摘要
目的:系统评价头痛宁胶囊治疗偏头痛的疗效,在临床护理中为偏头痛患者进行健康指导。方法:通过检索国内外已公开发表的头痛宁胶囊治疗偏头痛的随机对照试验,按照纳入、排除标准筛选文献,采用RevMan5.2软件对入选文献进行汇总分析,计算各研究的合并效应量指标,并使用漏斗图评价入选文献的发表偏倚。结果:共纳入24项研究,其中头痛宁胶囊治疗者为1309例,氟桂利嗪对照组1263例。Meta分析结果显示,头痛宁胶囊治疗偏头痛的总有效率(OR=2.72,95%CI为2.01～3.68)、VAS评分(WMD=-1.11,95%CI为-2.13～-0.10)、头痛发作次数(WMD=-1.40,95%CI为-1.49～-1.32)优于氟桂利嗪。在血液流变学影响方面,2组血浆黏度(WMD=-0.89,95%CI为-0.98～-0.81)、血小板聚集率(WMD=-13.23,95%CI为-14.51～-11.95)、红细胞压积(WMD=-0.08,95%CI为-0.09～-0.06)、全血黏度(WMD=-1.21,95%CI为-1.36～-1.06)差异具有统计学意义;在治疗机制研究方面,头痛宁胶囊改善偏头痛患者的血浆5-羟色胺(WMD=2.48,95%CI为-15.30～20.26)、降钙素基因相关肽水平(WMD=0.44,95%CI为-1.48～2.36)差异无统计学意义,而对血浆甲硫脑啡肽水平影响(WMD=-10.97,95%CI为-13.84～-8.10)差异有统计学意义。结论:采用头痛宁胶囊治疗偏头痛的疗效确切,在总有效率、VAS评分、改善血液流变学指标、降低血浆甲硫脑啡肽方面优于氟桂利嗪,可作为治疗偏头痛的备选药。
Objective:Evaluate the curative effect of curative effect of Toutongning capsules on treating migraine, To provide health advice for patients with migraine in clinical care.Methods:The randomized controlled trials of Toutongning capsules on treating migraine published were searched and then the literature were picked up by inclusion and exclusion criteria and was made meta-analysis by RevMan 4.2software and publication bias was tested by flannel plot.Results:There were 24 randomized controlled trials coincided with the inclusion and exclusion criteria,including 1309cases of Toutongning capsules and 1263cases of flunarizine.Meta-analysis showed that the total response rate [RR=2.73,95%CI(2.18,3.42)],VAS scores[WMD=-1.11,95% CI(-2.13,-0.10)],the frequency of headache episodes [WMD=-1.40,95%CI(-1.49,-1.32)]were statistical significant.Two study mete-analysis showed the changes of hematological parameter,such as plasma viscosity [WMD=-0.89,95%CI(-0.98,-0.81)],Platelet aggregation [WMD= -13.23,95%CI(-14.51,-11.95)],Hematocrit[WMD=-0.08,95%CI(-0.09,-0.06)land blood viseosity[WMD=-1.21, 95%CI(-1.36,-1.06)],were significantly different between two groups.There was no significant difference in plasma level of 5-hydroxytryptamine [WMD=2.48,95%CI(-15.30,20.26)land calcitonin gene-related [WMD=0.44,95%CI(- 1.48,2.36)].The level of methionine enkephalin [WMD=-10.97,95%CI (-13.84-8.10)]was significantly different between toutongning capsules and flunarizine.Conclusion:Toutongniug eapsules was superiority over flunarizine in terms of total response rate,VAS scores,frequency of headache episodes and the change of hematological parameter and the decrease i n plasma level of methionine enkephalin,which can be used as alternative drng to treat migraine.
作者
刘凤莲
LIU Fenglian(The Second Affiliated Hospital of Bengbu Medical College,Anhui Bengbu 233000,China)
出处
《中医药临床杂志》
2018年第11期2044-2049,共6页
Clinical Journal of Traditional Chinese Medicine
