疏风清热法治疗偏头痛的Meta分析

Meta-analysis of Wind-dispersing and Heat-clearing Method for Migraine

对疏风清热法治疗偏头痛的随机对照试验进行系统评价。通过对CNKI、万方、PubMed、The Cochrane Library等数据库进行检索,收集整理疏散风热法治疗偏头痛的临床随机对照试验(RCT),检索时间自建库至2019年6月。两名研究者独立完成文献筛选、资料提取及偏倚风险评价,使用Cochrane 5.2.3推荐的工具进行偏倚风险评估,采用RevMan5.3软件进行Meta分析。共纳入8个RCT,均报告了临床有效率,提示疏风清热法疗效[RR=1.19,95%CI(1.13,1.26),P<0.000 01]优于单纯西药治疗;有2个研究报道了MCA和PCA血流变化,提示疏风清热法对MCA血流变化改善情况优于单纯西药治疗,PCA血流变化改善情况[RR=-1.01,95%CI(-2.65,0.63),P=0.23]与单纯西药治疗比较未见显著差异;有3个研究报告个别患者出现口干、腹泻、睡眠改变等不良反应,3个研究报告未发生不良事件。然而由于文献的数量和质量有限,其临床疗效及安全性有待进一步验证。

Objective A systematic review of randomized controlled trials of migraine treatment with wind-dispersing and heat-clearing method.CNKI,Wanfang,PubMed,The Cochrane Library database were searched from the inception to June 2019.RCTs of wind-dispersing and heat-clearing method for migraine were collected.Two investigators independently screened the articles,extracted the data,and evaluated the risk of bias of the included studies.The risk assessment was based on the bias risk assessment tool recommended by Cochrane 5.2.3,and Meta-analysis was performed using RevMan5.3 software.8 RCTs were included,all of which reported clinical efficacy,suggesting that the wind-dispersing and heat-clearing method[RR=1.19,95%CI(1.13,1.26),P<0.00001]is more effective compared with using western medicine alone;two studies have reported blood flow changes of MCA And PCA,suggesting that the improvement of MCA blood flow changes by wind-dispersing and heat-clearing method is better than that of using western medicine alone,and the improvement of PCA blood flow changes[RR=-1.01,95%CI(-2.65,0.63),P=0.23]had no significant statistic difference compared with western medicine treatment alone.Three studies reported adverse reactions such as dry mouth,diarrhea,and sleep changes in individual patients,and three studies reported no adverse events.However,due to the limitations of the number and quality of studies included,its clinical efficacy and safety are subject to more high-quality studies.