中药对心房颤动消融术后再发心律失常的影响:系统评价与Meta分析  

Systematic evaluation and meta-analysis of Chinese herbal medicine for recurrent atrial tachyarrhythmia after catheter ablation of atrial fibrillation

作　　者：崔兆睿 王亚慧 朱晏辰 胡继强[2] Cui Zhaorui;Wang Yahui;Zhu Yanchen;Hu Jiqiang(The Second Clinical Medical College,Beijing University of Chinese Medicine,Beijing 100072,China;不详)

机构地区：[1]北京中医药大学第二临床医学院,北京100072 [2]北京中医药大学东方医院心血管科,北京100072

出　　处：《中国循证心血管医学杂志》2023年第8期914-919,共6页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：首都卫生发展科研专项(首发2020-2-4203)。

摘　　要：目的 评价中药干预对心房颤动(房颤)导管消融术后再发快速房性心律失常的影响。方法 在INPLASY进行研究方案注册,注册号为INPLASY202250096。系统检索由建库至2022年4月30日中国知网、维普、万方、中国生物医学文献数据库(SinoMed)、Pubmed、Embase、Cochrane Library、ProQuest dissertations and Theses Global(PQDT)、中国临床试验注册库相关随机对照研究,采用Cochrane图书馆提供的偏倚风险评估工具对纳入的研究进行偏倚风险评估,使用RevMan 5.3进行数据分析。结果 共纳入11项研究,共908名受试者。在房颤消融术后3月内,中药干预组在再发心律失常(RR=2.60,95%CI:1.71~3.96,P<0.00001)、左房内径(LAD)(MD=1.61,95%CI:0.70~2.52,P=0.0005)、左室射血分数(LVEF)(MD=-2.58,95%CI:-3.22~-1.94,P<0.00001)、白介素-6(IL-6)(MD=3.21,95%CI:0.35~6.07,P=0.03)方面优于常规西药治疗组。在消融术3月后,中药干预组在再发心律失常(RR=1.78,95%CI:1.28~2.48,P=0.0006)及LAD(MD=1.24,95%CI:0.48~2.00,P=0.001)方面优于对照组。结论与常规西药治疗相比,中药干预在减少房颤患者消融术后再发快速房性心律失常方面可能具有潜在的疗效,其作用机制仍待进一步探索。今后应开展大样本、多中心、符合CONSORT报告声明的随机对照试验进一步验证该结论。Objective To assess the effectiveness of Chinese herbal medicine for recurrent atrial tachyarrhythmia after catheter ablation of atrial fibrillation.Methods The research protocol has been registered with the INPLASY website(Registration number:INPLASY202250096).We searched relevant randomized controlled trials(RCTs) published before April 30,2022.The databases include China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Journal Database(VIP),Wanfang databases,China Biology Medicine(SinoMed),PubMed,the Cochrane Library,Embase,ProQuest dissertations and Theses Global(PQDT),and The Chinese Clinical Trial Register.We used the Cochrane risk of bias tool to assess the methodological quality of trials.Review Manager 5.3 software was used to analyze data.Results Eleven studies were included,including 908 participants.Within three months after catheter ablation,the results of the meta-analysis showed that Chinese herbal medicine was more significant in the frequency of recurrent atrial tachyarrhythmia(RR=2.60,95%CI:1.71~3.96,P<0.00001),left anterior descending(LAD,MD=1.61,95%CI:0.70~2.52,P=0.0005),left ventricular ejection fraction(LVEF,MD=-2.58,95%CI:-3.22~-1.94,P<0.00001),and IL-6(MD=3.21,95%CI:0.35~6.07,P=0.03).After three months of catheter ablation,Chinese herbal medicine could reduce the frequency of recurrent atrial tachyarrhythmia(RR=1.78,95%CI:1.28~2.48,P=0.0006) and improve LAD(MD=1.24,95%CI:0.48~2.00,P=0.001).Conclusions Compared with conventional western medicine,Chinese herbal medicine may have potential efficacy in reducing recurrent atrial tachyarrhythmia after catheter ablation of atrial fibrillation,and the mechanism remains to be further explored.The findings should be further validated in the future by conducting large-sample,multicenter randomized controlled trials according to the CONSORT reporting statement.

关 键 词：心房颤动 导管消融 中医药 随机对照试验 META分析 

分 类 号：R541.75[医药卫生—心血管疾病]