Meta-Analysis Of Atrial Fibrillation Treated By WenXin Granule

Objective:Select RCTs of atrial fibrillation treated by WenXin Granule,to assess the effectiveness and safety of WenXin Granule by meta-analysis and provide evidence for the future evaluation.Methods: According to Mete analysis,mainly retrieve in the library of Chengdu University of TCM database,which includes VIP,Tsinghua Tongfang CNKI series database,Wanfang Date,CBM,Pubmed,the Superstar Duxiu Academic Search and CALIS.Select literature according to the inclusion and exclusion criteria,and evaluate the quality of the relative literature by Jadad scale.Gather and analyse data by Review Manager 5.3 software.Results: 48 RCTs were included in this analysis.Through the meta-analysis results,31 RCTs studied the clinical efficiency of Wenxin Granule in treatment of atrial fibrillation:[OR=3.45,95%CI=[2.78,4.27],Z=11.31(P<0.00001)];7 RCTs studied the efficiency of left atrial diameter:[MD =-1.39,95% CI = [-1.89,-0.88],Z = 5.39(P<0.00001)];9 RCTs studied the impact of left ventricular ejection fraction [MD = 6.09,95%CI = [3.87,8.30],Z = 5.38(P < 0.00001)];9 RCTs studied the rate of sinus rhythm reversion:[OR=2.62,95%CI=[1.75,3.92],Z=4.67(P<0.00001)];8 RCts studied the frequency of atrial fibrillation:[OR=-2.00,95%CI=[-3.04,-0.96],Z=3.77(P=0.0002)];7RCTs studied the time of conversion:[MD =-4.02,95% CI = [-4.95,-3.01],Z = 8.51(P <0.00001)];16 RCTs studied the maintenance of sinus rhythm:[OR=3.39,95%CI=[2.63,4.39],Z=9.36(P<0.00001)];18 RCTs studied ventricular rate:[MD =-8.05,95% CI =[-10.04,-6.06],Z=7.93(P<0.00001)];7 RCTs studied the influence of p wave dispersion:[MD =-3.72,95% CI = [-6.84,-0.61],Z = 2.34(P = 0.02)];3 RCTS studied the effect of 6 minutes exercise test:[MD = 89.96,95% CI = [80.50,99.41],Z = 18.64(P <0.00001)].On the safety valuation of WenXin Granule,42 articles described the adverse reaction.7studies had no side effect neither in the treatment group nor the control group,36 studies described the side effects,including: side effects of cardiovascular system,digestive system,thyroid,respiratory system,nervous system and abnormal liver function.Most of the patientshad mild symptoms,which could be restored on their own or eased after simple treatment.There were 49 cases dropped due to some serious side effects.As the data shows:[OR=-0.09,95%CI=[-0.13,-0.04],Z=3.95(P<0.0001)],indicating that Wenxin Granule has clinical effect and low side effect in the treatment of atrial fibrillation.Conclusion: The results of this analysis suggest that the use of Wenxin Granules(alone or combined with antiarrhythmic Western medicine)in treatment of atrial fibrillation has clinical efficiency,the result shows that WenXin Granule has advantages on the treatment of left atrial diameter,left ventricular ejection fraction,transfer rate,cardioversion time,the frequency of AF,maintenance sinus rhythm,ventricular rate,p wave dispersion and 6min exercise test.Safety valuation shows that the incidence of adverse reactions in Wenxin Granule group was significantly lower than in control group.However,due to the poor quality of the included literatures,there is bias and high heterogeneity in the group.Conducting more multicenter,large sample,high quality research program is needed to standardize and unify clinical randomized controlled trials,in order to evaluate its efficacy and safety more effective and accurate.