[关键词]
[摘要]
目的 基于网状Meta分析对不同种类的口服中成药治疗眩晕的有效性及安全性进行评价。方法 计算机检索中国知网、万方数据、维普、中国生物医学文献数据库、PubMed、Web of Science、Scopus、Embase、Cochrane Library数据库的随机对照试验(randomized controlled trials,RCTs),时间限定为建库至2023年7月31日,运用Review Manager 5.3、Stata 15进行数据分析。结果 最终纳入108篇RCTs,涉及12种中成药,总样本量10 639例,其中试验组5 368例,对照组5 271例。网状Meta分析显示:在提高临床总有效率方面,累积排序曲线下面积(surface under the cumulative ranking curve,SUCRA)排名前3的干预措施为眩晕灵+西医常规、舒颈定眩颗粒+西医常规、养血清脑颗粒+西医常规;在降低眩晕障碍调查量表(dizziness handicap inventory,DHI)评分方面,SUCRA排名前3的干预措施为强力定眩片+西医常规、银杏叶片+西医常规、清眩醒脑颗粒+西医常规;在加快基底动脉(basilar artery,BA)收缩峰流速方面,SUCRA排名前3的干预措施为脑得生丸+西医常规、眩晕宁+西医常规、定眩颗粒+西医常规;在加快椎动脉(vertebral artery,VA)收缩峰流速方面,SUCRA排名前3的干预措施为眩晕宁+西医常规、脑得生丸+西医常规、银杏叶片+西医常规;在降低血浆黏度(plasma viscosity,PV)方面,SUCRA排名前3的干预措施为眩晕灵+西医常规、强力定眩片+西医常规、银杏叶片+西医常规。结论 口服中成药联合西医常规治疗眩晕能够提高临床总有效率,降低DHI评分,增加基底动脉、椎动脉血流速度,降低血浆黏度。受纳入研究的质量限制,仍需要更多的大样本、多中心、高质量的RCTs加以验证。
[Key word]
[Abstract]
Objective To evaluate the efficacy and safety of different kinds of oral Chinese patent medicines in the treatment of vertigo based on network Meta-analysis. Methods The randomized controlled trials (RCTs) were retrieved from CNKI, Wanfang data, VIP, Chinese Biomedical literature Database, PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases, with a time limit from database establishment to July 31, 2023. Data analysis was conducted using Review Manager 5.3 and Stata 15. Results A total of 108 RCTs were included, involving 12 kinds of Chinese patent medicines, with a total sample size of 10 639 cases, including 5 368 cases in the experimental group and 5 271 cases in the control group. Network Meta-analysis revealed: In terms of improving clinical total effective rate, the top 3 interventions with surface under the cumulative ranking curve (SUCRA) were Xuanyunling (眩晕灵) + conventional western medicine (CWM), Shujing Dingxuan Granules (舒颈定眩颗粒) + CWM and Yangxue Qingnao Granules (养血清脑颗粒) + CWM; In terms of reducing the dizziness handicap inventory (DHI) score, the top 3 interventions with SUCRA were Qiangli Dingxuan Tablet (强力定眩片) + CWM, Yinxingye Pills (银杏叶片) + CWM and Qingxuan Xingnao Granules (清眩醒脑颗粒) + CWM; In terms of accelerating the contractile peak velocity of basilar artery (BA), the top 3 interventions with SUCRA were Naodesheng Pills (脑得生丸) + CWM, Xuanyunning (眩晕宁) + CWM and Dingxuan Granules (定眩颗粒) + CWM; In terms of accelerating the systolic peak velocity of vertebral artery (VA), the top 3 interventions with SUCRA were Xuanyunning + CWM, Naodesheng Pills + CWM and Yinxingye Pills + CWM; In terms of reducing plasma viscosity (PV), the top 3 interventions with SUCRA were Xuanyunling + CWM, Qiangli Dingxuan Tablet + CWM and Yinxingye Pills + CWM. Conclusion Oral Chinese patent medicine combined with CWM treatment of vertigo can improve clinical total effective rate, reduce DHI score, increase BA and VA flow velocity, and reduce PV. Due to the quality limitations of the included studies, more large-sample, multicenter, high-quality RCTs are still needed for validation.
[中图分类号]
[基金项目]
国家自然科学基金青年科学基金项目(81904173);赣南医学院心脑血管疾病防治教育部重点实验室开放基金(XN202011);湖南省自然科学基金项目(2023JJ30362);湖南省卫健委科研课题(202103100126)