稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常有效性及安全性的Meta分析  

Meta-analysis of the Efficacy and Safety of Wenxin Granules Combined with Amiodarone in the Treatment of Heart Failure Complicated with Ventricular Arrhythmia

作　　者：宋子贤 赵晗[1] 潘婷婷 周倩倩 张泽[2] SONG Zixian;ZHAO Han;PAN Tingting;ZHOU Qianqian;ZHANG Ze(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属医院,沈阳110032

出　　处：《中西医结合心脑血管病杂志》2024年第19期3491-3497,共7页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家中医药管理局重点学科基金项目;沈阳市科技局公共卫生研发专项(No.20-205-4-080)。

摘　　要：目的:系统评价稳心颗粒结合胺碘酮治疗心力衰竭并发室性心律失常的疗效与安全性。方法:计算机检索中国知网(CNKI)、维普网(VIP)、万方、中国生物医学文献数据库(CBM)、PubMed、Web of Science和the Cochrane Library等数据库,检索有关稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常的随机对照试验(RCT)。由2名研究者分别对文献进行筛选、提取数据和评价纳入研究的偏倚风险后,采取RevMan 5.3及R语言统计软件进行Meta分析。结果:共纳入18项研究,涉及1 527例病人。Meta分析结果显示,稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常,在提高临床总有效率[RR=1.19,95%CI(1.14,1.25),P<0.000 1]、减少室性期前收缩次数[SMD=-2.42,95%CI(-4.66,-0.18),P=0.03]、稳定心率[SMD=-1.66,95%CI(-1.94,-1.37),P<0.000 1]、增加左室射血分数[SMD=1.57,95%CI(0.54,2.61),P=0.003]均优于单独使用胺碘酮,且不良反应发生率低于单独使用胺碘酮[RR=0.59,95%CI(0.43,0.80),P=0.000 8]。结论:现有证据表明,稳心颗粒联合胺碘酮在治疗心力衰竭并发室性心律失常,能够明显提高临床疗效、LVEF,且不良反应更少,安全性较好。Objective:To evaluate the effectiveness and safety of Wenxin Granules with amiodarone for the treatment of heart failure with ventricular arrhythmia.Methods:The databases of CNKI,VIP,WanFang,CBM,PubMed,Web of Science and the Cochrane Library were searched for the randomized controlled trials(RCT) of Wenxin Granule combined with amiodarone for the treatment of heart failure complicated with ventricular arrhythmia.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.RevMan 5.3 and R language statistical software were used for Meta-analysis.Results:Eighteen studies involving 1 527 patients were included.Meta-analysis demonstrated that Wenxin Granules with amiodarone could significantly improve the total clinical effective rate(RR=1.19,95%CI 1.14-1.25,P<0.000 1),reduce ventricular premature beats(SMD=-2.42,95%CI-4.66--0.18,P=0.03),stabilize heart rate(SMD=-1.66,95%CI-1.94--1.37,P<0.000 1),and increase left ventricular ejection(LVEF)(SMD=1.57,95%CI 0.54-2.61,P=0.003) compared to that of amiodarone alone.Furthermore,the incidence of adverse reactions were lower than that of amiodarone alone(RR=0.59,95%CI 0.43-0.80,P=0.000 8).Conclusion:The existing evidence shows that Wenxin Granule combined with amiodarone for the treatment of heart failure complicated with ventricular arrhythmia can significantly improve the clinical efficacy and LVEF,with fewer adverse reactions and better safety.

关 键 词：心力衰竭 室性心律失常 稳心颗粒 胺碘酮 室性期前收缩 

分 类 号：R541.7[医药卫生—心血管疾病] R541.6[医药卫生—内科学]