通窍活血汤联合西药治疗血管性痴呆临床疗效和安全性Meta分析

Meta-analysis of Clinical Efficacy and Safety of Tongqiao Huoxue Decoction Combined with Western Medicine in Treating Vascular Dementia

【目的】系统评价通窍活血汤联合西药与常规疗法(简称西药治疗)治疗血管性痴呆的临床疗效和安全性。【方法】计算机检索PubMed、Embase、Medline、Cochrane Library、中国知网、维普、万方、中国生物医学文献数据库(CBM)等,收集关于通窍活血汤联合西药与常规疗法(观察组)对比西药与常规疗法(对照组)治疗血管性痴呆的随机对照试验(RCTs),通过Cochrane偏倚风险评估工具对纳入的研究进行文献质量评价,采用RevMan 5.3软件进行Meta分析。【结果】共纳入16项研究,合计1415例患者,其中对照组707例,观察组708例。Meta分析结果显示:通窍活血汤联合西药治疗血管性痴呆的临床疗效显著高于单纯西药治疗[OR=3.28,95%CI(2.45,4.40)],通窍活血汤联合西药较单纯西药治疗可显著提高简易精神状态评价量表(MMSE)评分[MD=3.31,95%CI(2.63,3.99)],差异均有统计学意义(P<0.00001)。两组之间在用药安全性方面差异无统计学意义[OR=0.87,95%CI(0.42,1.80),P=0.71]。【结论】目前文献证据表明,在西药治疗的基础上加用通窍活血汤可有效提高血管性痴呆的临床疗效,改善MMSE评分,并且不会明显增加不良反应的发生率。

Objective To systematically evaluate the clinical efficacy and safety of Tongqiao Huoxue Decoction combined with oral use of western medicine and conventional therapy(hereinafter referred to as western medicine treatment)in the treatment of vascular dementia.Methods Randomized controlled trials(RCTs)of Tongqiao Huoxue Decoction combined with western medicine treatment(observation group)versus western medicine treatment(control group)in the treatment of vascular dementia were collected by computer retrieval of the databases of PubMed,Embase,Medline,Cochrane Library,CNKI,VIP,Wanfang,and CBM.The literature quality of the included studies was evaluated by Cochrane bias risk assessment tool,and meta-analysis was performed by using RevMan5.3 software.Results A total of 16 studies were included and involved 1415 patients,707 patients in the control group and 708 patients in the observation group.The results of meta-analysis showed that the clinical efficacy of Tongqiao Huoxue Decoction combined with western medicine treatment in treating vascular dementia was superior to that of the western medicine treatment[OR=3.28,95%CI(2.45,4.40)],and Tongqiao Huoxue Decoction combined with western medicine treatment was more effective on improving the MMSE scores than western medicine treatment alone[MD=3.31,95%CI(2.63,3.99)],the differences being all significant(P<0.00001).There was no significant difference in medication safety between the two groups[OR=0.87,95%CI(0.42,1.80),P=0.71].Conclusion Current literature evidence shows that the application of Tongqiao Huoxue Decoction on the basis of western medicine treatment can effectively enhance the clinical efficacy for vascular dementia and improve the MMSE scores,without increasing the incidence of adverse reactions.