摘要
目的基于Meta的分析方法系统评价川芎清脑颗粒联合常规西药治疗对比单用常规西药治疗偏头痛的有效性和安全性,以期为临床治疗提供循证参考。方法依据Meta的分析流程,首先制定合理的关键词和主题,运用综合搜索策略,计算机检索PubMed、Embase、Medline、Scifinder、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库、万方数据库,检索时限为自建库3统计软件进行Meta分析。结果共计纳入11项RCT,合计1099例患者。Meta分析结果显示,试验组患者的总有效率[OR=3.36,95%CI(2.33,4.84),P<00001]、血液流变学指标下降情况[OR=-0.59,95%CI(-0.73,-0.46),P<0.00001]、VAS评分下降情况[OR=-1.59,95%CI(-10,-1.09),P<0.00001]均优于对照组,差异均有统计学意义;而不良反应发生情况[OR=0.59,95%CI(0.24,1.45),P=0.25]与对照组相比无统计学意义。结论在治疗偏头疼上,川芎清脑颗粒联合常规西药较单独常规西药能显著提高临床总有效率,降低患者的血液流变学指标和VAS评分;但由于纳入本Meta分析的样本数量有限,且临床研究质量不高,必须开展更多设计严格、多中心、长期随访的大样本RCT进一步验证。
Objective To systematically review the effectiveness of Chuanxiong Qingnao granules combined with conventional western medicine in the treatment of migraine and provide evidences-based reference for clinical treatment.Methods Retrieved from Pub Med,Embase,Medline,Scifinder,Cochrane,CJFD,Wanfang Database,VIP and Wanfang Database from establishment to July 2019.RCTs were collected and Meta-analysis of data of clinical studies extracting was performed using Rev Man 5.3 software and quality evaluation was conducted using the Rev.Man 5.3 statistical software.Results Totally 11 RCTs were enrolled,involving 1099 patients.The results of meta-analysis showed that total effective rate[OR=3.36,95%CI(2.33,4.84),P<0.00001]was higher than the control group,and the level of hemorrheological parameters[OR=-0.59,95%CI(-0.73,-0.46),P<0.00001],the level of VAS score[OR=-1.59,95%CI(-2.10,-1.09),P<0.00001]was lower than the control group.The differences were statistically significant between two groups.But the occurrence of adverse reactions[OR=0.59,95%CI(0.24,1.45),P=0.25]had no statistical significance compared with the control group.Conclusions In the treatment of migraine,Chuanxiong Qingnao granule combined with conventional western medicine can significantly improve the clinical total effective rate,reduce the hemorheological index and VAS score of patients compared with conventional western medicine alone.However,due to the limited amount of samples and the low quality of clinical studies in this Meta-analysis,more RCTs with rigorous design,large scale and multiple centers,and long-term follow-up must be further verified.
作者
陈伟峰
CHEN Weifeng(Department of Neurology,Xingyang People’s Hospital,Henan Province,Xingyang 450100,China)
出处
《光明中医》
2020年第5期646-651,共6页
GUANGMING JOURNAL OF CHINESE MEDICINE
