益气温阳法治疗缓慢性心律失常临床疗效的Meta分析

发布时间：2018-07-14 09:54

【摘要】：目的:通过对中医的益气温阳法治疗缓慢性心律失常进行荟萃分析,以评价其临床疗效和药物使用的安全性,并作为循证医学证据供临床医生或科研人士参考。方法:综合各数据库检索词的要求和检索方法的迥异,制定相匹配的检索策略,根据已定的纳入标准,搭配手动检索辅助电子计算机进行检索。检索中文发表2012-2016年间,与益气温阳法治疗缓慢性心律失常相关的文献。运用Cochrane的“偏倚风险评估工具”评价入选的各文献的质量,并最终通过Review Manager 5.3统计软件进行结果分析。结果:本研究共检索到文献237篇,经过两轮筛选,纳入17篇文献。共有病例数1456例,其中治疗组(具有益气温阳功能的中药配合基础治疗)735例,对照组(西药治疗配合基础治疗)721例。Meta分析的结果如下:1.关于临床有效性的比较:益气温阳法治疗缓慢性心律失常有效,且有效率高于基础西药组(OR=3.17,95%CI[2.35,4.27],Z检验=7.53,P0.00001),其差异有统计学意义;2.在提高患者的平均心率方面:益气温阳组的疗效更优于西药组(MD=5.80,95%CI[5.17,6.42],假设Z检验=18.28,P0.00001)且差异有统计学意义;3.在提高患者的最慢心率方面:益气温阳组优于西药组(SMD=1.26,95%CI[0.79,1.73],假设检验Z=5.27,P0.00001),差异有统计学意义。4.中医证候疗效的比较:Z=2.61,P=0.009,益气温阳组的疗效优于单纯西药组。结论:1.运用益气温阳法可以提高缓慢性心律失常患者的的临床有效率,中医证候疗效,平均心率及最慢心率,且疗效优于单纯西药治疗。2.根据纳入文献提及的不良反应情况,益气温阳法治疗缓慢性心律失常安全性良好,可为临床医生在用药的安全性方面提供了一定的参考。3.受纳入文献的数量和质量的影响,所以本研究可能存在偏倚。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of traditional Chinese medicine (TCM) in the treatment of chronic arrhythmias and to provide evidence for clinicians or researchers. Methods: according to the different requirements and retrieval methods of each database, the matching retrieval strategy was formulated. According to the included criteria, the retrieval was carried out with the manual retrieval assistant computer. To retrieve the literature published in Chinese from 2012-2016 on the treatment of bradyarrhythmia with warming air temperature and yang method. Cochrane's bias risk Assessment tool was used to evaluate the quality of selected literature, and the results were analyzed by the Review Manager 5.3 statistical software. Results: a total of 237 articles were retrieved and 17 articles were included after two rounds of screening. There were 1456 cases, including 735 cases in the treatment group (traditional Chinese medicine combined with basic treatment) and 721 cases in the control group (western medicine combined with basic treatment). The results of Meta analysis were as follows: 1. Comparison of clinical effectiveness: the effective rate of tonifying air temperature and yang method in treating slow arrhythmia was higher than that in the basic western medicine group (ORX 3.17595 CI [2.35 卤4.27] Z test 7.53 P0.00001), and the difference was statistically significant (P 0.00001). In increasing the mean heart rate of the patients, the curative effect of the warming Yang group was better than that of the western medicine group (MDV 5.8095 CI [5.176.42], assuming Z test 18.28% P 0.00001) and the difference was statistically significant (P 0.00001). In the aspect of increasing the slowest heart rate of the patients, the warming Yang group was better than the western medicine group (SMD-1.2695 CI [0.79 卤1.73], the hypothesis test showed that the difference was statistically significant (P 0.00001). Comparison of syndromes of traditional Chinese Medicine (TCM). The effect of warming yang group was better than that of western medicine group. Conclusion 1. The method of tonifying air temperature and yang can improve the clinical effective rate of patients with bradyarrhythmia, the curative effect of TCM syndromes, the average heart rate and the slowest heart rate, and the curative effect is better than that of western medicine alone. According to the adverse reactions mentioned in the literature, it is safe to treat bradyarrhythmia by warming air temperature and yang method, which can provide a certain reference for clinicians in the safety of drug use. 3. Due to the quantity and quality of the literature included, this study may be biased.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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