稳心颗粒干预心肌缺血大鼠电生理重构的系统评价
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国家自然科学基金重点项目经费资助(81430098)


Systematic Review on Intervention of Wenxin Granules in Electrophysiological Remodeling of Myocardial Ischemical Rats
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    摘要:

    目的:运用系统评价方法评价中成药稳心颗粒对心肌缺血后心肌电生理重构的影响。方法:以“稳心”的中英文检索式为主题词检索CNKI、CBM、万方、维普、EBbase、Pubmed、Cochrane、Web of science数据库中的期刊学术论文,筛选出符合纳入排除标准的动物实验研究,运用SYRCLE动物实验偏倚风险评估工具对文献质量进行评估并分析结局指标。结果:共纳入7篇有效动物实验研究,评估后认为质量均较低。主要结局指标是心电图、缝隙连接结构、缝隙连接蛋白及其mRNA,CaM/CaMKII信号转导通路相关蛋白,相关mi-RNAs以及心肌细胞动作电位,由于纳入研究中结局指标均缺少具体数值,无法量化,故使用描述性系统评价对结局指标进行总结性评价;结论:稳心颗粒能改善不同类型的心律失常并且直观地反映在心电图上,同时能够改善缝隙连接超微结构,改变缝隙连接蛋白及其mRNA、CaM/CaMKII信号转导通路相关蛋白、相关mi-RNAs的表达水平,调节心肌细胞离子通道以维持正常的心肌细胞动作电位,从而发挥改善大鼠缺血心肌电生理重构的作用,但纳入评价研究质量均较低,还需要方法学更完善的高质量实验研究进行相关机制的深入探索。

    Abstract:

    To evaluate effects of Chinese patent medicine-Wenxin Granules compound on myocardial electrophysiological remodeling after myocardial ischemia by the method of systematic review.Methods:Academic papers from journals in CNKI,CBM,Wanfang,VIP,EBbase,Pubmed,Cochrane and Web of science databases were searched by using Chinese and English search terms of “Wenxin” as subject words,and animal experimental studies meeting inclusion and exclusion criteria were screened out.An assessment tool of bias risk in animal experiment-SYRCLE was applied to evaluate quality of literature and analyze outcome indicators.Results:A total of 7 papers on effective animal experiment were included.After the evaluation,it was found that their quality was relatively low.The main outcome indicators were ECG,gap junction structure,gap junction protein and its mRNA,CaM/CaMKII signaling pathway related proteins,related mi-RNAs and action potential of cardiomyocytes.Due to the lack of specific values and quantification of outcome indicators in the included studies,descriptive systematic review was used for summative evaluation of outcome indicators.Conclusion:Wenxin Granules can improve different types of arrhythmia and make it intuitively reflected on the electrocardiogram.At the same time,it can improve the ultrastructure of gap junction,change expression levels of the gap junction protein and its mRNA,the CaM/CaMKII signaling pathway related proteins,and the related mi-RNAs,and regulate cardiomyocyte ion channels to maintain normal cardiomyocyte action potentials,thereby improving the electrophysiological remodeling of ischemic myocardium in rats.However,the quality of studies included in the evaluation is relatively low,which requires further exploration of relevant mechanism by high-quality experimental studies with better methodology.

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黄涯,何天麦,吴爱明,商洪才.稳心颗粒干预心肌缺血大鼠电生理重构的系统评价[J].世界中医药,2019,(10).

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  • 收稿日期:2019-09-10
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  • 在线发布日期: 2019-11-21
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