小柴胡汤治疗中风后眩晕的Meta分析

Meta-analysis of Xiaochaihu Tang in Treating Apoplectic Vertigo

目的:系统评价小柴胡汤(Xiaochaihu Tang)治疗中风后眩晕(apoplectic vertigo)的临床疗效。方法:电子计算机检索The Cochrane Library,Pubmed,Embase,中国期刊全文数据库(CNKI),中国生物医学文献数据库(CBM),中国科技期刊全文数据库(VIP)和万方数据库,检索时间限定为建库至2015年6月19日,检索所有小柴胡汤治疗中风后眩晕的随机对照试验(randomized controlled trials,RCTs),并追索纳入研究的参考文献。由两位评价者独立对纳入研究的质量进行严格评价和资料提取后,采用Rev Man 5.3软件进行Meta分析。结果:最终纳入12个研究,共1 181例患者。Meta分析结果显示:小柴胡汤治疗中风后眩晕患者在临床总有效率和降低血浆黏度方面均优于单纯使用西医治疗方案[总有效率:OR=7.53,95%CI(5.08,11.17),Z=10.05,P<0.000 01;降低血浆黏度:MD=-0.49,95%CI(-0.53,-0.45),Z=21.99,P<0.000 01],两组差异均具有统计学意义。不良反应方面,2项研究跟踪报道了治疗中出现的不良反应:试验组患者治疗期间均未出现严重不良反应,对照组患者治疗期间共出现5例口干,5例嗜睡,7例肠胃不适,数据比较有统计学意义(P<0.5)。结论:小柴胡汤治疗中风后眩晕能显著提高临床有效率和降低血浆黏度,相比单纯使用西医治疗方案具有一定优势。但本系统评价纳入的所有研究方法学和报告质量均较低,且样本量较少,故小柴胡汤治疗中风后眩晕的临床疗效以及安全性仍需要严格的、多中心、大样本的随机双盲试验加以验证。

Objective： To systematically evaluate the safety and efficacy of Xiaochaihu Tang in treating apoplectic vertigo. Method： We searched the Cochrane Library,Pubmed, Embase, CNKI, CBM, VIP and Wanfang Data through computer for data as at June19,2015. All of randomized controlled trials（ RCTs） of Xiaochaihu Tang in treating apoplectic vertigo were searched,and research literatures included in the RCTs were also traced. Two researchers independently conducted the strict quality evaluation and data extraction for the included studies and made a Meta-analysis by using Rev Man 5. 3 software Result： Totally 12 RCTs involving 1 181 patients were included into the study. The Meta-analysis results showed that compared with the pure application of western medicine,Xiaochaihu Tang can significantly improve the clinical effective rate [OR = 7. 53,95% CI（ 5. 08,11. 17）, Z = 10. 05, P 〈 0. 000 01 ], reduce plasma viscosity [MD =-0. 49, 95% CI（-0. 53,-0. 45）,Z = 21. 99,P 〈 0. 000 01],with statistical significant differences. In the adverse reactions,only two study showed the adverse reactions in follow-up reports： the experiment group showed no serious adverse eventsduring treatment,whereas the control group showed 5 cases of dry mouth,5 cases of sleepiness and7 cases of intestines and stomach discomfort during treatment, with statistically significant differences（ P 〈 0. 5）.Conclusion： Xiaochaihu Tang in treating apoplectic vertigo can effectively improve the clinical effective rate and reduce plasma viscosity and is advantageous over the simple administration with western medicine. However,due to the low methodology and quality and small sample size of included RCTs in this study,more strict multicenter,randomized,double-blind trials with a large sample size are required to further verify the efficacy and safety of Xiaochaihu Tang in treating apoplectic vertigo.