發(fā)布時間：2018-07-14 09:54

【摘要】：目的:通過對中醫(yī)的益氣溫陽法治療緩慢性心律失常進行薈萃分析,以評價其臨床療效和藥物使用的安全性,并作為循證醫(yī)學證據(jù)供臨床醫(yī)生或科研人士參考。方法:綜合各數(shù)據(jù)庫檢索詞的要求和檢索方法的迥異,制定相匹配的檢索策略,根據(jù)已定的納入標準,搭配手動檢索輔助電子計算機進行檢索。檢索中文發(fā)表2012-2016年間,與益氣溫陽法治療緩慢性心律失常相關(guān)的文獻。運用Cochrane的“偏倚風險評估工具”評價入選的各文獻的質(zhì)量,并最終通過Review Manager 5.3統(tǒng)計軟件進行結(jié)果分析。結(jié)果:本研究共檢索到文獻237篇,經(jīng)過兩輪篩選,納入17篇文獻。共有病例數(shù)1456例,其中治療組(具有益氣溫陽功能的中藥配合基礎(chǔ)治療)735例,對照組(西藥治療配合基礎(chǔ)治療)721例。Meta分析的結(jié)果如下:1.關(guān)于臨床有效性的比較:益氣溫陽法治療緩慢性心律失常有效,且有效率高于基礎(chǔ)西藥組(OR=3.17,95%CI[2.35,4.27],Z檢驗=7.53,P0.00001),其差異有統(tǒng)計學意義;2.在提高患者的平均心率方面:益氣溫陽組的療效更優(yōu)于西藥組(MD=5.80,95%CI[5.17,6.42],假設(shè)Z檢驗=18.28,P0.00001)且差異有統(tǒng)計學意義;3.在提高患者的最慢心率方面:益氣溫陽組優(yōu)于西藥組(SMD=1.26,95%CI[0.79,1.73],假設(shè)檢驗Z=5.27,P0.00001),差異有統(tǒng)計學意義。4.中醫(yī)證候療效的比較:Z=2.61,P=0.009,益氣溫陽組的療效優(yōu)于單純西藥組。結(jié)論:1.運用益氣溫陽法可以提高緩慢性心律失�；颊叩牡呐R床有效率,中醫(yī)證候療效,平均心率及最慢心率,且療效優(yōu)于單純西藥治療。2.根據(jù)納入文獻提及的不良反應(yīng)情況,益氣溫陽法治療緩慢性心律失常安全性良好,可為臨床醫(yī)生在用藥的安全性方面提供了一定的參考。3.受納入文獻的數(shù)量和質(zhì)量的影響,所以本研究可能存在偏倚。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of traditional Chinese medicine (TCM) in the treatment of chronic arrhythmias and to provide evidence for clinicians or researchers. Methods: according to the different requirements and retrieval methods of each database, the matching retrieval strategy was formulated. According to the included criteria, the retrieval was carried out with the manual retrieval assistant computer. To retrieve the literature published in Chinese from 2012-2016 on the treatment of bradyarrhythmia with warming air temperature and yang method. Cochrane's bias risk Assessment tool was used to evaluate the quality of selected literature, and the results were analyzed by the Review Manager 5.3 statistical software. Results: a total of 237 articles were retrieved and 17 articles were included after two rounds of screening. There were 1456 cases, including 735 cases in the treatment group (traditional Chinese medicine combined with basic treatment) and 721 cases in the control group (western medicine combined with basic treatment). The results of Meta analysis were as follows: 1. Comparison of clinical effectiveness: the effective rate of tonifying air temperature and yang method in treating slow arrhythmia was higher than that in the basic western medicine group (ORX 3.17595 CI [2.35 鹵4.27] Z test 7.53 P0.00001), and the difference was statistically significant (P 0.00001). In increasing the mean heart rate of the patients, the curative effect of the warming Yang group was better than that of the western medicine group (MDV 5.8095 CI [5.176.42], assuming Z test 18.28% P 0.00001) and the difference was statistically significant (P 0.00001). In the aspect of increasing the slowest heart rate of the patients, the warming Yang group was better than the western medicine group (SMD-1.2695 CI [0.79 鹵1.73], the hypothesis test showed that the difference was statistically significant (P 0.00001). Comparison of syndromes of traditional Chinese Medicine (TCM). The effect of warming yang group was better than that of western medicine group. Conclusion 1. The method of tonifying air temperature and yang can improve the clinical effective rate of patients with bradyarrhythmia, the curative effect of TCM syndromes, the average heart rate and the slowest heart rate, and the curative effect is better than that of western medicine alone. According to the adverse reactions mentioned in the literature, it is safe to treat bradyarrhythmia by warming air temperature and yang method, which can provide a certain reference for clinicians in the safety of drug use. 3. Due to the quantity and quality of the literature included, this study may be biased.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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