天麻钩藤饮及其加减治疗眩晕的系统评价

Systematic Review on Vertigo Treatment with Tian-Ma Gou-Teng Decoction and Its Modifications

目的：系统、全面评价天麻钩藤饮治疗眩晕的临床有效率和安全性。方法：计算机检索中国期刊全文数据库、重庆维普中文科技期刊数据库、中国知网数据库、中国生物医学文献数据库网络版、万方数据库和中国中医药期刊文献数据库，查找天麻钧藤饮治疗眩晕的随机对照试验，检索时限均从建库至2013年3月31日。由2名研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后，采用RevMan5．0．2软件进行Meta分析。结果：共计纳入33项试验，涉及2922例眩晕患者。Meta分析结果显示，在临床有效性方面，中医治疗组与西医治疗组对比（OR=3．67，95％CI[2．66～5．07]）、中西医治疗组与西医治疗组对比（OR=3．28，95％CI[2．33～4．621），中医联合其他方法（如针灸、推拿）治疗组与中医其他方法治疗组对比（OR=2．29，95％CI[1．34。3．911），试验组疗效均优于对照组；在复发率方面，天麻钩藤饮治疗眩晕与对照组相比（OR=0．27，95％CI[0．12-0．651），天麻组优于对照组；在不良反应方面，天麻钩藤饮治疗眩晕与对照组相比（OR=0．40，95％CI[0．13～1．241）天麻组优于对照组；其他指标如生活质量，由于并没有完全报道的文献，未能进行下一步的分析。结论：本系统评价结果显示，与其他方法相对比，天麻钩藤饮治疗眩晕具有更好的临床有效率，且复发率较低，但安全性有待进一步评价。由于纳入研究的文献质量不高，当前证据尚不能确定完全适用于临床，但其疗效优势值得进一步研究，特别需要高质量的多中心、大样本及双盲的随机对照试验加以验证。

This study was aimed to make a systematic and comprehensive evaluation on clinical efficacy and safety of vertigo treatment with Tian-Ma Gou-Teng （TMGT） Decoction. Articles had been searched in the Chinese Journal Full-text Database, Chongqing VIP Chinese Scientific Journals Database, China National Knowledge Infrastructure （CNKI）, Chinese Biomedical Literature Database Online, Wanfang Data and Chinese Medicine Journal Literature Database for randomized controlled trials （RCT） on vertigo treatment with TMGT Decoction. The data retrieval time was from the establishment time of the database until present. Two investigators screened literatures, extracted data and assessed quality according to inclusion and exclusion criteria independently. RevMan5.0.2 was used in the meta-analysis. The results showed that a total of 33 trials were involved, which covered 2922 vertigo cases. The meta-analysis showed that from the aspect of clinical effectiveness, the comparison between Chinese medicine treatment group and modern medicine treatment group （OR = 3.67, 95% CI [2.66-5.07]）, comparison between integrative medicine treatment group and modern medicine treatment group （OR = 3.28, 95% CI [2.33-4.62]）, the comparison between Chinese medicine combined with other method （such as acupuncture, Tuina） treatment group＆amp;nbsp;and other Chinese medicine treatment group （OR = 2.29, 95% CI [1.34-3.91]）, therapeutic effect in the experimental group was better than the control group. For the aspect of relapse rate, TMGT Decoction in the treatment of vertigo was better than the control group （OR = 0.27, 95% CI [0.12-0.65]）. In the aspect of adverse reactions, TMGT Decoction in the treatment of vertigo was better than the control group （OR = 0.40, 95% CI [0.13-1.24]）. For aspects of other indicators such as quality of life, no further analysis was conducted since there was no complete reported literature. It was concluded that the system evaluation results showed that compared with other methods, TMGT Decoction has better clinical efficacy and low recurrence rate, but safety needs to be further eualuated. However, due to the quality of included studies was not high, current evidences cannot be determined to be fully applicable in the clinical practice. But its efficacy advantages are worthy of further research. It especially requires high quality multi-center, large sample, double-blind, RCTs to verify.