复方罗布麻片联合胺碘酮治疗冠心病室性心律失常的系统评价和Meta分析

目的系统评价复方罗布麻片联合胺碘酮治疗冠心病室性心律失常的有效性和安全性。方法计算机检索在PubMed、中国知识基础设施工程网（CNKI）、中国生物医学文献数据库（CBM）、维普（VIP）和万方（WanFang）数据库收录的有关复方罗布麻片联合胺碘酮治疗冠心病室性心律失常的疗效对比文献。采用Cochrane Handbook 5.1.0评价随机对照试验的质量标准，对纳入文献进行质量评价，判断偏倚风险。应用RevMan5.3软件进行统计学分析。结果最终纳入9项研究，合计1 033例病人，其中治疗组464例，对照组569例（胺碘酮组464例，普罗帕酮组105例）。Meta分析结果:复方罗布麻片联合胺碘酮治疗心律失常的临床总有效率高于单用胺碘酮（OR=5.46；95%CI:3.40~8.75；Z=7.04；P < 0.00001；I2=0%）、普罗帕酮（OR=2.99；95%CI:1.48~6.07；Z=3.04；P=0.002；I2=0%）；室早发生次数（SMD=-1.39；95%CI:-1.61~-1.17；Z=12.34；P < 0.00001；I2=0%）和短阵室速发生次数（SMD=-1.51；95%CI:-1.73~-1.28；Z=13.16；P < 0.00001；I2=0%）比单用胺碘酮均明显减少；治疗后不良反应发生率比较，2组差异无统计学意义（OR=0.94；95%CI:0.58~1.53；Z=0.25；P=0.80；I2=0%）。结论复方罗布麻片联合胺碘酮治疗冠心病室性心律失常的效果优于单独使用胺碘酮、普罗帕酮，并且应用安全。

Systematic evaluation and Meta-analysis of Fufang Luobuma Pills combined with amiodarone in the treatment of coronary heart disease with ventricular arrhythmias

ObjectiveTo evaluate the efficacy and safety of Fufang Luobuma Pills combined with amiodarone in the treatment of coronary heart disease with ventricular arrhythmia.MethodsThe literatures on Fufang Luobuma Pills combined with amiodarone in the treatment of coronary heart disease with ventricular arrhythmia were searched from PubMed, China National Knowledge Infrastructure(CNKI), China Biomedical Literature Database(CBM), VIP Database and WanFang Database by computer.The Cochrane Handbook 5.1.0 was used to evaluate the quality criteria of randomized controlled trials, and the quality and risk of bias of literatures were evaluated, and statistically analyzed using RevMan5.3 software.ResultsA total of 1 033 patients in 9 studies were enrolled, which included 464 cases of treatment group and 569 cases of control group(464 cases of amiodarone group and 105 cases of propafenone group).The results of Meta-analysis showed that the total clinical effective rate of Fufang Luobuma Pills combined with amiodarone was higher than that of amiodarone alone(OR=5.46;95% CI:3.40-8.75;Z=7.04;P < 0.00001;I2=0%) or propafenone alone(OR=2.99;95% CI:1.48-6.07;Z=3.04;P=0.002;I2=0%).The number of ventricular premature beats(SMD=-1.39;95% CI:-1.61--1.17;Z=12.34;P=0.00001;I2=0%) and occurrence of short array ventricular tachycardia(SMD=-1.51;95% CI:-1.73--1.28;Z=13.16;P < 0.00001;I2=0%) in treatment group were significantly reduced compared with those in amiodarone group.The difference of the incidence rate of adverse reaction between two groups was not statistically significant(OR=0.94;95% CI:0.58-1.53;Z=0.25;P=0.80;I2=0%).ConclusionsThe effects of Fufang Luobuma Pills combined with amiodarone in the treatment of coronary heart disease with ventricular arrhythmia is better and safer than that of amiodarone and propafenone alone.