桃核承气汤治疗脑出血疗效及安全性的Meta分析

Efficacy and Safety of Taohe Chengqi Decoction for Cerebral Hemorrhage:A Meta-analysis

目的:系统评价了桃核承气汤治疗脑出血的疗效及安全性。方法:检索9个中英文数据库,纳入桃核承气汤联合西医常规治疗与单用西医药物比较治疗脑出血性疾病的随机对照试验(RCTs)。结果:11篇RCTs(n=811)的荟萃分析的结果显示,桃核承气汤联合西医常规观察组的有效率高于对照组(RR=1.12,95%CI为1.05~1.19,P<0.001);与对照组比较,观察组能显著减少脑出血量(WMD=-3.88,95%CI为-5.14~-2.61,P<0.001),改善脑出血症状评分(WMD=-3.72,95%CI为-7.38~-0.06,P=0.046)及血清C反应蛋白和降钙素原水平(WMD=-11.47,95%CI为-17.82~-5.12,P<0.001;WMD=-1.92,95%CI为-2.75~-1.09,P<0.001),且未增加不良反应。结论:桃核承气汤治疗脑出血能提高有效率,改善脑出血量、脑出血症状评分、血清C反应蛋白和降钙素原,且不良反应发生率未增加。

Objective:To systematically evaluate the efficacy and safety of Taohe Chengqi Decoction in treating cerebral hemorrhage.Methods:The randomized controlled trials(RCTs)for the treatment of cerebral hemorrhage by western medicine with/without Taohe Chengqi Decoction were screened from 9 academic journal databases.Results:A total of 11 RCTs(n=811)were included in this study.The results of the meta-analysis showed that Taohe Chengqi Decoction+western medicine group had higher response rate than the control group(RR=1.12,95%CI 1.05 to 1.19,P<0.001).Compared with the control group,Taohe Chengqi Decoction+western medicine group reduced the amount of cerebral bleeding(WMD=-3.88,95%CI-5.14 to-2.61,P<0.001)and recovered the cerebral hemorrhage symptom score(WMD=-3.72,95%CI-7.38 to-0.06,P=0.046)and the serum levels of C-reactive protein(CRP)(WMD=-11.47,95%CI-17.82 to-5.12,P<0.001)and procalcitonin(PCT)(WMD=-1.92,95%CI-2.75 to-1.09,P<0.001)without increasing the incidence of adverse reactions.Conclusion:Taohe Chengqi Decoction improves the response rate by regulating the cerebral bleeding amount,symptom score,and serum CRP and PCT levels without increasing the incidence of adverse reactions in the treatment of cerebral hemorrhage.