| Objective: To understand the current clinical distribution of traditional Chinese medicine Syndromes of arrhythmia,and to systematically evaluate the effectiveness and safety of Zhigancao Decoction in the treatment of arrhythmia.By summarizing the distribution of arrhythmia clinical syndrome types and discussing the clinical efficacy of Zhigancao Decoction from the perspective of evidence-based medicine,it can provide reference for the selection of clinical treatment scheme,and better inherit and play the value and advantages of traditional Chinese medicine.Method: a retrospective study was conducted in 267 patients with arrhythmia in the Second Affiliated Hospital of Shandong University of traditional Chinese medicine.The basic data and clinical syndromes of patients were collected through the developed case collection table.The common clinical symptoms,syndrome differentiation and distribution rules were analyzed by SPSS 23.0 software,and the correlation rules of syndrome elements were analyzed,so as to establish the core target of clinical treatment.Based on the principles and methods of evidence-based medicine,according to the characteristics of different databases,the method of combining subject words and free words retrieval is adopted.Computer retrieval includes CNKI,VIP database,Wanfang database,CBMdisc,Pub Med and Cochrane.The randomized controlled trials of Zhigancao Decoction in the treatment of arrhythmia in the library were collected,and the modern literatures published from January 2005 to November 2020 were collected.Two researchers independently screened the literature,extracted the data and evaluated the quality of the final included literature.Revman5.3 software was used for statistical analysis of the collected data.Result: Clinical research: 267 cases of arrhythmia patients were collected,the incidence was related to age,the difference was statistically significant.The top ten symptoms with the highest frequency were palpitation(24.4%)> chest tightness(17.8%)>mental fatigue(8.9%)> dizziness(8.1%)> shortness of breath(5.9%)> easy to wake up(5.7%)> sweating(3.9%)> chest pain(3.6%)> lack of food = insomnia(2.5%).The traditional Chinese medicine syndrome types were 147 cases(55.1%)of qi deficiency and blood stasis syndrome,54 cases(20.2%)of heart and spleen deficiency syndrome,33 cases(12.4%)of heart and kidney yang deficiency syndrome,18 cases(6.7%)of phlegm stagnation syndrome,and 5 cases(1.9%)of Qi Yin deficiency syndrome.The incidence of qi deficiency and blood stasis syndrome and heart and spleen deficiency syndrome was related to gender,and the difference was statistically significant.Systematic review: a total of 1018 literatures were obtained by comprehensive search of domestic and foreign databases,and 136 literatures were preliminarily screened out by reading topics and abstracts.After reading the full text,those who did not meet the criteria were excluded by the nanoparticle exclusion criteria.Finally,25 randomized controlled trials of Zhigancao Decoction and its addition and subtraction in the treatment of arrhythmia were obtained,and a total of 1993 cases were included in the study 5.3 software system evaluation.Meta-analysis showed that: compared with conventional western medicine or Chinese patent medicine,modified Zhigancao Decoction can effectively improve the clinical symptoms efficiency [RR = 1.28,95% CI(1.17,1.41),P < 0.00001],improve the total clinical efficacy efficiency [RR = 1.27,95% CI(1.21,1.33),P < 0.00001],and significantly improve the ECG results [RR = 1.27,95% CI(1.21,1.33),P < 0.00001] =18,95% CI(1.08,1.30),P = 0.0003]and reduced the incidence of adverse reactions [RR = 0.33,95% CI(0.21,0.54),P < 0.00001].Conclusion: Traditional Chinese medicine Syndrome Distribution: arrhythmia is more common in middle-aged and elderly patients,based on previous studies tend to be younger.traditional Chinese medicine symptoms are palpitation,chest tightness,mental fatigue,dizziness,shortness of breath,easy to wake up,sweating and chest pain.The distribution of traditional Chinese medicine syndrome types is mainly Qi deficiency and blood stasis syndrome type,and in Qi deficiency and blood stasis syndrome type,male is more common,in heart and spleen deficiency syndrome type,female is more common.Systematic review: the results of meta-analysis showed that Zhigancao Decoction and its modification were better than the control group in the treatment of arrhythmia.However,due to the quality limitation of the included literatures,more high-quality randomized controlled trials are needed to verify the results. |
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