川芎茶调散加减联合氟桂利嗪治疗偏头痛疗效的Meta分析

Clinical Efficacy of Chuanxiongchatiao Powder Combined with Flunarizine in the Treatment of Migraine:A Meta-analysis

目的:评价川芎茶调散加减联合盐酸氟桂利嗪治疗偏头痛的临床疗效与安全性。方法:使用计算机检索CNKI、VIP、CBM、WANFANG以及FMJS、CL、MEDLINE、EMBASE、WOS的相关文献,筛选出国内外有关以"川芎茶调散加减"为基础的不同中药复方制剂联合盐酸氟桂利嗪(西比灵)治疗偏头痛的临床随机对照实验(RCT),提取资料,采用Cochrane协作网推荐的偏倚风险评估工具评估偏倚风险,运用Rev man5.3软件进行Meta分析。结果:共纳入12项RCT,包括1302例偏头痛患者。Meta分析结果显示:川芎茶调散加减联合氟桂利嗪治疗偏头痛有较好的临床疗效,其疗效优于单纯西药治疗;前者减缓大脑前、中、后动脉血流速度及降低血液纤维蛋白原的作用优于后者;两组降低血液黏度的作用无统计学差异;两组不良反应发生率均较低。结论:通过临床观察,川芎茶调散加减联合盐酸氟桂利嗪治疗偏头痛有较好的临床疗效及安全性,但鉴于纳入研究的偏倚风险较大,尚需进一步开展多中心、高质量、大样本的临床随机对照实验予以验证。

Objective:To assess the clinical efficacy and safety of Chuanxiongchatiao powder combined with flunarizine hydrochloride in treatment of migraine.Methods:We searched for related articles in Chinese journal full text database(CNKI),Chinese science and technology periodical database(VIP),Chinese biomedical literature service system(CBM)WANFANG data and Western biomedical journal literature service system(FMJS),the Cochrane library(CL),MEDLINE,EMBASE as well as the Wed of Sciences(WOS)by computer,and then screened at home and abroad to find out the randomized clinical trials(RCT)which use different traditional Chinese medicine preparation based on the addition and subtraction of Chuanxiongchatiao powder combined with flunarizine hydrochloride(Sibelium)in the treatment of migraine.After that,extracted data and used bias risk assessment tool recommended by Cochrane collaboration to assess bias risk.Meta-analysis was carried out by using Rev Man 5.3 software.Results:A total of 12 RCT were included,including 1302 patients with migraine.Meta-analysis showed that:Chuanxiongchatiao powder combined with flunarizine in treatment of migraine,the clinical efficacy is better than pure western medicine group;the former is superior to the latter in slowing the velocity of blood flow in the cerebra′s anterior,middle and posterior arteries and reducing the blood fibrinogen;the effect of the two groups on reducing blood viscosity was not statistically significant;the incidence of two groups of adverse reactions was low.Conclusion:As far as the current clinical evidence is concerned,Chuanxiongchatiao powder combined with flunarizine hydrochloride in the treatment of migraine has better clinical efficacy and safety,however,in view of the greater risk of bias in the inclusion study,further clinical randomized controlled trials of multi center,high quality and large sample need to be further tested.