益气活血方药治疗血管性痴呆的Meta分析

Meta Analysis of Replenishing Qi and Activating Blood prescription for Treatment of Vascular Dementia

目的评价益气活血方药治疗血管性痴呆的疗效和安全性。方法利用计算机检索中国生物医学文献数据库、中国知网、万方数据库与维普数据库,检索时间均从建库至2017年6月,查找研究方案为随机对照实验(RCT),干预措施为益气活血方药治疗血管性痴呆且已发表的较高质量文献。采用Rav Man 5.3.5软件进行Meta分析。结果最终纳入的RCT 21篇,共1716例血管性痴呆患者。结果显示:益气活血方药联合西药治疗血管性痴呆总体临床疗效与单纯西药治疗比较,其差异有统计学意义[OR=2.69,95%CI(2.15,3.37),P<0.00001];益气活血方药联合西药治疗血管性痴呆的MMSE评分与单纯西药治疗比较,差异有统计学意义[MD=2.68,95%CI(2.32,3.03),P<0.00001];益气活血方药联合西药常规治疗血管性痴呆的HDS评分与单纯西药常规治疗比较,差异有统计学意义[MD=4.56,95%CI(4.32,4.81),P<0.00001];治疗过程中未见明显不良反应。结论现有的证据表明益气活血方或益气活血方药联合西药治疗血管性痴呆的临床疗效优于单纯西药治疗,且能延缓精神状态与智力的损伤。

Objective To evaluate the efficacy and safety of clinical research studies of replenishing qi and activating blood prescription in the treatment of vascular dementia. Methods CBM, CNKI, VIP and Wanfang database were electronically searched for randomized controlled trials（ RCTs） on replenishing qi and activating blood prescription in the treatment of vascular dementia（ from June 1994 to June 2017）. Two reviewers independently screened literature according to the inclusion and exclusion criteria,and meta-analyses were performed by using Rev Man5.3.5 software. Results The results of meta-analysis indicated replenishing qi and activating blood prescription combined with western medicine had significant differences in the effective rate for vascular dementia compared with single western medicine routine treatment [ OR =2.69, 95% CI（ 2.15, 3.37）, P〈0.00001], and it had significant differences in treating the mini-mental state examination compared with single western medicine routine treatment [MD=2.68, 95% CI（ 2.32, 3.03）, P〈0.00001]. In addition, replenishing qi and activating blood prescription combined with western medicine was superior to single western medicine routine treatment [MD=4.56, 95%CI（4.32, 4.81）, P〈0.00001] in improving the Hasegawa dementia scale. Adverse reaction and event was slight in research report. Conclusion The existed limited evidences suggest replenishing qi and activating blood prescription combined with western medicine is quite effective in treating vascular dementia, it also can improve the mini-mental state examination and Hasegawa dementia scale.