中药注射液辅助治疗血管性痴呆的网状Meta分析

Network Meta-analysis of Clinical efficacy of Traditional Chinese Medicine Injection Combined with Western Medicine in the Treatment of Vascular Dementia

目的基于网状Meta分析系统评价中药注射液辅助治疗血管性痴呆的效果。方法计算机检索PubMed、Web of Science、Cochrane Library、中国知网(CNKI)、万方数据库(Wanfang)、中国生物医学文献数据库(CBM)、维普数据库(VIP)等数据库中有关中药注射液辅助治疗血管性痴呆的临床随机对照试验(RCT),检索时限为各数据库建库到2021年12月。用Cochrane偏倚风险评估工具对所纳入的研究进行质量评价,应用Stata16.0软件进行Meta网状分析。结果最终纳入46个RCTs,涉及6种中药注射液。网状Meta分析结果显示:(1)改善总有效率方面:中药注射液疗效排序依次为西医常规治疗联合复方丹参注射液>醒脑静注射液>舒血宁注射液>银杏达莫注射液>疏血通注射液>丹红注射液>西医常规治疗;(2)在MMSE评分方面:中药注射液疗效排序依次为西医常规治疗联合复方丹参注射液>醒脑静注射液>银杏达莫注射液>舒血宁注射液>丹红注射液>疏血通注射液>西医常规治疗;(3)在ADL评分方面:中药注射液疗效排序依次为西医常规治疗联合疏血通注射液>醒脑静注射液>复方丹参注射液>银杏达莫注射液>舒血宁注射液>丹红注射液>西医常规治疗。结论中药注射液辅助西医治疗对血管性痴呆的治疗均显示出优势。其中复方丹参注射液在有效率、MMSE评分改善方面,疏血通注射液在ADL评分改善方面,称为最佳选择的可能性最大。

Objective To assess the efficacy of Traditional Chinese Medicine(TCM)injection in the treatment of vascular dementia(VD)by using the method of network Meta-analysis.Methods Randomized controlled trials of Traditional Chinese Medicine injection for vascular dementia were retrieved from PubMed、Web of Science、Cochrane Library、CBM、CNKI、Wanfang and VIP databases from the time of database establishment to December 2021.The quality of the included RCTs was evaluated according to the Cochrane bias risk standard,and the data was analyzed by Stata 16.0.Results A total of 6 kinds of Traditional Chinese Medicine(TCM)injection in 27 RCTs were eventually included.According to the results of network Meta-analysis.①In terms of the effective rate,the order of Traditional Chinese Medicine injection was conventional Western medicine combined with Compound Danshen Injection>combined with Xingnaojing Injection>combined with Suxuening Injection>combined with Yinxingdamo Injection>combined with Shuxuetong Injection>Danhong Injection>conventional Western medicine.②In terms of MMSE score,the order of Traditional Chinese Medicine injection was conventional Western medicine combined with Compound Danshen Injection>combined with Xingnaojing Injection>combined with Yinxingdamo Injection>combined with Suxuening Injection>Danhong Injection>conventional Western medicine.③In terms of ADL scores,the order of Traditional Chinese Medicine injection was conventional Western medicine combined with Shuxuetong Injection>Xingnaojing Injection>Compound Danshen Injection>Yinxingdamo Injection>Suxuening Injection>Danhong Injection>conventional Western medicine.Conclusion Traditional Chinese Medicine injection combined with western medicine can improve the clinical efficacy in the treatment of vascular dementia.Compound Danshen Injection and Shuxuetong Injection had the greatest possibility to be the best choice in terms of efficiency and MMSE score improvement.