目的 通過Meta分析的方法評價(jià)穩(wěn)心顆粒對房顫患者心臟結(jié)構(gòu)重構(gòu)及炎癥因子的影響。方法 檢索PubMed、Embase、Cochrane Library、Web of Science、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)庫（Wanfang Data）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、維普生物醫(yī)學(xué)數(shù)據(jù)庫（VIP）中穩(wěn)心顆粒治療房顫的臨床隨機(jī)對照試驗(yàn)（RCTs）；使用Excel錄入文獻(xiàn)基本信息；使用RevMan 5.4進(jìn)行質(zhì)量評價(jià)、異質(zhì)性檢驗(yàn)及森林圖繪制；使用StataMP 17.0進(jìn)行漏斗圖繪制及Egger檢驗(yàn)。結(jié)果 共納入39項(xiàng)RCTs，包含4 211例研究對象。Meta分析結(jié)果顯示：穩(wěn)心顆?？商岣叻款澔颊咦笫疑溲?jǐn)?shù)（LVEF，MD＝6.01，95%置信區(qū)間（CI）［5.03，6.99］，P＜0.000 01），降低房顫患者左室舒張末期內(nèi)徑（LVEDd，MD＝-6.35，95% CI ［-7.66，-5.04］，P＜0.000 01）、左室收縮末期內(nèi)徑（LVESd，MD＝-4.35，95% CI［-4.80，-3.90］，P＜0.000 01）、左房內(nèi)徑（LAd，MD＝-3.63，95% CI ［-5.43，-1.83］，P＜0.000 1）、超敏C反應(yīng)蛋白（hs-CRP，MD＝-2.28，95% CI ［-3.07，-1.48］，P＜0.000 01）、C反應(yīng)蛋白（CRP，MD＝-5.71，95% CI ［-6.62，-4.79］，P＜0.000 01）、白細(xì)胞介素-6（IL-6，MD＝-10.37，95% CI ［-17.00，-3.74 ］，P ＝ 0.002 ）、基質(zhì)金屬蛋白酶-9（MMP-9，MD＝-23.27，95% CI ［-26.42，-20.11］，P＜0.000 01）、基質(zhì)金屬蛋白酶-2（MMP-2，MD＝-55.85，95% CI［-90.44，-21.27］，P＝0.002），其差異具有統(tǒng)計(jì)學(xué)意義。試驗(yàn)組不良反應(yīng)發(fā)生率低于對照組（RR＝0.74，95% CI ［0.59，0.93］，P＝0.009），其差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論 穩(wěn)心顆粒可改善房顫患者結(jié)構(gòu)重構(gòu)指標(biāo)、降低炎癥因子，且安全性較好。

Objective To evaluate the effects of Wenxin Granule on structural remodeling and inflammatory markers in patients with atrial fibrillation (AF) by Meta-analysis. Methods PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, SinoMed, VIP and China Biology Medicine disc (CBM) were searched for randomized controlled trials (RCTs) of Wenxin Granule in treatment of AF. Excel was used to input the basic information of the article. RevMan 5.4 was used for quality assessment, heterogeneity test and forest map drawing. StataMP 17.0 was used for funnel plot and Egger test. Results A total of 39 RCTs involving 4 211 participants were included. Results of Meta-analysis showed that:Wenxin Granule could improve left ventricular ejection fraction (LVEF, MD = 6.01, 95%CI [5.03, 6.99], P < 0.000 01), reduce left ventricular end-diastolic diameter (LVEDd, MD = -6.35, 95%CI [ -7.66, -5.04], P < 0.000 01), left ventricular end-systolic diameter (LVESd, MD = -4.35, 95%CI [-4.80, -3.90, P < 0.000 01), left atrial diameter (LAd, MD = -3.63, 95%CI [-5.43, -1.83], P < 0.000 1), hypersensitive C-reactive protein (hs-CRP, MD = -2.28, 95%CI [-3.07, -1.48], P < 0.000 01), C-reactive protein (CRP, MD = -5.71, 95%CI [-6.62, -4.79], P < 0.000 01), interleukin-6 (IL-6, MD = -10.37, 95%CI [-17.00, -3.74], P= 0.002), matrix metalloprotein-9 (MMP-9, MD = -23.27, P < 0.000 01), 95%CI [-26.42, -20.11], P < 0.000 01), matrix metalloprotein-2 (MMP-2, MD = -55.85, 95%CI [ -90.44, -21.27], P= 0.002) in AF patients, the difference was statistically significant. The incidence of adverse reactions in the experimental group was lower than that in the control group (RR = 0.74, 95%CI [0.59, 0.93], P= 0.009), the difference was statistically significant. Conclusion Wenxin Granule can alleviate structural remodeling and reduce inflammatory markers in patients with atrial fibrillation with good safety.

R972

中華中醫(yī)藥學(xué)會(huì)青年求實(shí)項(xiàng)目（2023-QNQS-01）;第六批北京市級中醫(yī)藥專家學(xué)術(shù)經(jīng)驗(yàn)繼承工作項(xiàng)目