半夏白术天麻汤治疗眩晕痰浊证的Meta分析

Meta Analysis of Pinellia and White Atractylodes and Gastrodia Decoction in Treating Vertigo with Phlegm Turbid Syndrome

目的:系统评价半夏白术天麻汤治疗眩晕痰浊证的有效性和安全性。方法:利用计算机检索中国知网(CNKI)、维普数据库(VIP)、万方数据库、PubMed数据库,收集半夏白术天麻汤治疗眩晕的临床随机对照研究文献。采用循证医学的方法,用Cochrane Reviewer′s Handbook评分评价纳入研究的文献质量,提取有效数据,采用RevMan 5.3软件对数据进行Meta分析。结果:共纳入14篇随机对照试验文献。Meta分析结果显示,半夏白术天麻汤治疗眩晕痰浊证的有效率明显优于氟桂利嗪组[OR=4.25,95%CI(0.97,6.09)],差异有统计学意义(P<0.001)。6个月复发率优于氟桂利嗪[OR=0.29,95%CI(0.15,0.56)],差异有统计学意义(P<0.001),但不良反应发生率比较,差异无统计学意义[RD=-0.03,95%CI(-0.07,0.02),P=0.31(>0.05)]。结论:半夏白术天麻汤治疗眩晕痰浊证疗效显著,且不良反应与氟桂利嗪无明显差异。但受限于纳入文献质量,难免对Meta分析结果造成一定的影响,所以有关结论尚需更多高质量研究加以验证。

Objective:To systematically evaluate the efficacy and safety of Pinellia and White Atractylodes and Gastrodia Decoction in treating vertigo with phlegm turbid syndrome.Methods:By using computer to search CNKI,VIP,Wanfang and PubMed databases,the clinical randomized controlled study literature of Pinellia and White Atractylodes and Gastrodia Decoction in treating vertigo was collected.By using the method of evidence-based medicine,and Cochrane reviewer′s Handbook score,the quality of the literature included in the study was evaluated,and the effective data was extracted.Revman 5.3 software was used to make Meta analysis of the data.Results:A total of 14 randomized controlled trials were included.The results of Meta analysis showed that the effective rate of Pinellia and White Atractylodes and Gastrodia Decoction in treating vertigo with phlegm turbid syndrome was significantly higher than that of flunarizine Group [OR=4.25,95%CI(0.97,6.09)],and the difference was statistically significant(P<0.01).The 6-month recurrence rate was better than that of flunarizine [OR=0.29,95%CI(0.15,0.56)],and the difference was statistically significant(P<0.01),but there was no significant difference in the incidence of adverse reactions[RD=-0.03,95%CI(-0.07,0.02),P=0.31(>0.05)].Conclusion:Pinellia and White Atractylodes and Gastrodia Decoction has a remarkable clinical curative effect on vertigo with phlegm turbid syndrome.There was no significant difference in the adverse reactions between it and flunarizine.However,limited by the quality of the included literature,it is inevitable to have some impact on the results of Meta-analysis,so more high-quality research is needed to verify the relevant conclusions.