Meta-analysis Of The Treatment Of Bradyarrhythmia With Warming Yang, Nourishing Qi And Activating Blood

Purpose:To analyze the clinical efficacy of the method of warming yang and supplementing qi and promoting blood circulation in the treatment of slow arrhythmia by using meta-analysis method,and to provide a theoretical basis for further exploration of TCM treatment of slow arrhythmia.Material and method:Strictly formulated the inclusion and exclusion criteria.The databases of Knowledge Network Database(CNKI),wanfang Database,and Chongqing Weipu Chinese Science and Technology Periodical Database(VIP),Chinese Biomedical Literature Database Collection(CBM),Pub Med.Retrieving the published Chinese literature from 2008 to 2018,on the RCT test of the method of warming yang and supplementing qi and promoting blood circulation combined with conventional western medicine for bradyarrhythmia,The two researchers independently and strictly carried out the data extraction and quality assessment of the included literature,and used the bias risk assessment standard of the Cochrane system evaluation manual for evaluation,and the Rev Man5.3 software for meta-analysis.Results:A total of 27 articles were included in the study.There were 2374 cases in total,including 1229 cases in the treatment group(warming yang and supplementing qi method,and combined with western medicine)and 1145 cases in the control group(Western medicine or comfort).The results of the meta-analysis are as follows:(1)A total of 27 articles included clinically effective analysis of the treatment group and the control group,OR=5.08(95%CI:4.05,6.37),and the test result was P<0.00001,indicating that the clinical effective difference between the two groups was statistically significant,the clinical effective rate of the treatment group was 5.08 times that of the control;(2)A total of 8 articles included the evaluation of TCM symptom efficacy,OR=6.40(95%CI:4.08,10.06),and the test result was P<0.00001,indicating that the difference in TCM symptom efficacy between the two groups was statistically significant.The TCM symptom efficacy was 6.40 times that of the control;(3)A total of 19 articles analyzed the average heart rate of patients in the treatment group and the control group,MD=5.57(95%CI:4.63,6.52),and the test result was P<0.00001.There was a difference in the average heart rate between the treatment group and the control group,and the average heart rate of the treatment group was higher than that of the control group;(4)12 of the included literatures studied the difference in the slowest heart rate between the treatment group and the control group,MD=3.93(95%CI:2.68,5.18),and the test result was P<0.05,indicating the treatment group and the control group.There was a difference in slow heart rate,and the treatment group was superior to the control group;(5)Three of the included literatures referred to recurrence rate,OR=0.31(95% CI: 0.16,0.58),and the test result was P<0.05.The results showed that the recurrence rate of the test group was lower than that of the control group;(6)A total of 3 references mentioned heart rate variability,meta-analysis of SDNN: combined MD = 14.01(95% CI: 1.21,26.81),P < 0.05;meta-analysis of SDANN: combined MD =-9.46(95% CI:-18.38),-0.54),P < 0.05;meta-analysis of RMSSD: combined MD =-6.71(95% CI:-8.99,-5.33),P < 0.05,indicating statistically significant results,the study group was superior to the control group in improving autonomic function.(7)Three of the included literatures referred to SNRT,MD=MD=-351.47(95%CI:-663.39,-39.55),P < 0.05,and the results were statistically significant,The test group can significantly shorten the SNRT.(8)Three of the included literatures referred to SACT,MD=-74.54(95% CI:-121.49,-27.59),P < 0.05,and the results were statistically significant,the test group SACT shortened better than the control group.Conclusion:The treatment of bradyarrhythmia with the method of warming yang and supplementing qi and promoting blood circulation is clinically effective and safe.Not only can it significantly improve the clinical treatment efficiency of patients with bradyarrhythmia,improve the efficacy of TCM syndromes,improve the patient's 24-hour average heart rate and minimum heart rate;but also reduce the rate of hospital re-hospitalization,improve cardiac autonomic function and sinus node SNRT,SACT and other related indicators.