| Objective:Relevant literatures were collected and collated to systematically evaluate the efficacy and safety of the method of tonifying qi,nourishing Yin and promoting blood circulation in the treatment of arrhythmia of coronary heart disease by Meta analysis,so as to provide evidence-based reference for clinical treatment.Methods:Computer searches were conducted on CNKI,VIP,Wanfang,CBM,The Cochrane Library,Pub Med and Embase.A search was conducted for randomized controlled trials published before January 2021 on the treatment of arrhythmias of coronary heart disease by tonifying qi,nourishing Yin and activating blood circulation.Qualified literatures were screened according to inclusion and exclusion criteria,general information and experimental data were extracted,and Meta-analysis was performed using Rev Man5.3 software.Results:Conform to the requirements of paper into 30,a total of 2654 patients,including the treatment group(qi and nourishing Yin and blood-activation therapy or combined western medicine therapy)1358 cases and control group(simple western medicine therapy or placebo)in 1296 cases.The results of the Meta-analysis are as follows:1.The 23 included studies reported the total clinical response rate,and the results showed a significant difference between the two groups(OR=3.61,95%CI[2.81,4.64],P<0.00001),indicating that the total clinical response rate of the treatment group was better than that of the control group;The study evaluated the arrhythmia event number,2 study description arrhythmia types,including 16 study evaluated the room number earlier,six study evaluated the room early times,4 study evaluation,sexual premature beat frequency between the four study evaluation matrix incidents,atrial fibrillation,according to the results of the treatment group in control room early,early,border sex premature beat,short a number of atrial fibrillation and aspects,is better than that of control group(P<0.05).Only one study evaluated the number of short ventricular velocity events,and the results showed P=0.07,with no statistical significance.This may be related to the small number of included studies,which still needs further study.16 merger analysis showed that,compared with the control group,24 h control arrhythmia in the treatment group has obvious advantages in several aspects(MD=213.72,95%CI[251.21,176.23],P<0.00001);The 8 included studies reported the efficacy of TCM syndromes,and the results showed that the efficacy of TCM syndromes in the treatment group was significantly higher than that in the control group(OR=4.10,95%CI[2.51,6.71],P< 0.00001);A total of 5 studies reported ECG efficacy,and the results showed that the treatment group was better than the control group in improving ECG efficacy(OR=2.91,95%CI[1.82,4.65],P<0.00001).(5)Six studies reported a greater increase in left ventricular ejection fraction in the treatment group than in the control group(MD=9.20,95%CI[6.15,12.25],P< 0.00001);Hemorheological indicators:(1)Whole blood viscosity high cut: Five studies reported on the whole blood high shear viscosity index,the results show that the treatment group than the control group more can reduce the level of whole blood high shear viscosity(MD=0.98,95%CI[1.09,0.87],P<0.00001).(2)Low viscosity of whole blood: 5 studies reported low viscosity of whole blood,and the results showed that the treatment group had an advantage over the control group in reducing the index of low viscosity of whole blood(MD=-1.83,95%CI[-2.31,-1.36],P<0.00001).(3)Plasma viscosity:5 studies reported plasma viscosity index,the results showed that compared with the control group,the treatment group could significantly reduce the plasma viscosity level(MD=-0.42,95%CI[-0.49,-0.35],P<0.00001).2.Safety analysis: Out of the 30 included studies,13 articles reported the specific situation of adverse reactions.Results showed that the treatment group than control group in the incidence of adverse reaction is lower(OR=0.30,95%CI[0.20,0.46],P<0.00001).Conclusion:1.The application of the method of tonifying qi,cultivating Yin and promoting blood circulation in the treatment of arrhythmia of coronary heart disease can significantly improve the total clinical efficacy,the efficacy of TCM syndromes and the efficacy of electrocardiogram,effectively control the number of arrhythmia events in 24 hours,increase the left ventricular eigenfraction and improve the related indicators of hemorheology,which is more superior than the simple western medicine treatment.2.The incidence of adverse reactions in the treatment of coronary heart disease arrhythmias by tonifying qi,promoting Yin and promoting blood circulation is significantly reduced and the safety is higher.However,long-term follow-up has not been systematically studied,so the existence of long-term side effects cannot be ruled out. |
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