05],traditional Chinese medicine syndrome integral[SMD=-1.80,95%CI(-2.82,0.77),P<0.05],incidence of adverse reactions[RR=0.40,95%CI(0.22,0.71),P<0.05],plasma prothrombin time(PT)[SMD=2.99,95%CI(1.45,4.53),P<0.05],activated partial thromboplastin time(APTT)[SMD=1.30,95%CI(0.67,1.94),P<0.05],and plasma fibrinogen(FIB)[SMD=-2.70,95%CI(-4.21,-1.19),P<0.05]in the experimental group were better than those in the control group.Conclusion Current evidence showed that on the basis of conventional treatment,the combination of supplementing qi and activating blood circulation in the treatment of atrial fibrillation would provid better clinical effects and less adverse reactions.

关 键 词：心房颤动 益气活血 气虚血瘀 META分析 

分 类 号：R54[医药卫生—心血管疾病]