参松养心胶囊治疗慢性心力衰竭合并室性早搏疗效和安全性的Meta分析

摘要

目的 评价参松养心胶囊治疗慢性心力衰竭(CHF)合并室性早搏的疗效及安全性.方法 系统检索CNKI数据库、CBM数据库、万方数据库、Pubmed数据库、Cochrane Library数据库、Embase数据库,筛选出参松养心胶囊治疗CHF合并室性早搏的随机对照试验(RCT).运用Cochrane中心提供的RevMan5.3软件进行文献相关风险评估及Meta分析.结果 共检索到有关参松养心胶囊的文献1303篇,经过初筛和严格评价,纳入符合标准的文献12篇(改良版Jadad评分≥3分).其中3项研究表明参松养心胶囊对比西药在减少CHF合并室性早搏患者的24 h室性早搏数量及改善临床症状上有显著疗效[RR=1.19,95％CI(1.07～1.33),P<0.001];另3项研究亦说明参松养心胶囊有助于提高左室射血分数的作用[WMD=5.79,95％CI(4.05～7.52),P<0.0001].亦有8项研究证实参松养心胶囊在药物出现不良反应上优于对照组[RR=0.37,95％CI(0.23～0.58),P<0.0001].结论 系统的评价了参松养心胶囊治疗CHF合并室性早搏,无论在早搏数量的控制上还是在提高左室射血分数、临床症状等心力衰竭治疗上均安全有效,且优于西药;但由于样本量较少,篇幅及文献质量有限,有待于继续开展临床大样本、多中心的RCT试验以进一步证明.%Objective To evaluate the clinical efficacy and safety of Shensong Yangxin capsule for treating chronic heart failure patients with premature ventricular beats. Methods Randomized controlled trials ( RCTs) on the clinical efficacy and safety of Shensong Yan-gxin capsule for chronic heart failure patients with premature ventricular beats were retrieved from CNKI database,CBM database,Wan-fang database,Pubmed database,Cochrane Library database,and Embase databases. RevMan5. 3 supplied by The Cochrane Center was used for the risk assessment and meta-analysis of the outcomes of included RCTs. Results A total of 1303 articles were collected, twelve studies among which were in line with the inclusion criteria ( modified version of the Jadad score ≥3 points ) . Three studies showed that compared with western medicine,Shensong Yangxin capsule had significant efficacy in reducing the number of premature ventricular beats of the patients and improving the clinical symptoms [RR=1. 19,95％CI (1. 07-1. 33),P<0. 001]. Another three studies showed that Shensong Yangxin capsule was effective in improving left ventricular ejection fraction [ WMD =5. 79,95％CI (4. 05-7. 52),P<0. 0001]. Eight studies confirmed that Shensong Yangxin capsule caused fewer side effects than the control group [RR=0. 37,95％CI (0. 23-0. 58),P<0. 0001]. Conclusions The systematic evaluation of Shensong Yangxin capsule in the treat-ment of chronic heart failure combined with premature ventricular beat shows that Shensong Yangxin capsule is better than western med-icine in controlling the number of premature ventricular beats,improving left ventricular ejection fraction and relieving clinical symp-toms. But because of the small sample size,limited length of the articles and quality of literature,it is necessary to carry out large-sam-ple,multi-center RCT trials.