摘要
目的:系统评价中医药对心房颤动射频消融术后早期复发的影响。方法:计算机检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库(WanFang)、PubMed、the Cochrane Library 5个中英文数据库,检索时限从建库至2021年4月,筛选中医药治疗心房颤动射频消融术后的临床随机对照试验;运用Cochrane协作网偏倚风险评价工具对纳入研究进行文献质量评价,利用RevMan 5.3软件进行Meta分析。结果:共检索到相关文献2441篇,最终纳入10项研究,涉及病人756例,其中,试验组380例,对照组376例,纳入文献质量一般。Meta分析结果显示:中医药联合西药常规可降低心房颤动射频消融术后复发率[OR=0.31,95%CI(0.20,0.48),P<0.00001]、左房内径(LAD)[MD=-1.06,95%CI(-1.36,-0.76),P<0.00001]、超敏C反应蛋白(hs-CRP)[SMD=-2.42,95%CI(-4.31,-0.52),P=0.01]、白细胞介素-6(IL-6)[SMD=-2.65,95%CI(-4.43,-0.86),P=0.004]、肿瘤坏死因子-α(TNF-α)[SMD=-1.96,95%CI(-3.33,-0.60),P=0.005]水平,提高左室射血分数(LVEF)[MD=2.52,95%CI(1.51,3.53),P<0.00001]。复发率、LAD、LVEF关键结局指标的GRADE证据质量评级为中等级别证据;TNF-α、hs-CRP、IL-6重要结局指标为低级别证据。结论:现有证据表明,中医药联合常规西药可以预防心房颤动射频消融术后心房颤动再发,改善心功能,但鉴于纳入研究在数量及质量上存在一定局限性,得出的阳性结果仅作为临床诊疗的提示与参考,还需更多高质量的研究进一步证实其疗效。
Objective:To evaluate the effect of traditional Chinese medicine on early recurrence of atrial fibrillation after radiofrequency ablation.Methods:CNKI,VIP,WanFang,PubMed,and Cochrane Library were searched from the establishment of the database to April 2021 to screen the randomized controlled trials of traditional Chinese medicine in the treatment of atrial fibrillation after radiofrequency ablation.The bias risk assessment tool of Cochrane Collaboration Network was used to evaluate the quality of included studies,and RevMan 5.3 software was used for Meta-analysis.Results:There were 10 studies included involving 756 patients,with 380 patients in treatment group and 376 patients in control group.Meta analysis showed that traditional Chinese medicine combined with western medicine could reduce the recurrence rate of atrial fibrillation after radiofrequency ablation[OR=0.31,95%CI(0.20,0.48),P<0.00001],left atrial diameter(LAD)[MD=-1.06,95%CI(-1.36,-0.76),P<0.00001],high sensitivity C-reactive protein(hs-CRP)[SMD=-2.42,95%CI(-4.31,-0.52),P=0.01],interleukin-6(IL-6)[SMD=-2.65,95%CI(-4.43,-0.86),P=0.004],TNF-α[SMD=-1.96,95%CI(-3.33,-0.60),P=0.005],and increase LVEF[SMD=2.52,95%CI(1.51,3.53),P<0.00001].The grade evidence quality rating of recurrence rate,LAD,and LVEF key outcome indicators was medium evidence.The important outcome indicators TNF-α,hs-CRP,and IL-6 were low-level evidence.Conclusion:Available evidence suggests that the traditional Chinese medicine combined with conventional western medicine can prevent the recurrence of atrial fibrillation after radiofrequency ablation of atrial fibrillation and improve cardiac function.However,more high-quality studies are needed to confirm its efficacy.
作者
胡宇才
包宇
王永霞
卫靖靖
朱明军
HU Yucai;BAO Yu;WANG Yongxia;WEI Jingjing;ZHU Mingjun(First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;The First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《中西医结合心脑血管病杂志》
2023年第2期210-216,共7页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
河南省中医管理局国家中医临床研究基地科研专项(No.2017JDZX036)
国家自然科学基金项目(No.81102698,81803944)
国家中医药管理局中医药循证能力建设项目(No.2019XZZX-XXG003)
河南省中原千人计划-中原名医项目(No.2018JDZX009)。
关键词
心房颤动
射频消融
中医药
复发
META分析
atrial fibrillation
radiofrequency ablation
traditional Chinese medicine
recurrence
Meta-analysis
作者简介
胡宇才,E-mail:huyucai911@163.com。
