摘要
目的采用系统评价方法,对比美托洛尔和米多君治疗血管迷走性晕厥(VVS)的效果。方法计算机检索Pub Med、Cochrane Library、Science Direct、Sino Med、CNKI、Wanfang等数据库,检索时间从建库至2017年11月,根据Cochrane系统评价方法,筛选关于美托洛尔和(或)米多君治疗VVS的中、英文随机对照试验(RCTs),采用Rev Man 5.3软件进行meta分析。对比美托洛尔组和(或)米多君组疗效指标。结果症状好转率:4篇RCTs提示美托洛尔组疗效优于基础治疗组(P<0.01),4篇RCTs提示米多君组疗效好于基础治疗组(P<0.01),2篇RCTs提示美托洛尔组和米多君组差异无统计学意义(P=0.63);HUTT转阴率:6篇RCTs提示美托洛尔组疗效优于基础治疗组(P<0.01),3篇RCTs提示米多君组疗效好于基础治疗组(P<0.01),3篇RCTs提示美托洛尔组和米多君组差异无统计学意义(P=0.05);晕厥复发率:3篇RCTs提示美托洛尔组疗效优于基础治疗组(P<0.01),4篇RCTs提示米多君组疗效好于基础治疗组(P<0.01),2篇RCTs提示美托洛尔组和米多君组差异无统计学意义(P=0.51);不良反应发生率:3篇RCTs提示美托洛尔组和米多君组差异无统计学意义(P=0.14)。结论美托洛尔和米多君均能改善VVS患者的临床症状,增加治疗后HUTT试验转阴数,减少晕厥症状复发数,但两者在疗效方面无显著差异,仍需要大规模、多中心的RCT来探讨药物治疗VVS的疗效。
Objective To compare the effect of metoprolol with that of midodrine in the treatment of vasovagal syncope（VVS）using a systematic review. Methods The databases of Pub Med,Cochrane Library,Science Direct,CBM,CNKI and Wanfang were searched by computer. The search time was from the construction of databases to Nov. 2017. According to the Cochrane systematic review,we screened the data on the effects of metoprolol and/or midodrine on VVS;both English and Chinese randomized controlled trials（RCTs）were screened. Meta-analysis was performed using Rev Man 5.3 software. Efficacy of metoprolol group and/or midodrine group was compared. Results The symptom improvement rate：4 RCTs showed that metoprolol group was superior to the basic treatment group（P0.01）,4 RCTs suggested that the midodrine group was better than the basic treatment group（P0.01）,and 2 RCTs showed there was no significant difference between metoprolol group and midodrine group（P=0.63）;HUTT negative rate：6 RCTs showed metoprolol group was superior to the basic treatment group（P0.01）,3 RCTs indicated that the efficacy of midodrine group was better than the basic treatment group（P0.01）,and 3 RCTs indicated there was no significant difference between metoprolol group and midodrine group（P=0.05）,the recurrence syncope rate：3 RCTs showed that metoprolol group was better than the basic treatment group（P0.01）,4 RCTs indicated that the effect of midodrine group was better than that of the basic treatment group（P0.01）,and 2 RCTs showed that there was no significant difference between the metoprolol group and midodrine group（P=0.51）;adverse reaction rate：3 RCTs showed there was no significant difference between the metoprolol group and midodrine groups（P=0.14）.Conclusion Both metoprolol and midodrine can improve the clinical symptoms of patients with VVS,increase the number of negative HUTT test after treatment,and reduce the number of recurrence of syncope. However,there is no significant difference in efficacy i
作者
董童
牛少敏
刘亚红
董湘玉
DONG Tong,NIU Shao-min,LIU Ya-hong,DONG Xiang-yu(Department of Pediatric Cardiology,Lanzhou University Second Hospital , Lanzhou 730030, Chin)
出处
《中国实用儿科杂志》
CSCD
北大核心
2018年第5期353-359,共7页
Chinese Journal of Practical Pediatrics
基金
兰州市科技发展计划项目(2017-4-90)
