摘要
【目的】系统评价血府逐瘀汤加减联合西药治疗缺血性中风的临床疗效和安全性。【方法】检索中国知网期刊全文数据库(CNKI)、维普、万方、中国生物医学数据库(CBM)、PubMed、EMBase等数据库,筛选采用血府逐瘀汤加减联合西药治疗缺血性中风的随机对照试验(RCT)文献,应用Cochrane评价员手册进行风险偏倚评估。采用RevMan5.3软件对各研究的总有效率以及美国国立卫生研究院脑卒中量表(NIHSS)评分、Barthel指数(BI)、中医症候评分改善情况进行Meta分析。【结果】共纳入22篇RCT文献,涉及2 261例患者。Meta分析显示:血府逐瘀汤加减联合西药(治疗组)治疗缺血性中风在提高总有效率及改善NIHSS评分、BI评分、中医症候评分方面优于单纯西药(对照组),差异均有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。漏斗图提示纳入研究的文献同质性较好,发表性偏倚的可能性小。【结论】血府逐瘀汤加减联合西药治疗缺血性中风的临床疗效优于单纯西药治疗。但因纳入研究的文献质量偏低,此结论仍需更多高质量、多中心的大样本双盲随机对照试验加以验证。
Objective To evaluate the clinical efficacy and safety of modified Xuefu Zhuyu Decoction combined with western medicine in treating ischemic stroke,thus to supply evidence for its clinical application. Methods After searching randomized controlled trials（RCTs） of Xuefu Zhuyu Decoction combined with western medicine in treating ischemic stroke from CNKI,VIP,Wanfang,CBM,PubMed,EMBase databases,we evaluated the quality of RCTs by the Cochrane scale,and performed the meta-analysis of the clinical outcomes of total effective rate, National Institutes of Health Stroke Scale（NIHSS）scores, Barthel index（BI）scores and traditional Chinese medicine（TCM）symptom scores with Rev an5.3 software. Results A total of 22 RCTs were included,involving 2261 patients. Meta-analysis results showed that modified Xuefu Zhuyu Decoction combined with western medicine in treating ischemic stroke was more effective on enhancing the total effective rate,and on improving NIHSS scores,BI scores,TCM symptom scores than western medicine alone,the difference being statistically significant（P〈0.05）. But there was no significant difference in the adverse reactions between the two groups（P〈0.05）. The funnel chart showed that the included studies had good homogeneity, with less likely to having publication bias. Conclusion Modified Xuefu Zhuyu Decoction combined with western medicine is more effective for treating ischemic stroke than western medicine. However,for the quality of the included studies is relatively low, more high-quality and multicenter large-sample-size double-blind randomized controlled trials will be needed for verifying the conclusion.
作者
张令霖
连新福
方格
徐敏
王彬
李先涛
ZHANG Ling-Lin;LIAN Xin-Fu;FANG Ge;XU Min;WANG Bin;LI Xian-Tao(The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Neurology,Zhuhai Hosptial of Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai 519015 Guangdong,China;School of Basic Medical Science,Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong.China)
出处
《广州中医药大学学报》
CAS
2018年第5期927-933,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家重点基础研究发展计划(973计划)项目(编号:2014CB542901)
