炙甘草汤对比西药抗心律失常药物治疗室性期前收缩临床随机对照试验的Meta分析

摘要

Objective:To evaluate the efficiency and safety between Zhigancao Decoction and antiarrhythmic drug on PVCs.Methods:A total of 8 major electronic databases (CNKI,Wan Fang,VIP,CBMdisc,Cochrane Library,Web of Science,Pubmed,EMbase) were retrieved.We retrieve the data from January 2000 to October 2017.We used RCTs in the therapy of Zhigancao Decoction and antiarrhythmic drug on PVCs to analysis.Two reviewers screened literature according to the inclusion and exclusion criteria,extracted data,and assessed the methodological quality of the included studies.Then meta-analysis was performed using RevMan5.3 software.Results:Seventeen studies involving 1405 patients were finally included.The results of meta-analysis showed that compared with antiarrhythmic drug,the treating method of Zhigancao Decoction was better in efficiency (OR=3.68,95％ CI=[2.76,4.92],I2=34％,P ＜ 0.00001),decreasing PVCs frequency (MD=-184.03,95％ CI=[-242.51,-125.56],F2=17％,P＜ 0.00001) and TCM syndrome efficiency (OR=6.35,95％ CI=[2.72,14.83],I2=0％,P＜0.0001).Conclusions:Zhigancao Decoction has better efficiency on PVCs,compared with traditional antiarrhythmic drug.%目的 系统评价炙甘草汤治疗室性期前收缩(PVCs)的疗效及安全性.方法 计算机检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库(CBMdisc)等8个电子数据库,检索日期从2000年1月至2017年10月.收集炙甘草汤对比西药心律失常药物治疗室性期前收缩的随机对照试验(RCTs).由2位评价员按纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析.结果 最终筛选并纳入炙甘草汤治疗PVCs的17项随机对照试验(RCTs),共1405例PVCs患者.Meta分析结果显示:炙甘草汤治疗PVCs临床疗效(OR=3.68,95％CI=[2.76,4.92],I2=34％,P＜0.00001)、PVCs次数(MD=-184.03,95％CI=[-242.51,-125.56],I2=17％,P＜ 0.00001)、中医证候疗效(OR=6.35,95％CI=[2.72,14.83],I2=0％,P＜0.0001)均优于西药抗心律失常药物治疗.结论 炙甘草汤治疗PVCs临床疗效确切,显著优于西药抗心律失常药物,且临床疗效分别优于胺碘酮、美西律、美托洛尔等抗心律失常药物.