| 胺碘酮联合美托洛尔治疗心房颤动有效性及安全性Meta分析 |
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| 作者姓名： | 孙琳琳 李鑫 刘建和 吴晶 王建国 邹吉涛 |
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| 作者单位： | 湖南中医药大学, 湖南 长沙 410208;湖南中医药大学中医诊断研究所, 湖南 长沙 410007;湖南中医药大学第一附属医院, 湖南 长沙 410007,湖南中医药大学, 湖南 长沙 410208;湖南中医药大学中医诊断研究所, 湖南 长沙 410007,湖南中医药大学第一附属医院, 湖南 长沙 410007,湖南中医药大学, 湖南 长沙 410208,湖南中医药大学, 湖南 长沙 410208;湖南中医药大学中医诊断研究所, 湖南 长沙 410007,湖南中医药大学, 湖南 长沙 410208 |
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| 基金项目： | 湖南中医药大学中医诊断学国家重点学科开放基金项目（2015ZYZD34）；湖南省中医药科研计划项目（60010626）；湖南中医药大学博士科研课题（9982-1001-016）。 |
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| 摘 要： | 目的 评价胺碘酮联合美托洛尔治疗心房颤动的有效性及安全性。方法 全面检索CNKI中国期刊全文数据库、维普中文科技期刊全文数据库、万方医药期刊数据库、SinoMed、PubMed等数据库，同时手工检索相关杂志。按Cochrane 评价员手册评价符合纳入标准的文献质量，采用Review manager 5.3.5软件进行统计分析。结果 最终共纳入10篇文献，共计940例患者。结果显示，采用胺碘酮联合美托洛尔治疗心房颤动的疗效优于单用美托洛尔（Z=7.63，P<0.01）；对左房内径及射血分数的改善也优于美托洛尔（P<0.01）；但胺碘酮联合美托洛尔组的不良反应发生率高于单用美托洛尔。结论 基于目前证据，胺碘酮联合美托洛尔口服控制心室率、改善左房内径及射血分数的效果显著优于单用美托洛尔，但其安全性逊于美托洛尔。由于本研究所纳入的文献存在质量缺陷、异质性和区域局限性，今后应开展多中心、大样本、双盲、双模拟的随机对照试验以全面评价胺碘酮联合美托洛尔治疗心房颤动的临床疗效和安全性。
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| 关 键 词： | 心房颤动 胺碘酮 美托洛尔 有效性 安全性 Meta分析 |
| 收稿时间： | 2015/12/4 0:00:00 |
Meta-Analysis of Effectiveness and Safety of Amidarone combined with Metoprolol on Treatment of Atrial Fibrillation |
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| Authors: | SUN Linlin LI Xin LIU Jianhe WU Jing WANG Jianguo and ZOU Jitao |
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| Institution: | Hunan University of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Institute of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China,Hunan University of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Institute of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan 410007, China,The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China,Hunan University of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China,Hunan University of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Institute of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan 410007, China and Hunan University of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China |
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| Abstract: | Objective To evaluate the effectiveness and safety of amiodarone combined with metoprolol on treatment of atrial fibrillation. Methods We search the literatures by following database:CNKI, VIP, WanFang, SinoMed and Pubmed, and manual searching the journals. The literatures which met the inclusion criteria evaluated by Cochrane Reviewers'' Handbook, were statistically analyzed by Review Manger 5.3 software. Results A total of 10 papers including 940 patients were enrolled. The result showed that amidarone combined with metoprolol on treatment of atrial fibrillation was superior to the metoprolol group (Z=7.63, P<0.01). In the aspect of left atrial diameter and ejection fraction, the amidarone combined with metoprolol group was significantly superior to the metoprolol group (P<0.01). Unfortunately, the incidence of adverse reaction of amidarone combined with metoprolol group was significant higher than the metoprolol group. Conclusion Based on current evidence, the effect of oral amidarone combined with metoprolol in improving aspect heart rate control, the left ventricular internal diameter and ejection fraction was superior to the metoprolol only, but its safety was lower than metoprolol only. For the quality defects, heterogeneity and district limitation of enrolled literatures, it is necessary to conduct multi centers, large sample, double blind, double simulated randomised controlled trials to fully evaluate the clinical efficacy and safety of amidarone combined with metoprolol for the treatment of atrial fibrillation. |
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| Keywords: | atrial fibrillation amiodarone metoprolol effectiveness safety Meta-analysis |
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