清热化痰法治疗快速性心律失常的Meta分析  

Meta Analysis of the Therapy for Clearing Heat and Resolving Phlegm in Treating Tachyarrhythmia

作　　者：李颖妃 任雪玉 李星 林晖 胡继强[1] 刘静[1] 吴旸[1] 王轩[1] 高群 李冬 逯金金[1] 李岩[1] 崔晓云[1] LI Yingfei;REN Xueyu;LI Xing;LIN Hui;HU Jiqiang;LIU Jing;WU Yang;WANG Xuan;GAO Qun;LI Dong;LU Jinjin;LI Yan;CUI Xiaoyun(Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京市丰台社区卫生服务中心 [3]北京中医药大学东直门医院

出　　处：《中西医结合心脑血管病杂志》2023年第13期2356-2364,共9页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：北京市科技计划项目(No.Z191100006619071)。

摘　　要：目的:系统评价清热化痰法治疗快速性心律失常的有效性及安全性。方法:计算机检索中国知网(CNKI)、万方数据库、中国生物医学文献服务系统(SinoMed)、维普数据库(VIP)、PubMed、EMbase、the Cochrane Library数据库,检索时限为从建库至2022年6月1日,获取清热化痰法治疗快速性心律失常的随机对照试验文献,进行文献筛选、资料提取及质量分析,使用RevMan 5.4软件进行Meta分析。结果:最终纳入33篇文献,Meta分析结果显示,相比单纯西医治疗,清热化痰法治疗快速性心律失常能够提高24 h心电图疗效[RR=1.20,95%CI(1.11,1.29),P<0.000 01]、中医症状疗效[RR=1.36,95%CI(1.29,1.43),P<0.000 01],减少24 h心电图室性期前收缩次数[SMD=-2.86,95%CI(-3.91,-1.81),P<0.000 01],降低24 h平均心室率[SMD=-1.20,95%CI(-1.41,-1.00),P<0.000 01]、P波离散度[SMD=0.94,95%CI(-1.25,-0.63),P<0.000 01]、不良事件发生率[RR=0.37,95%CI(0.23,0.60),P<0.000 1],差异均有统计学意义。在降低最大P波时限方面,清热化痰法治疗与单纯西医治疗效果相当[SMD=-0.49,95%CI(-1.43,0.45),P=0.31]。结论:现有证据表明,清热化痰法治疗快速性心律失常较单用西医治疗在24 h心电图疗效、中医症状疗效、24 h室性期前收缩次数、24 h平均心室率和P波离散度方面有一定优势,且不良事件发生率较低,具有较好的安全性。Objective:To evaluate the efficacy and safety of the therapy for clearing heat and resolving phlegm in treating tachyarrhythmia.Methods:Literature of randomized controlled trials(RCTs)of treating tachyarrhythmia with clearing heat and resolving phlegm was searched.The included literature was screened to retrieve data and quality assessment was conducted.RevMan 5.4 was used for analyzing outcomes.Results:Thirty-three literatures were included,and the results of Meta-analysis showed that the therapy for clearing heat and resolving phlegm combined with western medicine was better than western medicine alone in treating tachyarrhythmia,which reflected in improved the 24 hour Holter monitor curative effect(RR=1.20,95%CI 1.11-1.29,P<0.00001),traditional Chinese medicine(TCM)syndrome efficacy(RR=1.36,95%CI 1.29-1.43,P<0.00001),and reduced 24 hours ventricular premature contraction(SMD=-2.86,95%CI-3.91--1.81,P<0.00001),the 24 hour average ventricular rate(SMD=-1.20,95%CI-1.41--1.00,P<0.00001),the dispersion of P wave(SMD=0.94,95%CI-1.25--0.63,P<0.00001),and adverse event rate(RR=0.37,95%CI 0.23-0.60,P<0.0001).In addition,there was no obvious differences between the experimental group and control group in the maximum time limit of P wave(SMD=-0.49,95%CI-1.43-0.45,P=0.31).Conclusion:Existing research suggests that thefor clearing heat and resolving phlegm therapy was better than western medicine alone in the 24 hour Holter monitor curative effect,TCM syndrome efficacy,24 hours ventricular premature contraction,the 24 hour average ventricular rate,and the dispersion of P wave in treating tachyarrhythmia.It also had lower risk of poor prognosis and better safety.

关 键 词：快速性心律失常 清热化痰法 META分析 随机对照试验 

分 类 号：R259[医药卫生—中西医结合]