参松养心胶囊联合美托洛尔治疗冠心病心律失常有效性及安全性的Meta分析
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摘要
目的系统评价参松养心胶囊联合美托洛尔治疗冠心病心律失常的有效性及安全性。方法检索中国知网、万方数据库、维普信息资源系统、中国生物医学文献数据库、Pub Med、Web of Science及Cochrane图书馆,收集所有已公开发表的参松养心胶囊联合美托洛尔治疗冠心病心律失常的随机对照试验,文献检索起止时间均为建库至2018年11月。使用Jadad改良法制定的量表对纳入的研究进行质量评价,采用Rev Man 5. 3软件对符合条件的研究进行Meta分析。结果最终纳入29项研究,样本总量为2647例。Meta分析结果显示,与单用美托洛尔相比,参松养心胶囊联合美托洛尔可显著提高临床症状疗效(OR=4. 63,95%CI 3. 60～5. 95,Z=11. 99,P<0. 001),明显降低治疗后缺血发生次数(MD=-3. 54,95%CI-3. 71～-3. 37,Z=41. 63,P <0. 001)、缺血发生时间(MD=-6. 13,95%CI-7. 02～-5. 23,Z=13. 37,P <0. 001)及B型脑钠肽(BNP)水平(MD=-59. 65,95%CI-65. 97～-53. 34,Z=18. 51,P <0. 001),治疗后不良反应发生率比较差异无统计学意义(OR=0. 86,95%CI 0. 55～1. 33,Z=0. 69,P=0. 49)。结论参松养心胶囊联合美托洛尔较单用美托洛尔治疗冠心病心律失常可显著提高临床疗效、明显降低治疗后缺血发生次数、缺血发生时间及BNP水平,且不会增加不良反应发生率。
Objective To review systematically the effectiveness and safety on arrhythmia of coronary heart disease( CHD) treated with shensong yangxin capsules and metoprolol. Methods Retrieving from CNKI,Wanfang,VIP,CBM Chinese databases,as well as Pub Med,Web of Science and Cochrane library,all of the RTCs on CHD arrhythmia treated with shensong yangxin capsules and metoprolol published were collected. The retrieval time was from the day of database establishment through to November 2018. The modified Jadad scale was adopted for the quality assessment of the included RTCs. Rev Man 5. 3 software was used for Meta analysis on the eligible RCTs. Results Finally,29 RTCs were included,with 2647 sample cases. Meta-analysis results showed that compared with metoprolol,the combined medication of metoprolol and shensong yangxin capsules significantly increases the clinical effects on the symptoms( OR = 4. 63,95% CI 3. 60 to 5. 95,Z = 11. 99,P < 0. 001),obviously reduces the attack frequency of ischemia( MD =-3. 54,95% CI-3. 71 to-3. 37,Z = 41. 63,P < 0. 001),ischemia time( MD =-6. 13,95% CI-7. 02 to-5. 23,Z = 13. 37,P < 0. 001) and BNP level( MD =-59. 65,95% CI-65. 97 to-53. 34,Z = 18. 51,P < 0. 001). The incidence of adverse reaction after treatment was not significantly different between the two groups( OR = 0. 86,95% CI 0. 55 to 1. 33,Z = 0. 69,P = 0. 49).Conclusion Shensong yangxin capsules combined with metoprolol significantly increases the effects on clinical symptoms,reduces the frequency of ischemia,time of ischemia and BNP level after treatment and cannot increase the incidence of adverse reaction in treatment of arrhythmia of coronary heart disease.
Objective To review systematically the effectiveness and safety on arrhythmia of coronary heart disease( CHD) treated with shensong yangxin capsules and metoprolol. Methods Retrieving from CNKI,Wanfang,VIP,CBM Chinese databases,as well as Pub Med,Web of Science and Cochrane library,all of the RTCs on CHD arrhythmia treated with shensong yangxin capsules and metoprolol published were collected. The retrieval time was from the day of database establishment through to November 2018. The modified Jadad scale was adopted for the quality assessment of the included RTCs. Rev Man 5. 3 software was used for Meta analysis on the eligible RCTs. Results Finally,29 RTCs were included,with 2647 sample cases. Meta-analysis results showed that compared with metoprolol,the combined medication of metoprolol and shensong yangxin capsules significantly increases the clinical effects on the symptoms( OR = 4. 63,95% CI 3. 60 to 5. 95,Z = 11. 99,P < 0. 001),obviously reduces the attack frequency of ischemia( MD =-3. 54,95% CI-3. 71 to-3. 37,Z = 41. 63,P < 0. 001),ischemia time( MD =-6. 13,95% CI-7. 02 to-5. 23,Z = 13. 37,P < 0. 001) and BNP level( MD =-59. 65,95% CI-65. 97 to-53. 34,Z = 18. 51,P < 0. 001). The incidence of adverse reaction after treatment was not significantly different between the two groups( OR = 0. 86,95% CI 0. 55 to 1. 33,Z = 0. 69,P = 0. 49).Conclusion Shensong yangxin capsules combined with metoprolol significantly increases the effects on clinical symptoms,reduces the frequency of ischemia,time of ischemia and BNP level after treatment and cannot increase the incidence of adverse reaction in treatment of arrhythmia of coronary heart disease.
引文
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[18]周静.参松养心胶囊治疗老年冠心病心律失常的效果探讨[J].中国继续医学教育,2017,9(15):180-182.
[19]丁海涛.参松养心胶囊联合美托洛尔片治疗冠心病心律失常的疗效分析[J].当代医药论丛,2017,15(5):70-71.
[20]王庆久,孙学玉.参松养心胶囊联合美托洛尔治疗老年冠心病心律失常疗效分析[J].中国农村卫生,2016(20):5.
[21]苏艳.参松养心胶囊与美托洛尔缓释片联合方案治疗冠心病心律失常的疗效评估[J].当代临床医刊,2015,28(1):1190-1191.
[22]曲娜,才江平.参松养心胶囊联合美托洛尔缓释片治疗冠心病心律失常的临床疗效观察[J].实用心脑肺血管病杂志,2015,23(4):109-110.
[23]李新春,王晓平.参松养心胶囊联合美托洛尔治疗心律失常的疗效观察[J].临床医学,2012,32(7):116-117.
[24]郭力鹏,许青宗,宋金玲.倍他乐克联合参松养心胶囊治疗室性早搏的临床研究[J].中国医药科学,2012,2(12):51-52.
[25]周利平,李洪.参松养心胶囊联合美托洛尔治疗冠心病合并频发室性早搏的临床疗效研究[J].中国民族民间医药,2011,20(5):102-105.
[26]黄华文,周宏霞,梁燕运.参松养心胶囊联合酒石酸美托洛尔胶囊治疗老年心律失常的疗效观察[J].广东医学院学报,2011,29(6):655-656.
[27]周茜.参松养心胶囊联合美托洛尔缓释片治疗室性心律失常冠心病患者的疗效观察[J].中国民康医学,2016,28(7):80-99.
[28]吕红娟.洒石酸美托洛尔片联合参松养心胶囊治疗心律失常的疗效分析[J].中西医结合心脑血管病杂志,2017,5(24):31-32.
[29]孙丽丽.参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常的疗效观察[J].中国医药指南,2018,16(29):176.
[30]于丽丽.老年冠心病心律失常应用参松养心胶囊联合美托洛尔缓释片治疗的效果观察[J].临床医药文献电子杂志,2017,93(4):18 369-18 372.
[31]朱俊先.对老年冠心病心律失常联合美托洛尔缓释片、参松养心胶囊治疗的疗效探讨[J].中西医结合心血管病电子杂志,2018,6(31):21-22.
[32]吕书娟.参松养心胶囊治疗室性期前收缩疗效观察[J].临床荟萃,2011,26(12):1078-1079.
[33]张琰,袁早送.参松养心胶囊联合倍他乐克治疗室性早搏有效性及安全性的Meta分析[J].疑难病杂志,2016,15(6):629-633.
[2]Qaseem A,Humphrey LL,Fitterman N,et al. Treatment of anemia in patients with heart disease:a clinical practice guideline from the American College of Physicians[J]. Annals of Internal Medicine,2013,159(11):770-779.
[3]张晨,王美玲,马华,等.参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常疗效观察[J].临床荟萃,2014,29(8):861-865.
[4]侯明桥,张春媛,邱玲.参松养心胶囊联合美托洛尔治疗老年冠心病心律失常患者的效果观察[J].疑难病杂志,2015,14(5):508-510,515.
[5]王莹,齐丽平.参松养心胶囊联合美托洛尔辨治气虚瘀阻证冠心病心律失常的临床观察[J].成都中医药大学学报,2016,39(2):86-89.
[6]董春放.参松养心胶囊联合琥珀酸美托洛尔治疗冠心病室性心律失常53例[J].江西中医药,2018,49(10):41-43.
[7]罗艳丽.参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常的效果研究[J].临床医学,2016,36(9):117-119.
[8]马尔旦·乌布利.参松养心胶囊联合美托洛尔治疗老年冠心病心律失常患者40例[J].中国社区医师,2018,34(27):91,93.
[9]李德环,蔡晓华,赵琛.参松养心胶囊联合美托洛尔缓释片治疗冠心病室性早搏疗效观察[J].青岛医药卫生,2017,49(6):412-414.
[10]张新昌.老年冠心病心律失常患者行参松养心胶囊联合美托洛尔治疗的临床价值探究[J].首都食品与医药,2018,25(18):57-58.
[11]魏铁彬.观察参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常疗效[J].中医临床研究,2016,8(24):41-42.
[12]陈智,冯小坚,徐细平.参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常疗效分析[J].中国社区医师,2015,31(14):90-92.
[13]马会亭.参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常的价值研究[J].中国社区医师,2018,34(28):108-109.
[14]谢咏镰.中西医结合治疗老年冠心病心律失常效果分析[J].深圳中西医结合杂志,2016,26(1):52-53.
[15]郑蛟.参松养心胶囊联合美托洛尔缓释片治疗冠心病心律失常老年患者的效果[J].医疗装备,2017,30(24):23-24.
[16]汤文夏.参松养心胶囊联合美托洛尔片治疗冠心病心律失常的效果分析[J].当代医药论丛,2017,15(20):89-90.
[17]董修禄.参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常疗效观察[J].基层医学论坛,2016,20(27):3771-3772.
[18]周静.参松养心胶囊治疗老年冠心病心律失常的效果探讨[J].中国继续医学教育,2017,9(15):180-182.
[19]丁海涛.参松养心胶囊联合美托洛尔片治疗冠心病心律失常的疗效分析[J].当代医药论丛,2017,15(5):70-71.
[20]王庆久,孙学玉.参松养心胶囊联合美托洛尔治疗老年冠心病心律失常疗效分析[J].中国农村卫生,2016(20):5.
[21]苏艳.参松养心胶囊与美托洛尔缓释片联合方案治疗冠心病心律失常的疗效评估[J].当代临床医刊,2015,28(1):1190-1191.
[22]曲娜,才江平.参松养心胶囊联合美托洛尔缓释片治疗冠心病心律失常的临床疗效观察[J].实用心脑肺血管病杂志,2015,23(4):109-110.
[23]李新春,王晓平.参松养心胶囊联合美托洛尔治疗心律失常的疗效观察[J].临床医学,2012,32(7):116-117.
[24]郭力鹏,许青宗,宋金玲.倍他乐克联合参松养心胶囊治疗室性早搏的临床研究[J].中国医药科学,2012,2(12):51-52.
[25]周利平,李洪.参松养心胶囊联合美托洛尔治疗冠心病合并频发室性早搏的临床疗效研究[J].中国民族民间医药,2011,20(5):102-105.
[26]黄华文,周宏霞,梁燕运.参松养心胶囊联合酒石酸美托洛尔胶囊治疗老年心律失常的疗效观察[J].广东医学院学报,2011,29(6):655-656.
[27]周茜.参松养心胶囊联合美托洛尔缓释片治疗室性心律失常冠心病患者的疗效观察[J].中国民康医学,2016,28(7):80-99.
[28]吕红娟.洒石酸美托洛尔片联合参松养心胶囊治疗心律失常的疗效分析[J].中西医结合心脑血管病杂志,2017,5(24):31-32.
[29]孙丽丽.参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常的疗效观察[J].中国医药指南,2018,16(29):176.
[30]于丽丽.老年冠心病心律失常应用参松养心胶囊联合美托洛尔缓释片治疗的效果观察[J].临床医药文献电子杂志,2017,93(4):18 369-18 372.
[31]朱俊先.对老年冠心病心律失常联合美托洛尔缓释片、参松养心胶囊治疗的疗效探讨[J].中西医结合心血管病电子杂志,2018,6(31):21-22.
[32]吕书娟.参松养心胶囊治疗室性期前收缩疗效观察[J].临床荟萃,2011,26(12):1078-1079.
[33]张琰,袁早送.参松养心胶囊联合倍他乐克治疗室性早搏有效性及安全性的Meta分析[J].疑难病杂志,2016,15(6):629-633.