Phytomedicine Plus (Nov 2023)
Clinical efficacy and safety of Shensong Yangxin capsule combined with metoprolol for treating cardiac arrhythmia: A meta-analysis of randomized controlled trials
Abstract
Background: Many studies have shown that Shensong Yangxin capsule (SSYX)–metoprolol combination has efficacy in treating cardiac arrhythmia. However, it is still lacking large randomized controlled trials and comprehensive and rigorous systematic evaluations. Purpose: A meta-analysis was conducted to evaluate the efficacy and safety of Shensong Yangxin capsule (SSYX) combined with metoprolol for treating cardiac arrhythmia. Methods: The following databases were searched from inception to October 2022 for randomized controlled trials evaluating the effect of SSYX combined with metoprolol for treating cardiac arrhythmia: Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Scientific Journal Database. The quality of the included studies was evaluated using the Cochrane risk-of-bias tool. Subgroup and sensitivity analyses were conducted to explore possible sources of heterogeneity across eligible studies. Results: A total of 107 publications and 9550 participants were included. Compared with metoprolol alone, SSYX combined with metoprolol significantly improved the total electrocardiographic efficacy (risk ratio [RR]: 1.26, 95% confidence interval [CI]: 1.24–1.28) and the total clinical efficacy on the symptoms (RR: 1.26, 95% CI: 1.24–1.29) and significantly reduced the number of premature ventricular contractions (weighted mean difference: −923.55, 95% CI: −1337.15 – −509.95). In addition, the incidence of adverse reactions was significantly lower with the SSYX–metoprolol combination than with metoprolol alone (RR: 0.65, 95% CI: 0.55–0.78). Subgroup analysis revealed that the efficacy was higher when the SSYX dose was 1.6 g. Conclusions: The combination of SSYX and metoprolol exhibited higher electrocardiographic and clinical efficacy and fewer adverse effects than metoprolol alone for treating cardiac arrhythmia.
