摘要
背景:单纯西药治疗动脉硬化闭塞症(arteriosclerosis obliterans,ASO)是常用治疗方法,然而该疗法存在一定副作用,对部分患者疗效不佳。中西医结合治疗ASO已有大量报道。目的:运用循证医学系统综述方法评价中西医结合治疗ASO的疗效。检索策略:计算机检索MEDLINE、PubMed、EMBASE、Cochrane图书馆(2009年第1期)、中国生物医学文献数据库(Chinese Biomedical Literature Database,CBM)、中国期刊网全文数据库(CNKI)、重庆维普中文科技期刊数据库和万方数据库。检索不受语种限制。检索日期截止于2009年5月20日。纳入标准:收集比较中西医结合疗法与单纯西药治疗ASO的随机对照试验(randomized controlled trial,RCT),无论是否采用盲法均纳入,语种不限。资料提取与分析:两名经过培训的评价者独立提取资料,采用Cochrane Reviewer's Handbook 5.0.1RCT的质量评价标准进行方法学质量评价和分析。结局的效应指标为相对危险度(relative risk,RR)、加权均数差(weighted mean difference,WMD)或标准化均数差(standardized mean difference,SMD),均以95%可信区间(confidence intervals,CI)表示。结果:共纳入13个中西医结合疗法与单纯西药比较治疗ASO的RCT,共968例患者。纳入的13个研究均未报道ASO相关病死率;纳入的2个研究报道了与ASO相关的截肢率,术后1年两组截肢率比较,差异无统计学意义;所纳入的研究中有10个研究进行了无效率分析,其中2个研究显示中西医结合组无效率低于西医组,RR及95%CI为0.36[0.13,0.99];另外8个研究进行了描述性分析,有4个研究显示中西医结合组无效率低于西医组,1个研究显示中西医结合组无效率高于西医组;次要指标如间歇性跛行、踝肱指数(ankle brachial index,ABI)、高密度脂蛋白(high-density lipoprotein,HDL)、低密度脂蛋白(low-densitylipoprotein,LDL)的改善均优于西医组;有1个研究显示西医组纤维蛋白原的改善程度较中西医结�
Background：The conventional therapy for arteriosclerosis obliterans （ASO） is Western medicine.However,it has some adverse effects and does not respond to some patients,and it is also very expensive.Objective：To evaluate the efficacy of integrated traditional Chinese （TCM） and Western medicine （WM） in treatment of ASO.Search strategy：Electronic and manual searches were conducted and the searches ended on May 20,2009.Inclusion criteria：We included randomized controlled trials （RCT） evaluating integrated TCM and WM （as treatment group） versus WM used alone （as control group）,and no language limits were set.Data extraction and analysis：Selection of trials for inclusion,assessment for methodological quality,data extraction and data syntheses were conducted according to protocol of a Cochrane systematic review by the authors.Results：Thirteen RCT were included,which encompassed a total of 968 patients.The results showed that all of the 13 included trials did not report mortality rate of ASO.The studies displayed that the amputation rate in the treatment group was lower than that in the control group,but there was no statistical significance.Ten studies adopted inefficiency analysis and 2 of them showed that the ineffective rate in the treatment group was lower than that in the control group,and the relative risk （RR） and 95% CI were 0.36 [0.13,0.99].We performed descriptive analysis on other 8 studies; analyses of secondary outcomes such as intermittent claudication,ankle brachial index,high-density lipoprotein （HDL）,and low-density lipoprotein （LDL） showed that integrated TCM and WM therapy was more effective than WM treatment alone; one study showed that WM was better than integrated TCM and WM therapy in decreasing the content of fibrinogen.All of the included trials did not report any critical adverse reactions occurred in the treatment group.Conclusion：The current evidence shows that integrated TCM and WM therapy is safe and effective in treating ASO,and tends to re
出处
《中西医结合学报》
CAS
2010年第10期917-927,共11页
Journal of Chinese Integrative Medicine
基金
广西自然科学基金资助项目(No.0728135)
关键词
中西医结合
动脉硬化
闭塞性
系统综述
META分析
integrated traditional Chinese and Western medicine
arteriosclerosis obliterans
systematic review
meta-analysis
