当归四逆汤与西药治疗偏头痛的疗效和安全性评价的Meta分析

Meta-analysis of Efficacy and Safety Evaluation of Dangguisini Decoction and Western Medicine in the Treatment of Migraine

目的:对当归四逆汤与西药治疗偏头痛的临床疗效和安全性对比进行系统评价。方法:检索CNKI、SinoMed、VIP、Wanfang Data、Pubmed、Embase、Cochrance数据库,从建库至2021年1月公开发表的当归四逆汤治疗偏头痛的随机对照试验,运用Review Manager 5.3软件进行分析。结果:6项临床随机对照试验(484例患者)疗效表明,当归四逆汤试验组治疗偏头痛可降低头痛程度积分[MD=-1.05,95%CI(-1.50,-0.60),P<0.000]、缩短头痛持续时间[MD=-1.23,95%CI(-1.65,-0.80),P<0.000]、改善症状积分[MD=-0.71,95%CI(-0.93,-0.50),P<0.000]、减少发病次数[MD=-1.22,95%CI(-1.54,-0.90),P<0.000],综合疗效[OR=4.39,95%CI(2.29,8.38),P<0.000]均优于对照组。结论:现有的临床试验表明,当归四逆汤治疗偏头痛其疗效优于对照组,鉴于纳入研究文献质量一般,需要设计严谨、方法学规范、报告明确的高质量临床随机对照试验进一步夯实证据。

Objective To systematically evaluate the clinical efficacy and safety of Dangguisini Decoction and western medicine in the treatment of migraine.Methods CNKI,Sinomed,VIP,WanfangData,PubMed,Embase,and Cochrance databases were retrieved.RCTs of Dangguisini Decoction in the treatment of migraine were analyzed by ReviewManager5.3 software from the establishment of the database to the publication in January 2021.Results Six clinical randomized controlled trials(484 patients)curative effect shows that the degree of angelica decoction group four treatment reduce migraine headache integral[MD=-1.05,95%CI(-1.50,-0.60),P<0.000],shorten the duration of headache[MD=-1.23,95%CI(-1.65,-0.80),P<0.000),the improvement of symptoms integral[MD=-0.71,95%CI(-0.93,-0.50),P<0.000),reduce the number[MD=-1.22,95%CI(-1.54,-0.90),P<0.000],the comprehensive efficacy[OR=4.39,95%CI(2.29,8.38),P<0.000]were better than the control group.Conclusion The existing clinical trials show that Dangguisini Decoction has better efficacy than the control group in the treatment of migraine.Considering the poor quality of the included studies,high-quality randomized controlled clinical trials with rigorous design,standardized methodology and clear reports are needed to further consolidate the evidence.