This systematic review was registered at PROSPERO (registration number CRD42013003200). A systematic literature search of 8 core electronic databases and 3 clinical trial registries in Chinese and English, yielded 10 trials whose randomness verified by contacting the authors. The included trials were assessed by the Cochrane risk of bias tool.
RESULTS:
Wenxin Keli might be more efficacious than placebo (Change of VPBs numbers, RR, 1.61, 95%CI, 1.48-1.76, P<0.00001, I2=0%;VPBs- related symptom, RR, 2.10, 95%CI, 1.91-2.30, P<0.00001, I2=0%), and the dual
therapy of
Wenxin Keli plus
amiodarone might also be more effective than the monotherapy of
amiodarone (Change of VPBs numbers, RR, 1.23, 95%CI, 1.10-1.39, P=0.0005, I2=0%; VPBs- related symptom, RR, 1.51., 95%CI, 1.30-1.76, P<0.00001, I2=0%), whereas
Wenxin Keli might be comparable to
metoprolol,
propafenone or
mexiletine (Change of VPBs numbers:
metoprolol, RR, 1.01, 95%CI, 0.91-1.11, P=0.88, I2=0%;
propafenone, RR, 1.05, 95%CI, 0.93-1.19, P=0.44, I2=0%;
mexiletine, RR, 1.06, 95%CI, 0.96-1.17, P=0.28. VPBs- related symptom:
metoprolol, RR, 0.95, 95%CI, 0.87-1.04, P=0.27, I2=0%,
propafenone. RR, 1.10, 95%CI, 0.93-1.30, P=0.29, I2=29%,
mexiletine,RR, 0.94, 95%CI, 0.78-1.12, P=0.47). Participants with ventricular
premature beats' numbers<360 beats/h or with
coronary heart disease benefited the most of the
Wenxin Keli therapy (Change of VPBs numbers:RR, 1.10, 95%CI, 1.02-1.20, P=0.02, I2=44%; RR, 1.71, 95%CI, 1.18-2.49, P=0.005, I2=54%, respectively). The safety analysis revealed that
Wenxin Keli did not statistically significant differed from the Western medicine in respect of the incidence of total
adverse drug reactions (RR, 0.59, 95%CI, 0.35-1.01, P=0.05, I2=0%), but
Wenxin Keli might be associated with a reduced risk of proarrhythmic reactions (P=0.007). The quality of the methodology of included trials was generally low. Several limitations existed that affected the validity of the findings, including the small sample size, insufficient randomization methods, poorly defined eligibility criteria, short duration of follow-up, absence of hard endpoints, and high risk of publication bias(P=0.013).
CONCLUSIONS: