摘要
目的系统评价犀角地黄汤辅助治疗脑出血的疗效和安全性。方法检索PubMed,Embase,Cochrane Library,SinoMed,中国知网、万方数据、维普网、中国临床试验注册中心(ChiCTR)从建库至2018年7月19日收录的中文及英文文献,获取犀角地黄汤辅助治疗脑出血的随机对照试验(RCT)。对纳入文献进行资料提取和偏倚风险评价,采用RevMan 5. 3和STATA 15. 0软件进行疗效及安全性评价,运用GRADE进行证据质量评价。结果最终纳入8篇文献,涉及721例脑出血患者,均为脑出血急性期。Meta分析显示,犀角地黄汤联合常规治疗可以改善患者美国国立卫生院神经功能缺损量表(NIHSS)评分[WMD=-2. 85,95%CI (-3. 72,-1. 98),P <0. 05]。犀角地黄汤联合常规治疗有降低患者死亡率趋势,但差异无统计学意义[RR=0. 17,95%CI (0. 02,1. 31),P=0. 09]。犀角地黄汤联合常规治疗组不良反应发生率与常规治疗组比较差异无统计学意义[RR=0. 06,95%CI (0. 00,1. 06),P=0. 06]。研究结果未发现存在发表偏倚。证据质量均为低级。结论犀角地黄汤联合常规治疗可改善患者NIHSS评分,有降低患者死亡风险的趋势,且未显示不良反应。
Objective To systematically assess the efficacy and safety of Xijiao Dihuang Decoction (犀角地黄汤) as an adjuvant therapy for intracerebral hemorrhage ( ICH). Methods The Chinese and English literature were searched from PubMed,Embase,Cochrane Library,SinoMed,Chinese National Knowledge Infrastructure ( CNKI), Wanfang Data,VIP,China Clinical Trial Registry ( ChiCTR) from the establishment of the library to July 19,2018, and the randomized controlled trials ( RCTs) for the treatment of cerebral hemorrhage with Xijiao Dihuang Decoction were obtained. The data extraction and bias risk evaluation were performed for the included literature. The efficacy and safety evaluation were performed by RevMan 5. 3 and STATA 15. 0 software,and the quality of evidence was evaluated by GRADE. Results Finally,8 papers were included,involving 721 patients with cerebral hemorrhage,all of which were acute cerebral hemorrhage. Meta-analysis showed that Xijiao Dihuang Decoction combined with conventional treatment can improve the National Institutes of Health Neurological Deficit Scale ( NIHSS) score [WMD =- 2. 85,95% CI (- 3. 72,- 1. 98),P < 0. 05]. Xijiao Dihuang Decoction combined with conventional treatment had a tendency to reduce mortality,but the difference was not statistically significant [RR = 0. 17,95% CI ( 0. 02, 1. 31),P = 0. 09]. There was no significant difference in the incidence of adverse reactions between Xijiao Dihuang Decoction combined with conventional treatment group and the conventional treatment group [RR = 0. 06,95% CI ( 0. 00,1. 06),P = 0. 06]. The study found no publication bias. The quality of the evidence was low. Conclusion Xijiao Dihuang Decoction combined with conventional therapy can improve the NIHSS score of patients,which has a tendency to reduce the risk of death and does not show adverse reactions.
作者
王鹏程
曹雨清
薛亚楠
李国春
孙瑾
WANG Pengcheng;CAO Yuqing;XUE Yanan;LI Guochun;SUN Jin(School of Medicine and Life Sciences,Nanjing University of Chinese Medicine,Nanjing 210023)
出处
《中医杂志》
CSCD
北大核心
2019年第11期943-948,共6页
Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81373512)
江苏省自然科学基金(BK20161575)
关键词
犀角地黄汤
脑出血
随机对照试验
系统评价
META分析
Xijiao Dihuang Decoction (犀角地黄汤)
intracerebral hemorrhage
randomized controlled trial
systematic review
Meta-analysis
