活血化瘀药治疗椎动脉型颈椎病的Meta分析

Meta-analysis of Treating Cervical Spondylosis of Vertebral Artery Type with Medicine of Activating Blood Circulation and Removing Stasis

目的:系统评价活血化瘀药治疗椎动脉型颈椎病的疗效与安全性。方法:计算机检索中国知网、万方、维普、Pub Med、Cochrane Library等数据库自收录以来至2016年12月发表的活血化瘀药治疗椎动脉型颈椎病的临床随机对照试验,并用Cochrane协作网提供的Review Manager 5.3软件对提取的数据进行Meta分析。结果:最终纳入10个研究,共1209例患者。合并10个研究结果显示,活血化瘀药治疗椎动脉型颈椎病临床总有效率与西药比较,差异有统计学意义,RR=1.15,95%CI=[1.10,1.20],P<0.000 01;临床治愈率与西药相比,差异有统计学意义,RR=1.62,95%CI=[1.31,2.01],P<0.000 01。结论:现有的证据表明,活血化瘀药治疗椎动脉型颈椎病有一定效果;但纳入研究数量偏少且质量偏低,尚需要更多大样本、多中心、双盲,甚至三盲的随机对照试验来进一步证实其临床疗效。

Objective：To systematically evaluate the efficacy and safety of medicine of activating blood circulation and removing stasis in the treatment of cervical spondylosis of vertebral artery type.Methods：A retrieval for randomly controlled trials for the treatment of vertebral artery type of cervical spondylosis with medicine of activating blood circulation and removing stasis was made from the databases such as CNKI,Wan Fang,VIP,PubMed,and Cochrane Library（from the establishment of each database to December 2016）.Review Manager 5.3 provided by the Cochrane Collaboration was used to make a meta-analysis to selected data.Results：There are 1209 patients in the ten studies involved.The results showed that the treatment differences between medicine of activating blood circulation and removing stasis and westen medicine were statistically significant（RR = 1.15,95% CI =[ 1.10,1.20],P 〈 0.000 01）.The difference of clinical cure rate between them was statistically signifcant（RR = 1.62,95% CI = [1.31,2.01],P 〈 0.000 01）.Conclusion：The available evidence suggests that medicine of activating blood circulation and removing stasis has a certain effect in the treatment of cervical spondylosis of vertebral artery type,but the number of the included studies is not enough and has low quality.Thus,more large-sample,multicenter,double-blind,even triple-blind randomly controlled trials are needed to further confrm the clinical curative effect.