半夏白术天麻汤治疗急性脑梗死临床疗效及安全性的Meta分析

Clinical Efficacy and Safety of Banxia Baizhu Tianma Decoction in the Treatment of Acute Cerebral Infarction:a Meta-analysis

目的系统评价半夏白术天麻汤治疗急性脑梗死的临床疗效及安全性。方法计算机检索PubMed、中文科技期刊全文数据库(VIP)、万方数据库、中国期刊全文数据库(CNKI)中有关半夏白术天麻汤治疗急性脑梗死的随机对照试验及临床对照试验,文献检索年限为各数据库建库至2018年4月,采用Cochrane风险评估表评价其质量,通过RevMan 5.3软件提取资料并进行Meta分析。结果共纳入24项临床对照试验,Meta分析结果显示,应用半夏白术天麻汤联合西医基础治疗急性脑梗死,临床总有效率高于单独西医治疗[OR=4.62,95%CI(3.39,6.30),P<0.000 01];美国国立卫生研究院卒中量表(NIHSS)评分[MD=6.29,95%CI(1.96,10.62),P=0.004]、日常生活质量量表(ADL)评分[MD=9.81,95%CI(7.04,12.58),P<0.000 01]、神经功能缺损程度[MD=3.26,95%CI(2.49,4.03),P<0.000 01]、血浆黏度[MD=0.84,95%CI(0.37,1.30),P=0.000 4]、全血黏度[MD=0.81,95%CI(0.30,1.32),P=0.002]、超敏C反应蛋白[MD=0.84,95%CI(0.64,1.04),P<0.000 01]等指标改善程度优于单纯西医治疗。结论应用半夏白术天麻汤联合西医治疗急性脑梗死的临床疗效优于单纯西医治疗,但需高质量临床研究加以佐证。

Objective To systematically evaluate the clinical efficacy and safety of Banxia Baizhu Tianma decoction(BBTD) in the treatment of acute cerebral infarction(ACI).Methods The randomized controlled trials(RCTs) and clinical controlled trials(CCTs) about BBTD in treating ACI were reviewed from PubMed,VIP,China National Knowledge Infrastructure(CNKI),Wanfang database until April 2018.After the literature screening,data extraction,Cochrane bias risk assessment,Meta-analysis was conducted with RevMan 5.3 software.Results A total of 24 CCT were included in the study.The results showed that compared with western medicine treatment alone,the total clinical effective rate of BBTD and western medicine in treating ACI was higher[OR=4.62,95%CI(3.39,6.30),P<0.000 01],the NIHSS score[MD=6.29,95%CI(1.96,10.62),P=0.004],ADL score[MD=9.81,95%CI(7.04,12.58),P<0.000 01],neurological deficit degree[MD=3.26,95%CI(2.49,4.03),P<0.000 01],plasma viscosity[MD=0.84,95%CI(0.37,1.30),P=0.000 4],whole blood viscosity[MD=0.81,95%CI(0.30,1.32),P=0.002],and sensitive C-reactive protein[MD=0.84,95%CI(0.64,1.04),P<0.000 01] were improved,and showed the better safety.Conclusion The clinical effect of BBTD and western medicine treatment in treating ACI was better than that of western medicine treatment alone.However,high-quality clinical researches were needed to support it.