| Objective: Arrhythmia is a common disease in the cardiovascular system.Western medicine treatment of arrhythmia means quite limited,especially for the treatment of slow arrhythmia,it is difficult to use drugs;At the same time,non-drug therapy is difficult to popularize due to its technical complexity and high cost.Therefore,more and more clinical experts focus their attention on traditional Chinese medicine treatment.Traditional Chinese medicine treatment,which has less toxic and side effects,is cheap and easy to be popularized,is favored by more and more clinicians.This paper will conduct a statistical study on the collected literatures on the clinical efficacy and drug safety of Shengmai decoction in the treatment of bradyarrhythmia by means of Meta-analysis,and provide corresponding evidence-based basis for the clinical application of Shengmai decoction in the treatment of bradyarrhythmia by means of evidence-based medicine。Methods: Each big database retrieval method and the way is not the same,according to the established complete and conform to the research purpose and exclusion criteria,and comply with the manual retrieval with computers using appropriate retrieval strategy in the knowledge network in China(CNKI,2011-2020),VIP(VIP,2011-2020),ten thousand(2011-2020),the Chinese biomedical literature(CBM,2011-2020),the Pubmed(2011-2020),and other 5 databases.Will retrieve out in accordance with established in to add flavor and exclusion standard requirements of pulse-activating decoction treating tardy related literature of arrhythmia in clinical curative effect observation,to extract the data and according to the Cochrane collaboration of "bias risk assessment tool" evaluation standard to evaluate evidence into literature,through the Review Manager 5.3 software for statistical analysis.Results: A total of 255 literatures were retrieved and 16 literatures were included after three rounds of screening.A total of 1316 cases were reported,including 659 cases in the treatment group(Shengmai decoction as the main prescription for flavored treatment or combined with basic western medicine treatment)and 657 cases in the control group(basic western medicine treatment or combined with basic western medicine treatment).Results of the Meta-analysis were as follows:(1)Comparison of the total clinical effective rate: a total of15 literatures reported the total clinical effective rate in detail,and a total of 1316 patients were included in the RCT.The analysis results showed that RR=1.30(95%CI: 1.23,1.37),Z=9.63(P < 0.00001).The test results were statistically significant,indicating that the total clinical effective rate of the treatment group was significantly higher than that of the control group.24 h(2)the comparison of the average heart rate to improve: a total of 24 h 7 articles were reported in detail the improvement of the average heart rate,a total of566 patients were included in the RCT,the analysis result shows:the MD = 7.58(95% CI: 5.32,9.84),Z = 6.57(P < 0.00001),the result is statistically significant,the use of pulse-activating decoction in treatment group that add and subtract treatment in improving the 24 h average heart rate is better than that in control group.(3)the comparison of 24 h average heart rate of different diseases to improve: a total of 2 articles 24 h type for different types of slow arrhythmia average heart rate were studied,the improvement in the inspection results are less than 0.00001,the results are statistically significant,that the treatment group of 24 h type of different types of slow arrhythmia the improvement of the average heart rate is better than the control group.(4)Comparison of improvement of arrhythmia symptoms: a total of two literatures mentioned the improvement of arrhythmia symptoms in detail,a total of 164 patients were included in the RCT.Analysis results showed that MD=-4.25(95%CI:-4.82,-3.68),Z=14.66(P < 0.00001),the test results were statistically significant,indicating that the treatment group was better than the control group in the improvement of arrhythmia symptoms.(5)Comparison of ejection fraction improvement: 2 literatures mentioned in detail the improvement of arrhythmia symptoms,and a total of 164 patients were included in RCTs.Analysis results showed that MD=9.97(95%CI:8.59,11.34),Z=14.22(P < 0.00001),which was statistically significant,indicating that the treatment group was better in improving ejection fraction.(6)Safety analysis: a total of 6articles mentioned adverse reactions,of which 1 article mentioned adverse reactions but did not mention the incidence of adverse reactions.Analysis results of the remaining 5articles showed that RR=0.18(95%CI: 0.05,0.58),Z=2.85(P=0.004),the results were statistically significant,indicating that adverse reactions in the treatment group were significantly less than those in the control group.Conclusion: The use of Shengmai Decoction in the treatment of bradyarrhythmia has a significant effect,its clinical total effective rate,24 hours average heart rate before and after treatment,arrhythmia symptoms before and after treatment,ejection fraction and other aspects are significantly better than the control group of simple western medicine treatment,its safety is also better than the control group. |
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