炙甘草汤加减治疗心律失常的系统评价再评价  

Re-evaluation of Systematic Reviews of Modified Zhigancao Decoction in the Treatment of Arrhythmia

作　　者：杜天依 孟闫燕[1] 赵伶俐 石榴 欧阳嘉慧 曲华[2] 高铸烨[2] DU Tianyi;MENG Yanyan;ZHAO Lingli;SHI Liu;OUYANG Jiahui;QU Hua;GAO Zhuye(Beijing University of Chinese Medicine,Beijing 100029,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院,北京100091

出　　处：《中西医结合心脑血管病杂志》2023年第4期591-600,共10页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：北京市中医药科技发展资金项目(No.JJ-2020-79);“重大新药创制”科技重大专项(No.2019ZX09201005-002-006);中国中医科学院科技创新工程重大攻关项目(No.CI2021A00920)。

摘　　要：目的:对炙甘草汤加减治疗心律失常的系统评价/Meta分析进行方法学质量和证据等级再评价。方法:计算机检索中英文数据库,搜集炙甘草汤加减治疗心律失常的系统评价/Meta分析,检索时限为建库至2021年12月31日。由2名研究员独立筛选和提取资料,基于PRISMA声明、AMSTAR2量表和GRADE分级方法对纳入研究的报告质量、方法学质量及证据质量进行评价。结果:共纳入7篇系统评价/Meta分析。PRIMSA声明评价显示,纳入研究得分为13.5~21.0分,5篇文献质量中等,2篇文献质量低。报告质量缺陷主要表现在方案与注册、研究选择、证据总结强度方面;AMSTAR2量表显示,7篇文章质量等级均为极低级,存在问题最多的有4个条目;GRADE证据显示,22个证据包括14个极低级证据,7个低级证据,仅有1个中等证据。导致降级的主要因素为局限性和发表偏倚。结论:炙甘草汤加减治疗心律的失常系统评价/Meta分析提供的方法学质量和证据等级总体偏低,建议进一步开展高质量临床试验,规范系统评价报告程序。Objective: To re-evaluate systematic reviews/Meta-analysis of Modified Zhigancao Decoction in the treatment of arrhythmia.Methods: The Chinese and English databases were searched for systematic reviews/Meta-analysis of Modified Zhigancao Decoction in the treatment of arrhythmia from datebase establishment to December 31st, 2021.Two reviewers independently screened literatures and extracted data.The PRISMA statement, AMSTAR2 scale, and GRADE classification were used to evaluate the quality, methodology, and evidence respectively.Results: A total of 7 systematic reviews/Meta-analyses were included.PRISMA statement indicated that the scores of included literatures ranged from 13.5 to 21.0,with 5 literatures of moderate quality and 2 literatures of low quality.The quality deficiencies of the report were mainly reflected in the scheme and registration, research selection, and the quality of evidence summary.AMSTAR2 scale showed that the quality grades of 7 literatures were very low, and there were 4 items with the most problems.GRADE evidence showed 22 evidence bodies included 14 very low evidence, 7 low evidence, and only 1 medium evidence.The main factors leading to quality degradation were limitation and publication bias.Conclusion: The methodological quality and evidence level provided by the systematic reviews/Meta-analysis of Modified Zhigancao Decoction in the treatment of arrhythmia were generally low.It was suggested that further high-quality clinical trials would be conducted and the systematic reviews reporting procedures showed be standardized.

关 键 词：心律失常 炙甘草汤加减 系统评价再评价 PRISMA声明 AMSTAR2量表 GRADE证据 

分 类 号：R259[医药卫生—中西医结合]