基于Meta分析的眩晕宁片治疗后循环缺血性眩晕临床评价研究

Meta-analysis of Clinical Evaluation of Xuanyunning Tablets in the Treatment of Posterior Circulation Ischemic Vertigo

目的:系统评价眩晕宁片治疗后循环缺血性眩晕的临床疗效以及安全性。方法:计算机检索CNKI、WanFang Data、VIP、SinoMed、PubMed、EMbase、the Cochrane Library和Web of Science数据库,搜集眩晕宁片治疗后循环缺血性眩晕的随机对照试验(RCT),检索时限均为从建库至2022年6月10日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4、Stata 13.0软件进行Meta分析和敏感性分析。结果:共纳入17个RCT,包括1 634例患者。Meta分析结果显示,眩晕宁片在后循环缺血性眩晕的治疗上对比常规西药治疗具有更高的痊愈率[RR=1.55,95%CI(1.38,1.75),P<0.000 01],能改善椎动脉血流速度[MD=5.80,95%CI(4.26,7.34),P<0.000 01]、血浆黏度[MD=-0.18,95%CI(-0.28,-0.08),P<0.000 01]、高切全血黏度[MD=-1.07,95%CI(-1.55,-0.59),P<0.000 01]、低切全血黏度[MD=-2.11,95%CI(-3.36,-0.86),P<0.000 01]和纤维蛋白原浓度[MD=-0.45,95%CI(-0.82,-0.09),P<0.000 01]。结论:在治疗后循环缺血性眩晕时,眩晕宁片在提高临床疗效、改善血液流变学指标方面有一定作用,但仍需更多大样本RCT加以证实。

Objective:To systematically review the clinical efficacy and safety of Xuanyunning tablets in the treatment of posterior circulation ischemic vertigo. Methods:CNKI, WanFang Data, VIP, SinoMed, PubMed, EMbase, the Cochrane Library and Web of Science databases were electronically searched to collect randomized controlled trials(RCTs) of Xuanyunning tablets in the treatment of posterior circulation ischemic vertigo from inception to July 10 th, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. RevMan 5.4, Stata13.0 software were used for meta-analysis and sensitivity analysis. Results: A total of 17 RCTs involving 1 634 patients were included. The results of meta-analysis showed that in the treatment of posterior circulation ischemic vertigo, Xuanyunning tablets had a better cure rate than conventional western medicine(RR=1.55, 95%CI 1.38 to 1.75, P<0.000 01). It could improve vertebral artery blood flow velocity(MD=5.80, 95%CI 4.26 to 7.34,P<0.000 01), plasma viscosity(MD=-0.18, 95%CI-0.28 to-0.08, P<0.000 01), high shear whole blood viscosity(MD=-1.07, 95%CI-1.55 to-0.59, P<0.000 01), low shear whole blood viscosity(MD=-2.11, 95%CI-3.36 to-0.86, P<0.000 01) and fibrinogen concentration(MD =-0.45, 95%CI-0.82 to-0.09, P<0.000 01). Conclusion:In the treatment of posterior circulation ischemic vertigo, Xuanyunning tablets have a certain effect on improving clinical efficacy and improving blood rheological indicators, but more large-sample double-blind RCTs are still needed to confirm the above conclusions.