目的 采用Meta分析的方法系統(tǒng)評(píng)價(jià)參松養(yǎng)心膠囊（SSYX）對(duì)心房顫動(dòng)（AF）患者心臟結(jié)構(gòu)功能及炎癥因子影響。方法 檢索8個(gè)主要中英文數(shù)據(jù)庫(kù)中SSYX治療AF的臨床隨機(jī)對(duì)照試驗(yàn)（RCT），同時(shí)手工檢索灰色文獻(xiàn)。文獻(xiàn)質(zhì)量評(píng)價(jià)以及森林圖生成在RevMan 5.4軟件中執(zhí)行，敏感性評(píng)估與Egger回歸在StataMP 17.0軟件中執(zhí)行。結(jié)果 共納入55項(xiàng)RCTs，包含5 815例研究對(duì)象。Meta分析結(jié)果顯示，SSYX可提高AF患者左室射血分?jǐn)?shù)[MD＝4.67，95%置信區(qū)間（CI）(3.69，5.39)，P＜0.000 01]、6 min步行距離[MD＝65.86，95% CI (53.96，77.75)，P＜0.000 01]，降低房顫患者左室舒張末期內(nèi)徑[MD＝-4.23，95% CI (-5.59，-2.86)，P＜0.000 01]、左室收縮末期內(nèi)徑[MD＝-4.06，95% CI (-5.07，-3.06)，P＜0.000 01]、左房?jī)?nèi)徑[MD＝-2.53，95% CI (-3.03，-2.03)，P＜0.000 01]、左房最大容積[MD＝-7.12，95% CI (-8.23，-6.01)，P＜0.000 01]、N末端腦鈉肽前體[MD＝-184.99，95% CI (-227.34，-142.64)，P＜0.000 01）、腦鈉肽（MD＝-54.29，95% CI (-94.32，-14.25)，P＝0.008]、血管緊張素Ⅱ[MD＝-26.64，95% CI (-30.85，-22.44)，P＜0.000 01]、超敏C反應(yīng)蛋白（MD＝-1.36，95% CI (-1.86，-0.87)，P＜0.000 01]、C反應(yīng)蛋白[MD＝-1.98，95% CI (-3.54，-0.42)，P＝0.01]、白細(xì)胞介素-6[MD＝-6.98，95% CI (-11.93，-2.03)，P＝0.006]，腫瘤壞死因子α[MD＝-1.98，95% CI (-2.43，-1.52)，P＜0.000 01]，基質(zhì)金屬蛋白酶2[MD＝-1.30，95% CI (-1.97，-0.64)，P＝0.000 1]。試驗(yàn)組不良反應(yīng)發(fā)生率低于對(duì)照組[RR＝0.66，95% CI (0.44，1.00)，P＝0.05]。結(jié)論SSYX可提升AF患者的心臟結(jié)構(gòu)功能水平，降低體內(nèi)炎癥反應(yīng)，同時(shí)安全性良好。

Objective To evaluate the effects of Shensong Yangxin capsule (SSYX) on cardiac structure, function and inflammatory factors in patients with atrial fibrillation (AF) by Meta-analysis. Methods Randomized controlled trials (RCTs) on SSYX for treating AF were searched from eight major Chinese and English databases. Grey literature was also manually searched. RevMan 5.4 was used for quality evaluation and forest map drawing. StataMP 17.0 was used for sensitivity analysis and Egger's test. Results A total of 55 RCTs involving 5 815 participants were included. The results of Meta-analysis showed that SSYX can improve left ventricular ejection fraction [MD = 4.67, 95% confidence interval (CI) (3.69, 5.39), P < 0.000 01] and 6-min walk distance [MD = 65.86, 95%CI (53.96, 77.75), P < 0.000 01] in patients with AF, and reduce left ventricular end-diastolic diameter [MD = -4.23, 95%CI (-5.59, -2.86), P < 0.000 01], left ventricular end-systolic diameter [MD = -4.06, 95%CI (-5.07, -3.06), P < 0.000 01], left atrial diameter [MD = -2.53, 95%CI (-3.03, -2.03), P < 0.000 01], maximum left atrial volume [MD = -7.12, 95%CI (-8.23, -6.01), P < 0.000 01], N-terminal pro-brain natriuretic peptide (MD = -93.43, 95%CI (-137.21, -49.65), P < 0.000 1], brain natriuretic peptide [MD = -54.29, 95%CI (-94.32, -14.25), P = 0.008], angiotensin Ⅱ [MD = -26.64, 95%CI (-30.85, -22.44), P < 0.000 01], high-sensitivity C-reactive protein [MD = -1.36, 95%CI (-1.86, -0.87), P < 0.000 01], C-reactive protein [MD = -1.98, 95%CI (-3.54, -0.42), P = 0.01], interleukin-6 [MD = -6.98, 95%CI (-11.93, -2.03), P = 0.006], tumor necrosis factor-α [MD = -1.98, 95%CI (-2.43, -1.52), P < 0.000 01], matrix metalloproteinase 2 [MD = -1.30, 95%CI (-1.97, -0.64), P = 0.000 1] in patients with atrial fibrillation. The incidence of adverse reactions in the trial group was lower than that in the control group [RR = 0.66, 95%CI (0.44, 1.00), P = 0.05]. Conclusion SSYX can improve cardiac structure and function in patients with AF, reduce systemic inflammation, and has 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(jí)中醫(yī)藥專家學(xué)術(shù)經(jīng)驗(yàn)繼承工作項(xiàng)目