Abstract
Objective:To systematically evaluate the clinical efficacy and safety of oral Chinese medicine combined with Metoprolol in the treatment of rapid arrhythmia.Method:Six databases including China National Knowledge Infrastructure(CNKI),Wanfang Data Knowl-edge Service Platform,VIP Chinese Journal Service Platform,SinoMed Database,PubMed,and Cochrane Library were searched by com-puter to select randomized controlled trials of oral Chinese medicine combined with metoprolol for the treatment of rapid arrhythmia.Co-chrane bias risk assessment tool was used to evaluate the quality of literature,and Meta analysis was conducted using ReviewManager 5.4 software.Result:A total of 19 randomized controlled trials were included,including 1 155 patients.The meta-analysis results showed that compared with the use of Metoprolol alone,oral Chinese medicine combined with Metoprolol can significantly improve the left ventricular ejection fraction(I2=13%,MD =3.39,95%CI[2.14,4.65],P＜0.000 01),reduce the left atrial diameter(I2= 90%,MD =-1.99,95%CI[-3.76,-0.22],P =0.004)and 24-hour average heart rate(I2=95%,MD =-11.99,95%CI[-18.86,-5.13],P =0.000 6)in patients with rapid arrhythmia,and improve the total effective rate of Chinese medicine syn-dromes(I2=0%,RR =4.26).3.95%CI[3.05,5.92],P＜0.000 01)and clinical total effective rate(I2=0%,RR =2.69,95%CI[1.78,4.07],P＜0.000 01),while reducing the total score of traditional Chinese medicine syndromes(I2=75%,MD =-3.28,95%CI[-4.29,-2.26],P＜0.000 01)and incidence of adverse reactions(I2=0%,RR =0.46,95%CI[0.23,0.93],P = 0.03).Subgroup analysis showed that the combination of oral traditional Chinese medicine and Metoprolol significantly reduced the left atrial diameter(MD =-2.81,95%CI[-4.64,-0.97],P =0.003)in patients diagnosed with deficiency syndrome,and significant-ly reduced the 24-hour average heart rate in patients diagnosed with deficiency syndrome(MD =-6.33,95%CI[-9.97,2.69],P =0.006)and those diagnosed with deficiency syndrome(MD =-7.75,95%CI[-12.82,-2.68],P＜0.000 01).Patients with solid inclusion(RR =2.39,95%CI[1.22,4.71],P =0.01)showed a more significant improvement in overall clinical efficacy,while other outcome measures showed no significant differences between subgroups.Conclusion:The combination of oral traditional Chinese medicine and Metoprolol has a significant therapeutic effect on rapid arrhythmia,which can significantly improve the patient's heart function,alleviate clinical and traditional Chinese medicine symptoms.关键词
快速性心律失常/中药/美托洛尔/随机对照试验/Meta分析Key words
rapid arrhythmia/traditional Chinese medicine/Metoprolol/randomized controlled trials/Meta analysis分类
医药卫生
