当前位置:

网站首页>文章详情

心宝丸联合常规西药治疗慢性心力衰竭伴窦性心动过缓的Meta分析

【PDF在线阅读】 【下载PDF】

摘要:

目的 系统评价心宝丸联合常规西药治疗慢性心力衰竭伴窦性心动过缓的有效性和安全 性。方法 计算机检索中国医学文献数据库(SinoMed)、维普数据库(VIP)、中国期刊全文数据库 (CNKI)和万方数据库(WanFang Data)以及英文数据库PubMed、The Cochrane Library,搜集心宝丸 治疗慢性心力衰竭伴窦性心动过缓的相关随机对照试验(RCT),检索时限均从建库至2019年4月。 由2名研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分 析。结果 共纳入5个RCT,包括486例患者。Meta分析结果显示:在常规西药治疗基础上联用心宝丸, 可有效改善慢性心力衰竭伴窦性心动过缓患者的NYHA心功能分级(RR=1.23,95%CI:1.14~1.32,P <0.00001)、提高左室射血分数(MD=6.85,95%CI:4.00~9.71,P<0.00001)、增加24 h平均心率 (MD=11.69,95%CI:8.03~15.34,P<0.00001)、增加心输出量(MD=0.58,95%CI:0.40~0.76, P<0.00001)、增加心脏每搏输出量(MD=3.72,95%CI:2.33~5.11,P<0.00001)、改善6 min步行 试验(MD=26.83,95%CI:13.65~40.02,P<0.0001)、降低N末端B型利钠肽原水平(MD=-0.24, 95%CI:-0.33~-0.14,P<0.00001)、减小左室舒张末期内径(MD=-2.23,95%CI:-3.45~-1.00, P=0.0004)、减小左室收缩末期内径(MD=-2.35,95%CI:-3.42~-1.28,P<0.0001)。结论 研究表明 心宝丸联合常规西药可改善慢性心力衰竭伴窦性心动过缓患者的心功能并提高心率。受纳入研究的数量 和质量的限制,本研究结论尚需开展更多高质量研究予以证实。

Abstract:

Objective To systematically evaluate the effectiveness and safety of Xinbao Wan combined with conventional western medicine in the treatment of chronic heart failure with sinus bradycardia. Methods The Chinese medical literature database (SinoMed), VIP database (VIP), Chinese journal full-text database (CNKI) and WanFang Data, and English databases PubMed and The Cochrane Library were searched to collect the relevant randomized controlled trials (RCTs) for the treatment of chronic heart failure with sinus bradycardia using Xinbao pills. The search period was from the establishment of the database to April 2019. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. Meta-analysis was performed using RevMan 5.3 software. Results Five RCTs were included, including 486 patients. Meta analysis results show that combining Xinbao pills with conventional western medicine can effectively improve the NYHA cardiac function classification in patients with chronic heart failure with sinus bradycardia (RR=1.23, 95%CI: 1.14~1.32, P<0.00001 ), increase left ventricular ejection fraction (MD=6.85, 95%CI:4.00~9.71, P<0.00001), increase the 24-hour average heart rate (MD=11.69, 95%CI:8.03~15.34, P<0.00001), increase Cardiac output (MD=0.58, 95%CI:0.40~0.76, P<0.00001), increase cardiac stroke output (MD=3.72, 95%CI:2.33~5.11, P <0.00001), improve 6-minute walking test (MD=26.83, 95%CI:13.65~40.02, P<0.0001), decrease N-terminal B-type natriuretic peptide level (MD=-0.24, 95%CI:-0.33~-0.14, P<0.00001), decrease Small left ventricular end-diastolic diameter (MD=-2.23, 95%CI:-3.45~-1.00, P=0.0004), and decrease left ventricular end-systolic diameter (MD=-2.35, 95%CI:-3.42~-1.28, P<0.0001). Conclusion Studies have shown that Xinbao pills combined with conventional western medicine can improve heart function and increase heart rate in patients with chronic heart failure and sinus bradycardia. Limited by the number and quality of included studies, the conclusions of this study need to be confirmed by more high-quality studies.

基金项目:

北京中医药大学重点学科开放课题(2013-ZDXKKF-27)

参考文献:

  • 2008

  • 1

通讯地址:北京市东城区东四十条南门仓5号
电话: 237499284 邮编:100700
网址:www.ebcvm..org Email: ebcvm_cj@126.com

copyright © 《中国循证心血管医学杂志》编辑部
当您在使用本网站投稿遇到困难时,
请直接将稿件投送到编辑部邮箱ebcvm_cj@126.com