Meta-analysis Of Wenxin Keli Combined With Western Medicine In The Treatment Of Heart Failure Complicated With Ventricular Arrhythmia

Objective:Meta-analysis method was used to systematically evaluate the efficacy and safety of Wenxin Keli combined with western medicine in the treatment of heart failure combined with ventricular arrhythmia,providing evidencebased basis for the clinical application of Wenxin Keli in the treatment of heart failure combined with ventricular arrhythmia.Methods:The databases of CBM,VIP,Wanfang,CNKI,PubMed,web of science,EMBASE and the Cochrane library were searched by computer.The retrieval time is from the date of establishment to December 2020.Objective to collect the literature about the clinical randomized controlled trials of Wenxin Keli Combined with western medicine in the treatment of heart failure complicated with ventricular arrhythmia.According to the inclusion and exclusion criteria,the eligible literatures were screened,and the required data were extracted.The included literatures were evaluated according to the bias risk assessment criteria provided by Cochrane.Revman5.4 was used to test the heterogeneity of the extracted data and merge statistics,and the forest map was used to present the analysis results.For those with high heterogeneity of outcome indicators,subgroup analysis and sensitivity analysis were conducted.Funnel plot was used to explore whether there was publication bias,and the final conclusion was drawn.Results:1.Literature inclusion:A total of 12 literatures were included in this study,involving 12 randomized controlled trials of Wenxin Keli Combined with western medicine in the treatment of heart failure with ventricular arrhythmia.A total of 987 patients with heart failure and ventricular arrhythmia,495 patients in the treatment group,492 patients in the control group.The intervention measures of the treatment group were Wenxin Keli combined with western medicine treatment,and the intervention measures of the control group were western medicine treatment.2.Meta-analysis results:(1)The efficacy of ventricular arrhythmia: the combined effect of RR=1.31,95%CI[1.20,1.43],Z=5.96,P < 0.00001,the results were statistically significant,indicating that Wenxin Keli combined with western medicine was superior to western medicine alone in improving ventricular arrhythmia curative effect.(2)Efficacy of cardiac function: the combined effect of RR=1.56,95%CI[1.20,2.03],Z=3.33,P=0.0009,the results were statistically significant,indicating that Wenxin Keli combined with western medicine was superior to western medicine alone in improving cardiac function.(3)Resting heart rate: the combined effect of SMD =-3.02,95% CI [-4.12,-1.93],Z=5.42,P < 0.00001,the results were statistically significant,indicating that Wenxin Keli combined with western medicine was superior to western medicine alone in reducing the resting heart rate.(4)Left ventricular ejection fraction: the combined effect of SMD =1.36,95%CI[0.66,2.06],Z=3.80,P=0.0001,the results were statistically significant,indicating that Wenxin Keli combined with western medicine was superior to western medicine alone in improving left ventricular ejection fraction.(5)NT-pro BNP: the combined effect of SMD=-3.54,95%CI[-5.34,-1.73],Z=3.84,P=0.0001,the results were statistically significant,indicating that Wenxin Keli combined with western medicine was superior to western medicine alone in reducing NT-pro BNP.(6)Safety evaluation: Adverse reactions were reported in 7 of the included literatures : the combined effect of RR=0.52,95%CI[0.30,0.88],Z=2.41,P=0.02,the results were statistically significant,indicating that the adverse reaction rate of Wenxin Keli combined with western medicine was lower than that of Western medicine alone in terms of adverse reactions.Conclusion:1.Based on Meta analysis,Wenxin Keli combined with western medicine in the treatment of patients with heart failure complicated with ventricular arrhythmia was superior to the western medicine alone in improving the efficacy of ventricular arrhythmia,cardiac function efficacy,left ventricular ejection fraction level and reducing the level of resting heart rate.2.Based on the Meta-analysis,it was found that whether Wenxin Keli combined with western medicine was superior to the western medicine group alone in reducing the level of NT-pro BNP could not be drawn due to the poor stability of the results.More randomized controlled trials should be conducted to evaluate this indicator.