目的 采用Meta分析的方法系统评价参松养心胶囊（SSYX）对心房颤动（AF）患者心脏结构功能及炎症因子影响。方法 检索8个主要中英文数据库中SSYX治疗AF的临床随机对照试验（RCT），同时手工检索灰色文献。文献质量评价以及森林图生成在RevMan 5.4软件中执行，敏感性评估与Egger回归在StataMP 17.0软件中执行。结果 共纳入55项RCTs，包含5 815例研究对象。Meta分析结果显示，SSYX可提高AF患者左室射血分数[MD＝4.67，95%置信区间（CI）(3.69，5.39)，P＜0.000 01]、6 min步行距离[MD＝65.86，95% CI (53.96，77.75)，P＜0.000 01]，降低房颤患者左室舒张末期内径[MD＝-4.23，95% CI (-5.59，-2.86)，P＜0.000 01]、左室收缩末期内径[MD＝-4.06，95% CI (-5.07，-3.06)，P＜0.000 01]、左房内径[MD＝-2.53，95% CI (-3.03，-2.03)，P＜0.000 01]、左房最大容积[MD＝-7.12，95% CI (-8.23，-6.01)，P＜0.000 01]、N末端脑钠肽前体[MD＝-184.99，95% CI (-227.34，-142.64)，P＜0.000 01）、脑钠肽（MD＝-54.29，95% CI (-94.32，-14.25)，P＝0.008]、血管紧张素Ⅱ[MD＝-26.64，95% CI (-30.85，-22.44)，P＜0.000 01]、超敏C反应蛋白（MD＝-1.36，95% CI (-1.86，-0.87)，P＜0.000 01]、C反应蛋白[MD＝-1.98，95% CI (-3.54，-0.42)，P＝0.01]、白细胞介素-6[MD＝-6.98，95% CI (-11.93，-2.03)，P＝0.006]，肿瘤坏死因子α[MD＝-1.98，95% CI (-2.43，-1.52)，P＜0.000 01]，基质金属蛋白酶2[MD＝-1.30，95% CI (-1.97，-0.64)，P＝0.000 1]。试验组不良反应发生率低于对照组[RR＝0.66，95% CI (0.44，1.00)，P＝0.05]。结论SSYX可提升AF患者的心脏结构功能水平，降低体内炎症反应，同时安全性良好。

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

中华中医药学会青年求实项目（2023-QNQS-01）；第六批北京市级中医药专家学术经验继承工作项目