健脾法治疗后循环缺血性眩晕Meta分析

Meta Analysis of Spleen Strengthening Therapy for Posterior Circulation Ischemic Vertigo

目的:评价采用中医健脾法治疗后循环缺血性眩晕的临床疗效。方法:计算机检索知网、万方、维普、The Cochrane Library、PubMed等数据库,筛选所有健脾法治疗后循环缺血性眩晕的临床随机对照试验,时间为建库至2020年,并手动审核相关参考文献。对照组患者采用西药治疗,试验组患者采用健脾方(汤)或健脾方(汤)联合西药治疗,应用Review Manager 5.3软件对临床有效率、椎-基底动脉血流速度、血脂、不良反应进行Meta分析。结果:最终纳入23篇文献,共2109例患者。试验组患者临床有效率[RR=1.19,(1.14,1.23)]高于对照组,试验组椎-基底动脉血流速度包括左椎动脉(LVA)[MD=5.17,95%CI(1.43,8.90)]、右椎动脉(RVA)[MD=4.60,95%CI(0.81,8.39)]、基底动脉(BA)[MD=4.75,95%CI(3.69,5.81)]显著增加,血脂指标包括:TC[MD=-0.4,95%CI(-0.53,-0.27)]、LDL-C[MD=-0.2,95%CI(-0.33,-0.08)],差异均具有统计学意义。结论:该Meta分析结果提示健脾法治疗后循环缺血性眩晕的效果甚佳,可有效提高临床有效率,促进椎基底动脉血流速度,降低总胆固醇及低密度脂蛋白,但还需更今后多中心、大样本、高质量临床随机对照试验来进一步证实。

Objective:To evaluate the clinical effect of invigorating spleen in treating posterior circulation ischemic vertigo.Methods:Search CNKI,WanFang,VIP,The Cochrane Library,PubMed and other databases,To screen the clinical randomized controlled trial of strengthening spleen in the treatment of posterior circulation ischemic vertigo from the establishment of the database to 2020,Patients in the control group were treated with western medicine,while patients in the experimental group were treated with Jianpi Decoction or Jianpi Decoction combined with western medicine.The clinical effective rate,vertebral-basilar artery blood flow velocity,blood lipid and adverse reactions were Meta analyzed by using Review Manager 5.3 software.Results:23 literatures were included,with a total of 2109 patients.The clinical effective rate of patients in the experimental group[RR=1.19,(1.14,1.23)]was higher than that in the control group.The blood flow velocity of vertebral-basilar artery in the experimental group included left vertebral artery(LVA)[MD=5.17,95%CI(1.43,8.90)],right vertebral artery(RVA)[MD=4.60,95%CI(0.81,8.39)],basal artery(BA)[MD=4.75,95%CI(3.69,5.81)]increased significantly,The lipid indexes include TC[MD=-0.4,95%CI(-0.53,-0.27)]and LDL-C[MD=-0.2,95%CI(-0.33,-0.08)].The differences were statistically significant.Conclusion:The results of this meta-analysis suggest that the method of invigorating spleen is effective in treating ischemic vertigo of posterior circulation,which can effectively improve the clinical effective rate,promote the blood flow velocity of vertebrobasilar artery,and reduce total cholesterol and low density lipoprotein,but it needs to be further confirmed by future multicenter,large sample and high quality clinical randomized controlled trials.