泽泻汤加减治疗梅尼埃病疗效及安全性的Meta分析

A Meta-analysis of clinical safety and efficacy of the Zexie decotion on Meniere’s disease

目的:运用Meta分析方法评价泽泻汤加减治疗梅尼埃病疗效及安全性。方法:计算机检索PubMed、Embase、Cochrane Library、中国知网、万方数据库、维普数据库、中国生物医学文献数据库等数据库,手工检索会议论文、相关杂志文章,收集泽泻汤加减治疗梅尼埃病的随机对照试验,检索时限为从建库至2022年3月1日。提取文献数据并根据改良Jadad量表、Cochrane collaboration标准对纳入文献进行质量评价。纳入文献通过Review Manager 5.3软件进行Meta分析。结果:共纳入14项文献,共1131例患者。Meta分析结果显示,泽泻汤加减治疗梅尼埃病,对提高总有效率、降低患者眩晕障碍量表(Dizziness Handicap Inventory,DHI)评分、降低患者耳鸣残疾评估量表(Tinnitus Handicap Inventory,THI)评分、降低患者耳闷视觉模拟评分法(Visual Analogue Scale,VAS)评分、降低随访3个月平均发作次数、降低随访6个月平均发作次数方面均优于西医常规治疗,差异均有统计学意义。在降低听力下降VAS评分、不良反应发生率方面与西医常规治疗差异无统计学意义。结论:泽泻汤加减治疗梅尼埃病疗效确切、安全性高,与常规西医治疗相比,其总有效率更高,更能改善患者眩晕、耳鸣、耳闷等症状,更能降低远期的复发次数;在改善听力下降症状和不良反应发生率方面,与常规西医治疗相比差异无统计学意义。

Objective:To review the efficacy and safety of the Zexie decoction(泽泻汤)on Meniere’s disease.Methods:A Meta-analysis was conducted using the eligible randomized controlled trials(RCTs)found in relevant electronic databases,including PubMed,Embase,Cochrane Library,CNKI,Wanfang,VIP,SinoMed,conference papers and magazine articles are searched manually.RCTs of the Zexie decoction in the treatment of Meniere’s disease were collected.The search time limit is from the establishment of the database to March 1,2022.The literature data were extracted and the quality of the included literature was evaluated according to Jadad scale and Cochrane collaboration.Statistical analyses were performed using Review Manager 5.3.Results:Fourteen articles with a total of 1131 patients were included in this study.The results of Meta-analysis showed that the Zexie decoction was superior to the conventional Western medicine therapy in improving the the total effective rate,decreasing the DHI score,decreasing the THI score,reducing the ear stuffy VAS score,reducing the average number of seizures in 3 months of follow-up,and reducing the average number of seizures in 6 months of follow-up of patients with Meniere’s disease,and the differences were statistically significant.However,there was no significant difference in reducing the VAS score of hearing loss and the incidence of adverse reactions compared with the conventional Western medicine therapy.Conclusion:The Zexie decoction is effective and safe in the treatment of Meniere’s disease.Compared with conventional Western medicine,it can improve the the total effective rate,the symptoms of vertigo,tinnitus and ear stuffy,and reduce the number of long-term relapse.In improving the symptoms of hearing loss and the incidence of adverse reactions,there was no significant difference compared with conventional Western medicine.