辨证治疗疲劳型亚健康随机对照试验的系统评价

Systematic Evaluation of Randomized Controlled Trials on the Treatment of Sub-Health Fatigue Based on Syndrome Differentiation

目的:系统评价国内中药治疗疲劳型亚健康的临床疗效。方法:通过计算机检索中国知网(CNKI)、维普(VIP)及万方数据库(WANFANG DATA),收集中药治疗疲劳型亚健康随机对照试验(RCT),按照纳入标准和排除标准对文献进行筛选和数据提取。运用Rev Man 5.3软件对提取数据进行Meta分析,比较辨证治疗下的中药处方(剂型不限制)与一般治疗疲劳型亚健康的药物或方法临床有效率,以及各种生化指标的变化。结果:Meta分析结果显示,辨证治疗下的中药处方治疗疲劳型亚健康的效果优于一般治疗疲劳型亚健康的药物或方法,例如维康复、三磷酸腺苷、谷维素片等药物或健康宣教等方法;但纳入的研究大部分并未报道复发率、生活质量及不良反应,无法对这些指标进行进一步分析。结论:与一般治疗疲劳型亚健康的药物或方法相比,辨证治疗下的中药处方在治疗疲劳型亚健康上有更好的好转率和治愈率;但由于纳入文献数量较少,质量较低,所以需要设计严谨、合理的大样本随机对照试验进一步研究。

Objective:To systematically evaluate the clinical effect of Chinese medicinal on sub-health fatigue.Methods:Through computer retrieval of CNKI,VIP and Wanfang database,randomized controlled trials(RCTs)of Chinese medicinal in the treatment of sub-health fatigue were collected,the literature were screened and data were extracted according to the inclusion criteria and exclusion criteria.Rev Man 5.3 software was used to do Meta-analysis,the clinical efficiency of traditional Chinese medication(unlimited dosage form)based on syndrome differentiation were compared to that of general medication in terms of treating sub-health fatigue,the changes of various biochemical indexes were also compared.Results:The results of Meta-analysis showed that the effect of Chinese medication was better than that of general treatment,such as Weikangfu,triphosadenine,oryzanol and health education methods,in treating sub-health fatigue.However,most of the studies included in this study did not report the recurrence rate,quality of life and adverse reactions,which could not be further analyzed.Conclusion:This study shows that,compared to the general treatment for fatigue sub-health,the Chinese medication based on syndrome differentiation has a better improvement rate and cure rate;however,due to the small number of included literature and low quality,it is necessary to design rigorous and reasonable large sample randomized controlled trials for further study in the future.