稳心颗粒联合倍他乐克治疗室性早搏有效性和安全性的Meta分析

摘要

Objective To review the efficacy and safety of Wenxin Granules combining betaloc on ventricular premature beat (VPB).Methods The databases of CNKI, Cochrane Library, EMbase, VIP Database, WanFang Database and PubMed were retrieved for collecting randomized controlled trials (RCT) about the treatment of VPB with Wenxin Granules combining betaloc before Dec. 2015. All included RCT were given bias risk judgment, and then given a Meta-analysis by using RevMan 5.0 software.Results There were totally 10 RCT included. The results of Meta-analysis showed that the curative effect of Wenxin Granules combining betaloc on VPB was more significant than that of single betaloc (RR=1.24, 95%CI: 1.15~1.34,P<0.001). The curative effect of Wenxin Granules combining betaloc on symptoms of VPB was more significant than that of single betaloc (RR=1.23, 95%CI:1.15~1.32,P<0.001). The improve effect of Wenxin Granules combining betaloc on electrocardiogram (ECG) of VPB was more significant than that of single betaloc (RR=1.31, 95%CI: 1.19~1.44,P<0.001). The difference in adverse reactions between Wenxin Granules combining betaloc and single betaloc had no statistical significance (RR=0.77, 95%CI: 0.42~1.18,P=0.18).Conclusion Wenxin Granules combining betaloc has more significant curative effect than single betaloc, can relieve symptoms and improve ECG, and has no significant difference in adverse reactions compared with single betaloc. The quantity and quality of this study limited conducting large-sample RCT with higher quality for further proving the conclusion. It is suggested for clinicians to select rational therapies based on patient’s conditions.%目的：评价稳心颗粒联合倍他乐克治疗室性早搏的有效性及安全性。方法计算机检索中国期刊全文数据库、Cochrane图书馆、EMbase、维普数据库（VIP）、万方数据库及Pub Med等数据库中检索2015年12月以前关于稳心颗粒联合倍他乐克治疗室性早搏的随机对照试验（RCT），同时对纳入的相关研究进行偏倚风险判断，最终纳入的结果采用RevMan 5.0进行Meta分析。结果最终纳入10篇相关文献进行Meta分析，结果表明稳心颗粒联合倍他乐克与倍他乐克单用治疗室性早搏相比疗效显著，差异有统计学意义（RR＝1.24，95％CI：1.15~1.34，P＜0.001）；稳心颗粒联合倍他乐克与单用倍他乐克治疗室性早搏的临床症状疗效显著（RR＝1.23，95％CI：1.15~1.32，P＜0.001），差异有统计学意义；稳心颗粒联合倍他乐克与单用倍他乐克治疗室性早搏的心电图疗效显著（RR＝1.31，95％CI：1.19~1.44，P＜0.001）；稳心颗粒联合倍他乐克与单用倍他乐克治疗室性早搏的不良反应差异无统计学意义（RR＝0.77，95％CI：0.42~1.18，P=0.18）。结论稳心颗粒联合倍他乐克较单用倍他乐克在治疗室性早搏方面疗效显著，可明显改善患者临床症状及动态心电图表现，且不良反应无明显差异。受纳入研究数量和质量限制，尚需开展大样本、高质量的随机对照试验进一步论证上述结论，建议临床医生根据患者具体情况选择合理的治疗策略。