中国中药杂志

2019, v.44(23) 5198-5206

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稳心颗粒治疗慢性心力衰竭合并心房颤动的疗效性及安全性系统评价
Efficacy and safety of Wenxin Granules in treatment of chronic heart failure with atrial fibrillation: a systematic review

辛玉;戴雁彦;杨昊昕;张秀文;李博;
XIN Yu;DAI Yan-yan;YANG Hao-xin;ZHANG Xiu-wen;LI Bo;Dongzhimen Hospital,Beijing University of Chinese Medicine;Beijing Institute of Traditional Chinese Medicine,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University;Yanqing Hospital,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University;

摘要(Abstract):

系统评价稳心颗粒治疗慢性心力衰竭合并心房颤动的疗效性及安全性。计算机检索中国学术期刊全文数据库(CNKI)、万方数据资源系统、维普中文科技期刊全文数据库(VIP)、PubMed、Cochrane Library等数据库,收集稳心颗粒治疗慢性心力衰竭合并心房颤动的随机对照试验。由2名研究者独立根据纳排标准筛选文献、提取资料,并使用Cochrane评价手册中的风险偏倚评估工具进行质量评价,采用Cochrane系统评价软件Rev Man 5. 3进行数据分析。共纳入11篇随机对照试验,包含受试者941名,干预措施为稳心颗粒加指南推荐常规治疗,对照措施为单纯使用指南推荐的常规治疗。结果显示,稳心颗粒加常规治疗对比常规治疗可更好降低心衰合并房颤患者血浆B型利钠肽(BNP)水平(MD=-258. 18,95%CI [-464. 06,-52. 30],P=0. 01)或氨基末端B型利钠肽前体(NT-proBNP)水平,更好提高左室射血分数(MD=6. 72,95%CI[4. 61,8. 84],P<0. 000 01),I~2=65%,心室率降低更明显(MD=-11. 66,95%CI[-15. 79,-7. 54],P <0. 000 01),心功能改善有效率更高(RR=1. 20,95%CI[1. 11,1. 31],P<0. 000 1),I~2=23%。该研究发现稳心颗粒联合西医常规治疗对比单纯使用西医常规治疗,在降低心衰合并房颤患者血浆BNP或NT-proBNP水平、减慢心室率、提高左室射血分数等方面效果更好,不良反应少,但由于该系统评价所纳入文献数量较少且文献质量不高,故在临床上谨慎推荐使用。仍需开展更大规模、更严谨的随机对照试验来确定稳心颗粒治疗慢性心力衰竭合并房颤在改善心功能方面的疗效。
This systematic review aims to evaluate the efficacy and safety of Wenxin Granules in the treatment of chronic heart failure with atrial fibrillation. Databases,such as CNKI,Wan Fang Date,VIP,PubMed,Cochrane Library,were electronically retrieved for relevant randomized controlled trials of Wenxin Granules in the treatment of chronic heart failure with atrial fibrillation. Two researchers independently screened out the literatures,extracted data according to the inclusion criteria,and conducted a quality assessment by the risk bias assessment tool in the Cochrane evaluation manual. Cochrane systematic evaluation software Rev Man 5. 3 was used for data analysis. Totally 11 randomized controlled trials,including 941 subjects. The intervention measures were the conventional treatment recommended by the guidelines combined with Wenxin Granules; and the control measures were the conventional treatment recommended by the guidelines alone. The results showed that compared with conventional treatment alone,Wenxin Granules combined with conventional treatment can better reduce the BNP level in patients with heart failure with atrial fibrillation( MD =-258. 18,95% CI[-464. 06,-52. 30],P= 0. 01) or NT-proBNP level,better improve left ventricular ejection fraction( MD = 6. 72,95%CI[4. 61,8. 84],P<0. 000 01),I~2= 65%,And the ventricular rate decreased more significantly( MD =-11. 66,95% CI[-15. 79,-7. 54],P<0. 000 01),and the cardiac function was improved more efficiently( RR = 1. 20,95%CI [1. 11,1. 31],P<0. 000 1),I~2= 23%.In conclusion,compared with the single administration of conventional Western medicine,the combined administration of Wenxin Granules has better effects in reducing the level of BNP or NT-proBNP,slowing down the ventricular rate,and improving the left ventricular ejection fraction,with fewer adverse reactions. However,due to the small sample size and the low quality of literatures included in this systematic review,it is shall be carefully applied in clinic. More rigorous randomized controlled trials shall be conducted to determine the efficacy of Wenxin Granules in improving cardiac function in the treatment of chronic heart failure with atrial fibrillation.

关键词(KeyWords): 稳心颗粒;心力衰竭;心房颤动;系统评价;随机对照试验
Wenxin Granules;heart failure;atrial fibrillation;systematic review;randomized controlled trial

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81774146)

作者(Author): 辛玉;戴雁彦;杨昊昕;张秀文;李博;
XIN Yu;DAI Yan-yan;YANG Hao-xin;ZHANG Xiu-wen;LI Bo;Dongzhimen Hospital,Beijing University of Chinese Medicine;Beijing Institute of Traditional Chinese Medicine,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University;Yanqing Hospital,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University;

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