BackgroundThe relationship between serial changes in physical activity and the risk of developing atrial fibrillation (AF) has been rarely studied.ObjectivesTo evaluate the association between changes in physical activity over time and the incidence of AF.MethodsA total of 11,828 participants without AF at baseline (visit 1: 1987–1989) from the ARIC Study were included. Physical activity was measured using the modified Baecke Physical Activity Questionnaire at three different visits between 1987 and 2013. Physical activity trajectories over 25 years were identified using latent class trajectory modeling. The primary outcome was the incidence of AF. Multivariable Cox hazard regression models were used to evaluate the relationship between physical activity trajectories and the incidence of AF.ResultsOver a median follow-up of 24 years, 2,108 AF cases (17.8%) occurred. Four distinct physical activity trajectories were identified: light [n = 5,266 (43.3%)]; reduced moderate [n = 3,583 (29.0%)]; moderate [n = 2,691 (25.0%)]; and vigorous intensity [n = 288 (2.8%)]. Compared to the light group, the hazard ratio (HR) and 95% confidence interval (CI) for AF were 1.18 (1.07–1.30) (p < 0.001) for the reduced moderate group, 0.61 (0.53–0.70) (p < 0.001) for the moderate group, and 0.82 (0.59–1.12) (p = 0.21) for the vigorous group, after multivariate adjustments.ConclusionMaintaining moderate levels of physical activity is associated with a lower risk of AF, while a decrease in activity from moderate to light levels increases the risk. These findings highlight the importance of sustaining adequate physical activity levels for the prevention of AF.

Background Cardiovascular disease (CVD) is the leading cause of mortality, and vascular calcification has been highly correlated with CVD events. Abdominal aortic calcification (AAC) has been shown to predict subclinical CVD and incident CVD events. However, the relationship between vitamin C and abdominal aortic calcification remains unclear. Objective To investigate the relationship of dietary vitamin C with AAC among the adult population in the US. Methods The National Health and Nutrition Examination Survey (NHANES) 2013–2014 provided the data for the cross-sectional study. 2297 subjects (1089 males) were included in the study. Two scoring systems, AAC 24-point scale (Kauppila) and AAC 8-point scale (Schousboe), were used for the measurement of AAC score. Dietary vitamin C intake was calculated as the average of two rounds of 24-h interview recall data and classified in tertiles for analysis. We applied weighted multiple regression analyses to assess the relationship of dietary vitamin C with AAC score and the risk of having AAC. To ensure the robustness of the findings, subgroup and sensitivity analyses were performed. Additionally, smooth curve fittings, using generalized additive models (GAM) were employed to visualize potential nonlinear relationships. Furthermore, an exploratory analysis on the relationship of vitamin C supplements with AAC was also conducted. Results The results showed that higher dietary vitamin C intake was related to a reduction in AAC score (AAC-24: β = -0.338, 95% confidence interval [CI] -0.565, -0.111, P = 0.004; AAC-8: β = -0.132, 95%CI -0.217, -0.047, P = 0.002), and lower risk of AAC (odds ratio [OR] = 0.807, 95%CI 0.659, 0.989, P = 0.038). However, the relationship of vitamin C supplements with AAC was not identified. Conclusions The study revealed that higher intake of dietary vitamin C rather than vitamin C supplements was related to reduced AAC score and lower risk of AAC, indicating that diets rich in vitamin C are recommended due to its potential benefits for protecting against vascular calcification and CVD among the adult population in the US.

Objective To evaluate the association between dietary inflammatory index (DII) and Atherosclerotic cardiovascular disease (ASCVD) among U.S. adults. Methods We collected data from National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Adults who reported complete information to diagnose ASCVD and calculate DII were included. We used three models to differentially adjust the covariates, including age, sex, race or ethnicity, education level, smoking status, poverty, insurance, body mass index, hyperlipemia, hypertension, and diabetes. Logistic regression was used to estimate the Odds Ratio (OR) and 95% confidence interval (95% CI) for ASCVD grouped by DII deciles. We additionally conducted spline smoothing with the generalized additive model (GAM) and the log-likelihood ratio to examine the non-linear relationship between DII and ASCVD. If exists, the segmented linear regression will be used to detect the cutoff point. The subgroup analyses were stratified by various atherosclerotic cardiovascular diseases (i.e., CHD, angina, heart attack, and stroke) and sex. Results A total of 48,733 participants (mean age, 47.13 ± 0.19 years) with 51.91% women were enrolled, of which 5,011 were diagnosed with ASCVD. In the crude model, participants in the five highest deciles (D6, 7, 8, 9, and 10) of DII score had a significantly higher risk of having ASCVD compared to those in the first decile. In the fully adjusted model, those in the tenth decile [OR = 1.47, 95% CI = (1.18,1.84)] of DII had a significantly increased risk of ASCVD compared to the first decile. Notably, when DII is above 3, the ASCVD risk increased by 41% for each one increase in DII [OR = 1.41, 95% CI = (1.15,1.73)]. This relationship was more pronounced in females. Conclusion Our study revealed a positive and non-linearly association between DII and ASCVD in U.S. adults. This relationship was more pronounced in females. The findings provide a reference for future research and diet recommendations.

目的:系统评价麝香保心丸治疗心脏 X综合征的临床疗效.方法:检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、PubMed、EMbase,检索时限为建库至 2021 年 9 月,发表的麝香保心丸治疗心脏 X 综合征的随机对照试验.根据Cochrane 5.1手册推荐的偏倚风险评估工具对纳入的研究进行方法学质量评价,应用Review Manager 5.4软件进行Meta分析.结果:共纳入 13项研究,涉及 954例病人,多数研究存在一定程度的发表偏倚.Meta分析结果显示,与对照组比较,试验组总有效率升高[RR=1.19,95%CI(1.09,1.31),P =0.000 3],ST段压低最低电压幅度[WMD=-0.15,95%CI(-0.27,-0.02),P =0.03]、超敏 C反应蛋白(hs-CRP)[WMD=-2.47,95%CI(-4.27,-0.67),P<0.01]、内皮素-1(ET-1)[WMD=-23.26,95%CI(-42.19,-4.34),P =0.02]降低,一氧化氮(NO)[WMD=25.52,95%CI(20.68,30.36),P<0.01]升高.漏斗图提示可能存在一定的发表偏倚.结论:现有证据表明,应用麝香保心丸治疗心脏 X综合征可提高临床疗效.

AimsTo evaluate the relationship of the healthy eating index-2015 (HEI-2015) with abdominal aortic calcification (AAC) in US adults.MethodsWe conducted a cross-sectional study with data extracted from the National Health and Nutrition Examination Survey (NHANES). AAC score was measured using the scoring system of Kauppila (AAC-24) and Schousboe (AAC-8). HEI-2015, which was used for evaluating compliance with Dietary Guidelines for Americans (DGA), was calculated through two rounds of 24-h recall interviews. HEI-2015 was categorized as inadequate (<50), average (50~70), and optimal (≥70) groups for analysis, while the AAC-24 score was grouped by whether the score was >0. Weighted multiple regression analyses were conducted to estimate the association of HEI-2015 with AAC score and the presence of AAC. Moreover, smooth curve fittings, based on a generalized additive model (GAM), were applied to evaluate a possible non-linear relationship. Sensitivity analysis and subgroup analysis were performed to provide more supporting information.ResultsA total of 2,704 participants were included in the study (mean age, 57.61 ± 11.40 years; 51.78% were women). The mean score of HEI-2015 was 56.09 ± 13.40 (41.33 ± 6.28, 59.44 ± 5.54, and 76.90 ± 5.37 for inadequate, average, and optimal groups, respectively). After adjusting for covariates, higher HEI-2015 was associated with decreased AAC score (AAC-24: β = −0.121, 95% CI: −0.214, −0.028, P = 0.010; AAC-8: β= −0.054, 95% CI: −0.088, −0.019, P = 0.003) and lower risk of AAC (OR = 0.921, 95% CI: 0.855, 0.993, P = 0.031). Among the components of HEI-2015, a higher intake of fruits, greens, and beans was associated with a lower AAC score. Subgroup analysis showed that an inverse association of HEI-2015 with AAC score existed among different groups.ConclusionThe study presented that higher HEI-2015 was related to a lower AAC score and decreased risk of having AAC, indicating that greater compliance with 2015–2020 DGA, assessed by HEI-2015, might be beneficial for preventing vascular calcification and CVD among US adults.

Objective To compare and explore Chinese medicine（CM） prescription regularity in stable coronary artery disease（SCAD） patients who encountered recurrent cardiovascular events using real world data.Methods Clinical and follow-up data from 3 646 SCAD patients in 10 Grade-A tertiary hospitals across the country was collected. The patients were assigned to case group（recurrent cardiovascular events,346 cases） and control group（without recurrent cardiovascular events,3 300 cases） according to the recurrent cardiovascular events. Totally 200 cases were included in paired-control group after the cases and the controls paired based on risk factors. Frequency statistics and association rules were adopted to analyze the regularity of CM prescription in both groups. Results The percent of Qi deficiency and Yang deficiency is higher in case group,the percent of Qi stagnation,blood stasis and turbid phlegm is higher in paired-control group（P＜0.05,P＜0.01）. A total of 206 prescriptions in case group and 161prescriptions in paired-control group,consisting of 225 herbs were analyzed. The most frequently used herbs in the case group were Aurantii Fructus,Atractylodes Macrocephala Koidz,Poria Cocos（Schw.） Wolf,Angelicae Sinensis Radix,and Persicae Semen. The most frequently associated herbs in the case group were Angelicae Sinensis Radix,Chuanxiong Rhizoma,Persicae Semen,and Aurantii Fructus. The most frequently used herbs in the paired-control group were Hedysarum Multijugum Maxim,Radix Salviae,Arum Ternatum Thunb,Glycyrrhiza uralensis Fisch,and Radix Bupleuri. The most frequently associated herbs in the paired-control group were Hedysarum Multijugum Maxim,Panax Notoginseng,Radix Salviae,Trichosanthes Kirilowii Maxim,and Gastrodia Elata. Conclusions In real word practices,CM therapeutic rule of promoting blood flow and regulating Qi was more commonly applied in patients with recurrent cardiovascular events,while CM therapeutic rule of invigorating Qi and harmonizing blood,combined with promoting blood flow and dissipating phlegm was more commonly applied in patients without recurrent cardiovascular events.

《金匮要略》提出"血不利则为水"理论,"血不利"是血液运行不畅的病理状态,多指血瘀;"水"即痰湿水饮等病理产物,是病理性津液."血不利"及"水不利"贯穿高血压始终,而肝脾是重要脏腑.高血压初期以痰湿为主,治当化痰不忘祛瘀;中期痰瘀并重,治当活血化痰以通利血脉;后期虚实夹杂,以虚为主,治当益气养血,活血和络以和血脉.本文立足于"血不利则为水"理论分期辨治高血压,为中医辨治高血压提供了新的思路.

立足朱丹溪"六郁"理论,认为以气郁为首,火郁、血郁、食郁、痰郁、湿郁皆可致气机升降失司、气血津液运化失常,进而引发高血压.临床治疗高血压应重视理气行气,在此基础上辨治他郁,予宣散清热、活血化瘀、消食导滞、除湿化痰等治疗,郁久应注重滋阴降火、健脾益胃、补气养血等.

心房颤动属于中医"心悸""怔忡"范畴,在病因、病机及症状上均与李东垣的阴火理论有一定相关性.其发病率随年龄增长而上升,年老体虚,生化乏源,或饮食不节,滋腻碍胃,或情志不遂,肝郁犯脾,引起脾胃亏损,运化失司,心失所养;元气亏虚,阴火上扰,而出现心悸、乏力、心烦等症.在治疗上,以阴火理论作为指导,采用辛甘温补之品,如补中益气汤、升阳益胃汤等方药化裁,注重培补脾胃元气,亦可酌情辅以清降阴火,令元气得充,阴火得降,心得荣养,心无所扰,而心悸自止.

背景:左心疾病相关性肺动脉高压患者是目前最大的肺动脉高压人群,急需新的治疗方式、药物以及针对左心疾病相关性肺动脉高压(Pulmonary Hypertension due to Left Heart Disease,PH-LHD)的临床研究,中医药已显示出一定的治疗潜力和优势.目的:本研究通过收集PH-LHD患者的中医临床证候学资料,以期了解PH-LHD的证素分布规律及与疾病严重程度指标之间的相关性,初步探索PH-LHD中医证型出现形式,明确PH-LHD优势证素及与疾病严重程度相关的证素类型,为中医药临床辨证施治提供依据.方法:采用横断面的研究方法,从2017年6月-2018年12月于北京中医药大学东直门医院住院部收集314例PH-LHD患者,排除数据不全及患者拒绝配合等因素,共收集整理293例PH-LHD患者资料,完成293份中医证候调查表,通过频数、相关性、回归分析等数据统计方法进行研究,从中得出PH-LHD的证素分布规律、证素与心肺功能等与疾病严重程度相关指标之间的相关性、证素之间的内在关系,从而得出PH-LHD常见症状、体征、证素、可能出现的证素组合形式及与疾病严重程度相关的证素.结果:本研究调查PH-LHD临床常见8个证素,按照总的出现频次各证素由高到低排列依次为血瘀>气虚>痰浊>水饮>阴虚>阳虚>气滞>血虚.出现频次最多的四种证素分别是血瘀、气虚、痰浊、水饮,其中血瘀、气虚出现频次明显高于其他证型,这也符合气血理论是心系相关疾病的重要理论基础,痰浊、水饮也是PH-LHD发展过程中出现较多的病理产物;分析提取出54种复合证素类型,其中最常见的8种复合证型出现频次由高到低排列依次为气虚+血瘀>血瘀+痰浊>气虚+血瘀+水饮>气虚+血瘀+痰浊=气虚+阴虚>气虚+阴虚+血瘀+痰浊=血瘀+气滞、阳虚+水饮,其中两证素组合形式构成比最大,两证素组合形式中气虚+血瘀出现频次最多,在三证素中出现频次最高的复合证素是气虚+血瘀+水饮;研究将肺动脉高压分为轻度、中度、重度,其中轻度肺动脉高压患者有222例,中度肺动脉高压患者有55例,重度肺动脉高压患者有16例,轻度肺动脉高压患者证素出现频次排序为血瘀>气虚>痰浊>水饮>阴虚>阳虚>气滞>血虚,中度肺动脉高压患者证素出现频次排序为血瘀>气虚=水饮>阳虚>阴虚=痰浊>血虚,重度肺动脉高压患者证素出现频次排序为血瘀>痰浊>气虚>水饮>阴虚>阳虚>气滞>血虚;PH-LHD中医证素与氨基末端脑钠肽前体(N-terminal pro-brain Natriuretic Peptide,NT-proBNP)、左心室射血分数(Left Ventricular Ejection Fraction,LVEF)及肺动脉收缩压相关性分析得出水饮与疾病严重程度相关,差异均有统计学意义(P<0.05),其中水饮与NT-proBNP及肺动脉收缩压呈正相关,与LVEF呈负相关;通过数据分析进一步说明了以气、血、水功能失调所致"气虚血瘀,痰饮内停"之"心肺痰饮病"即PH-LHD的中医病因病机理论.结论:PH-LHD患者以气虚、血瘀为基本病机,随着疾病进展出现痰浊、水饮病理产物,其中水饮证与NT-proBNP、肺动脉收缩压呈正相关,和LVEF呈负相关,提示水饮与疾病严重程度密切相关,气虚、水饮、血瘀、痰浊集合可以反映PH-LHD患者最主要的疾病特征,气虚血瘀为基本病理基础,痰浊为重要的病理产物,水饮为PH-LHD的最终结果.

ETHNOPHARMACOLOGICAL RELEVANCE:Qing-Xin-Jie-Yu Granule (QXJYG) is an integrated traditional Chinese medicine formula used to treat atherosclerotic (AS) cardiovascular diseases. A randomized controlled trial found that QXJYG reduced cardiovascular events and experiments also verified that QXJYG attenuated AS by remodeling the intestinal flora. AIM OF THE STUDY:To determine whether QXJYG would attenuate AS and plaque vulnerability by regulating ferroptosis in high-fat diet-induced atherosclerotic ApoE-/- mice and to investigate the effects of QXJYG on macrophage ferroptosis in RAS-selective lethal 3 (RSL3)-induced J744A.1 cells. METHODS:AS models in ApoE-/- mice and RSL3-induced ferroptosis in J744A.1 cells were established to measure the protective and anti-ferroptotic effects of QXJYG in vivo and in vitro. The glutathione peroxidase 4 (GPX4)/cystine glutamate reverse transporter (xCT) signal pathway was examined by immunohistochemistry and western blotting. RESULTS:QXJYG attenuated AS progression and plaque vulnerability. Characteristic morphological changes of ferroptosis in the QXJYG-treated animals were rare. Total iron was significantly lower in the QXJYG group than in the model group (P < 0.05); QXJYG suppressed the lipid peroxidation (LPO) levels (malondialdehyde), enhanced the antioxidant capacity (superoxide dismutase and glutathione), and reduced inflammatory factors (interleukin [IL]-6, IL-1β, tumor necrosis factor-α) associated with ferroptosis. Expression of GPX4/xCT in aorta tissues was remarkably increased in the QXJYG group. QXJYG inhibited ferroptosis in J744A.1 macrophages disturbed using RSL3. The Fe2+, LPO, and reactive oxygen species levels were lower in the QXJYG group than in the RSL3 group (P < 0.05). The QXJYG group showed higher expression of the GPX4/xCT signal pathway. CONCLUSION:QXJYG inhibits ferroptosis in vulnerable AS plaques partially via the GPX4/xCT signaling pathway.

Background Necroptosis, a recently discovered programmed cell death, has been pathologically linked to various diseases and is thus a promising target for treating diseases. However, a comprehensive and objective report on the current status of entire necroptosis research is lacking. Therefore, this study aims to conduct a bibliometric analysis to quantify and identify the status quo and trending issues of necroptosis research in the last decade. Methods Articles were acquired from the Web of Science Core Collection database. We used two bibliometric tools (CiteSpace and VOSviewer) to quantify and identify the individual impact and cooperation information by analyzing annual publications, journals, co-cited journals, countries/regions, institutions, authors, and co-cited authors. Afterwards, we identified the trending research areas of necroptosis by analyzing the co-occurrence and burst of keywords and co-cited references. Results From 2012 to 2021, a total of 3,111 research articles on necroptosis were published in 786 academic journals by 19,687 authors in 885 institutions from 82 countries/regions. The majority of publications were from China and the United States, of which the United States maintained the dominant position in necroptosis research; meanwhile, the Chinese Academy of Sciences and Ghent University were the most active institutions. Peter Vandenabeele published the most papers, while Alexei Degterev had the most co-citations. Cell Death & Disease published the most papers on necroptosis, while Cell was the top 1 co-cited journal, and the major area of these publications was molecular, biology, and immunology. High-frequency keywords mainly included those that are molecularly related (MLKL, TNF-alpha, NF-κB, RIPK3, RIPK1), pathological process related (cell-death, apoptosis, necroptosis, necrosis, inflammation), and disease related (cancer, ischemia/reperfusion injury, infection, carcinoma, Alzheimer’s disease). Conclusion Necroptosis research had a stable stepwise growth in the past decade. Current necroptosis studies focused on its cross-talk with other types of cell death, potential applications in disease treatment, and further mechanisms. Among them, the synergy with ferroptosis, further RIPK1/RIPK3/MLKL studies, its association with inflammation and oxidative stress and translational applications, and the therapeutic potential to treat cancer and neurodegenerative diseases are the trending research area. These might provide ideas for further research in the necroptosis field.

阵发性心房颤动发作突发突止,急骤多变,以心中悸动不安、脉结代为主症.取象比类思维是中医学理论的重要思想,据中医学取象比类思维方式,阵发性心房颤动发作的特征与风邪善动、风胜则摇的致病特点类似.笔者团队认为心风是阵发性心房颤动的重要因素,倡导从"心风内动"论治阵发性心房颤动.心风包括实风与虚风,以虚风为主.心主神明,主血脉.心之阴阳亏虚,导致心之气血逆乱,心脏主神明、主血脉的生理功能异常,则虚风内动,发为心悸.此外尚有肝阳上亢化风;脾虚生痰,痰郁日久化热,热极生风;湿属土,木属风,肺脾肾气化失常,水湿痰饮泛滥,而致湿极,则湿反克木,出现震颤等"风"之状;肝郁气滞出现血瘀,气血相搏,形成类似"风"的征象.心体阴阳失衡,兼夹肝风、痰浊、水饮、瘀血、热邪等实邪,激发心风,可诱发心悸.从心风论治阵发性心房颤动,宜重视阴阳平和,强调滋心肾之阴,以平虚风,同时重镇安神,以灭心风.对于夹杂实邪者,在调和阴阳的基础上兼顾实邪,以达临床疗效.

ObjectiveThe objective of this study was to measure the efficacy of various types and dosages of statins on C-reactive protein (CRP) levels in patients with dyslipidemia or coronary heart disease.MethodsRandomized controlled trials were searched from PubMed, Embase, Cochrane Library, OpenGray, and ClinicalTrials.gov. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for data extraction and synthesis. The pairwise meta-analysis compared statins and controls using a random-effects model, and a network meta-analysis compared the types and dosages of statins using the Bayesian random-effects model. The PROSPERO registration number is CRD42021242067.ResultsThe study included 37 randomized controlled trials with 17,410 participants and 20 interventions. According to the pairwise meta-analysis, statins significantly decreased CRP levels compared to controls (weighted mean difference [WMD] = −0.97, 95% confidence interval [CI] [−1.31, −0.64], P < 0.0001). In the network meta-analysis, simvastatin 40 mg/day appeared to be the best strategy for lowering CRP (Rank P = 0.18, WMD = −4.07, 95% CI = [−6.52, −1.77]). The same was true for the high-sensitivity CRP, non-acute coronary syndrome (ACS), <12 months duration, and clear measurement subgroups. In the CRP subgroup (rank P = 0.79, WMD = −1.23, 95% CI = [−2.48, −0.08]) and ≥12-month duration subgroup (Rank P = 0.40, WMD = −2.13, 95% CI = [−4.24, −0.13]), atorvastatin 80 mg/day was most likely to be the best. There were no significant differences in the dyslipidemia and ACS subgroups (P > 0.05). Node-splitting analysis showed no significant inconsistency (P > 0.05), except for the coronary heart disease subgroup.ConclusionStatins reduced serum CRP levels in patients with dyslipidemia or coronary heart disease. Simvastatin 40 mg/day might be the most effective therapy, and atorvastatin 80 mg/day showed the best long-term effect. This study provides a reference for choosing statin therapy based on LDL-C and CRP levels.

室性早搏属中医"心悸"范畴,其发病特点与中医"风证"有相似之处."风为百病之长",外风、内风均可导致室性早搏的发生.外风可由表及里或直中于心而发病,多伴有表证,治疗上应注重风药的使用;内风多由热极生风、痰热生风、肝风内动、血虚生风、阴虚动风等扰动心神而发病,在清热、化痰、平肝、养血、滋阴的基础上,亦当注重祛风熄风."邪之所凑,其气必虚."无论外风、内风致悸,皆应重视补益心气、养心安神,使心神得养,则邪不可干而风自止.

To systematically evaluate the efficacy and safety of Ningxinbao Capsules in treatment of arrhythmia by Meta-analysis. Randomized controlled trial(RCT) or quasi-randomized control trial(Quasi-RCT) on Ningxinbao Capsules treating arrhythmia were obtained by computer-based retrieval in CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and EMbase as well as manual retrieval, with time limit from database establishment to April 7, 2020. According to the inclusion and exclusion criteria of trials, all RCTs were screened and evaluated. Then the effective data were collected and RevMan 5.3 Meta-analysis software was used for analysis. Thirteen trials were included, involving 1 379 patients in total. Ningxinbao Capsules combined with anti-arrhythmia Western medicine were adopted as the intervention, and the patients in control group were treated with the anti-arrhythmia Western medicine alone. Meta-analysis results showed that as compared to control group, Ningxinbao Capsules combined with anti-arrhythmia Western medicine group was superior in clinical efficacy, dynamic electrocardiogram and average heart rate in patients with bradycardia, with indicated statistically significant differences. Ningxinbao Capsules had fewer adverse reactions and could relieve the toxic and side effects of anti-arrhythmia medicine possibly. The study showed that Ningxinbao Capsules played a role in treatment of arrhythmia and was relatively safe. However, due to the limited quality of the included studies, high-quality clinical trials are needed to verify the conclusions.

目的 系统评价血栓心脉宁治疗冠心病的临床疗效及安全性.方法 计算机检索中国知网(CNKI)、万方数据库(WanFang Date)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Cochrane Library、EMbase以及手工检索相关资料,全面收集血栓心脉宁治疗冠心病病人的随机对照试验(RCT).所有数据库检索时限均为建库至2019年9月30日.根据纳入和排除标准对文献进行筛选,采用RevMan5.3软件进行Meta分析.结果 本研究共纳入8篇文献,涉及病人751例.Meta分析结果显示:治疗组心绞痛改善总有效率[RR=1.24,95％CI(1.15,1.33),P<0.00001]、心电图改善总有效率[RR=1.24,95％CI(1.10,1.39),P=0.0005]高于对照组,差异均有统计学意义;治疗组与对照组不良反应发生率比较差异无统计学意义[RR=0.77,95％CI(0.36,1.64),P=0.50].证据等级显示:心绞痛改善总有效率及心电图改善总有效率为低级,不良反应为极低级.结论 现有证据表明,血栓心脉宁能够有效提高冠心病心绞痛及心电图改善总有效率,且具有良好的安全性.

目的 评估桂枝甘草龙骨牡蛎加味汤治疗冠心病室性期前收缩的疗效及安全性.方法 计算机检索中国知网(CNKI)、万方、维普、中国生物医学文献数据库(CBM)、Web of Science、PubMed、Cochrane Library、EMbase,同时手工检索相关资料,全面收集使用桂枝甘草龙骨牡蛎加味汤治疗冠心病室性期前收缩的随机对照试验(RCT),检索时限为1999年3月5日—2019年3月5日.根据研究的纳入和排除标准,由2名研究者独立对文献进行筛选,并进行质量评估,提取有效数据,采用RevMan 5.3软件进行Meta分析.结果 共纳入9篇文献,涉及755例病人.Meta分析结果显示:桂枝甘草龙骨牡蛎加味汤能改善冠心病室性期前收缩病人总有效率[RR=1.35,95％CI(1.20,1.51),Z=5.19,P<0.00001]、24 h室性期前收缩次数[MD=735.11,95％CI(731.29,738.93),Z=377.38,P<0.00001]、中医证候评分[MD=4.57,95％CI(3.03,6.10),Z=5.83,P<0.00001],且无明显不良反应[RR=0.62,95％CI(0.35,1.08),Z=1.69,P=0.09].结论 现有证据表明,桂枝甘草龙骨牡蛎加味汤治疗冠心病室性期前收缩效果较好.

早搏又称期前收缩,是最常见的心律失常之一,属于中医“心悸”“怔忡”的范围,导师李玉峰根据多年临床经验总结,认为早搏发生的根本原因在于心阴阳的失调,因此,治疗当调和阴阳,常用桂枝甘草龙骨牡蛎汤合天王补心丹为主方辨证加减治疗,临床疗效显著.