麝香保心丸联合胺碘酮治疗高血压心脏病合并心房颤动有效性和安全性的Meta分析
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摘要
目的运用Meta分析方法评价麝香保心丸联合胺碘酮对高血压心脏病合并心房颤动的有效性和安全性。方法检索PubMed、Cochrane Library(Issue 3 of 12,March 2018)、EMBASE、维普、中国知网数据库(CNKI)、中国生物医学文献服务系统(CBM)、万方数据库建库至2018年3月31日麝香保心丸治疗心房颤动的临床随机对照试验。使用Review Manager对两种治疗后心率、收缩压、舒张压、房颤复发时间、不良反应进行Meta分析。结果纳入3项随机对照试验,合计446例高血压合并心房颤动的病人。Meta分析结果显示,与单用胺碘酮方法相比,联合麝香保心丸能够延长心房颤动的复发时间[MD=53.07,95%CI(50.44,55.69),P<0.01];两组心率[MD=-1.60,95%CI(-6.31,3.11),P=0.51]、收缩压[MD=-0.92,95%CI(-7.43,5.60),P=0.78]、舒张压[MD=-0.71,95%CI(-5.10,3.69),P=0.75]和不良反应发生率[RR=1.02,95%CI(0.64,1.62),P=0.95]比较差异无统计学意义。结论麝香保心丸联合胺碘酮可延长心房颤动复发时间。
Objective To assess the efficacy and safety of Shexiang Baoxin pill(SXBXP)and amiodarone in the treatment of atrial fibrillation complicated with hypertension using meta-analysis.Methods The relevant randomized controlled trials(RCTs)about SXBXP and amiodarone for atrial fibrillation complicated with hypertension were retrieved from PubMed,Cochrane Library(Issue 3 of 12,March 2018),EMBASE,VIP database,China National Knowledge Infrastructure(CNKI),China Biology Medicine database(CBM),and WanFang database since the establishment of the database to March 31,2018.Meta-analysis of heart rate,systolic blood pressure,diastolic blood pressure,and the recurrence time of atrial fibrillation was performed by RevMan 5.3 software.Results Four RCTs were enrolled,involving 446 patients.Compared with the amiodarone alone,SXBXP and amiodarone prolonged the recurrence of atrial fibrillation[MD=53.07,95% CI(50.44,55.69),P <0.01].There was no significant difference in lowering systolic blood pressure[MD=-0.92,95%CI(-7.43,5.60),P =0.78],lowering diastolic blood pressure[MD=-0.71,95%CI(-5.10,3.69),P =0.75],and the incidence of adverse reactions[RR=1.02,95%CI(0.64,1.62),P =0.95]between two groups.Conclusion SXBXP and amiodarone can prolong the recurrence time of atrial fibrillation.
Objective To assess the efficacy and safety of Shexiang Baoxin pill(SXBXP)and amiodarone in the treatment of atrial fibrillation complicated with hypertension using meta-analysis.Methods The relevant randomized controlled trials(RCTs)about SXBXP and amiodarone for atrial fibrillation complicated with hypertension were retrieved from PubMed,Cochrane Library(Issue 3 of 12,March 2018),EMBASE,VIP database,China National Knowledge Infrastructure(CNKI),China Biology Medicine database(CBM),and WanFang database since the establishment of the database to March 31,2018.Meta-analysis of heart rate,systolic blood pressure,diastolic blood pressure,and the recurrence time of atrial fibrillation was performed by RevMan 5.3 software.Results Four RCTs were enrolled,involving 446 patients.Compared with the amiodarone alone,SXBXP and amiodarone prolonged the recurrence of atrial fibrillation[MD=53.07,95% CI(50.44,55.69),P <0.01].There was no significant difference in lowering systolic blood pressure[MD=-0.92,95%CI(-7.43,5.60),P =0.78],lowering diastolic blood pressure[MD=-0.71,95%CI(-5.10,3.69),P =0.75],and the incidence of adverse reactions[RR=1.02,95%CI(0.64,1.62),P =0.95]between two groups.Conclusion SXBXP and amiodarone can prolong the recurrence time of atrial fibrillation.
引文
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[3]张宁,王颖,杨李鹏,等.麝香保心丸联合胺碘酮治疗高血压心脏病心房颤动临床分析[J].世界最新医学信息文摘,2014,14(7):204;208.
[4]彭小刚.麝香保心丸与胺碘酮联用对社区高血压心脏病合并心房颤动患者心率、血压及房颤情况的影响[J].新中医,2015,47(4):16-17.
[5]Gorenek Chair B,Pelliccia Co-Chair A,Benjamin EJ,et al.European Heart Rhythm Association(EHRA)/European Association of Cardiovascular Prevention and Rehabilitation(EACPR)position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society(HRS)and Asia Pacific Heart Rhythm Society(APHRS)[J].Eur J Prev Cardiol,2017,24(1):4-40.
[6]Ogunsua AA,Shaikh AY,Ahmed M,et al.Atrial fibrillation and hypertension:mechanistic,epidemiologic,and treatment parallels[J].Methodist Debakey Cardiovasc J,2015,11(4):228-234.
[7]Zhao LQ,Liu SW.Atrial fibrillation in essential hypertension:an issue of concern[J].J Cardiovasc Med(Hagerstown),2014,15(2):100-106.
[8]武多娇,洪华山,江琼.麝香保心丸减轻自发性高血压大鼠心肌纤维化的研究[J].中国中西医结合杂志,2005,25(4):350-353.
[9]李慧洋,李剑,吴帮卫,等.麝香保心丸对冠心病支架植入后靶血管血流改善作用的随机、双盲、对照研究[J].中国中西医结合杂志,2018,38(3):295-299.
[2]周和.麝香保心丸联合胺碘酮治疗高血压心脏病心房颤动临床观察[J].现代中西医结合杂志,2013,22(11):1201-1202.
[3]张宁,王颖,杨李鹏,等.麝香保心丸联合胺碘酮治疗高血压心脏病心房颤动临床分析[J].世界最新医学信息文摘,2014,14(7):204;208.
[4]彭小刚.麝香保心丸与胺碘酮联用对社区高血压心脏病合并心房颤动患者心率、血压及房颤情况的影响[J].新中医,2015,47(4):16-17.
[5]Gorenek Chair B,Pelliccia Co-Chair A,Benjamin EJ,et al.European Heart Rhythm Association(EHRA)/European Association of Cardiovascular Prevention and Rehabilitation(EACPR)position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society(HRS)and Asia Pacific Heart Rhythm Society(APHRS)[J].Eur J Prev Cardiol,2017,24(1):4-40.
[6]Ogunsua AA,Shaikh AY,Ahmed M,et al.Atrial fibrillation and hypertension:mechanistic,epidemiologic,and treatment parallels[J].Methodist Debakey Cardiovasc J,2015,11(4):228-234.
[7]Zhao LQ,Liu SW.Atrial fibrillation in essential hypertension:an issue of concern[J].J Cardiovasc Med(Hagerstown),2014,15(2):100-106.
[8]武多娇,洪华山,江琼.麝香保心丸减轻自发性高血压大鼠心肌纤维化的研究[J].中国中西医结合杂志,2005,25(4):350-353.
[9]李慧洋,李剑,吴帮卫,等.麝香保心丸对冠心病支架植入后靶血管血流改善作用的随机、双盲、对照研究[J].中国中西医结合杂志,2018,38(3):295-299.