摘要
目的系统评价中药对短暂性脑缺血发作(TIA)的疗效与安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)和万方(WanFang)数据库,检索单用或联用中药治疗TIA的随机对照试验(RCT)。由两位研究者按照纳入与排除标准独立筛选文献、提取资料,并采用Cochrane手册推荐的工具评价偏倚风险,任何分歧通过讨论或第3方仲裁解决,采用RevMan 5.3软件对数据进行Meta分析。结果纳入19项RCT,涉及病人1980例。Meta分析结果显示:就新发卒中而言,中西医联合较常规西医治疗可明显降低长期随访后(≥3个月)病人的新发卒中风险[RR=0.37,95%CI(0.22,0.62),P=0.0002];单独中药治疗较常规西医治疗对降低治疗结束后或随访后的新发卒中风险差异无统计学意义。亚组分析结果显示,在常规西医治疗的基础上,中医经典名方补阳还五汤能更明显地降低长期随访后新发卒中风险[RR=0.32,95%CI(0.15,0.68)]。4项研究报道了不良事件的发生,但无严重不良事件报道。结论现有证据表明,在TIA常规西医治疗的基础上联用中药可更好地降低新发卒中的风险,且未增加不良事件;但单独使用中药则未呈现明显的优势。
Objective To evaluate the efficacy and safety of Chinese herbal medicine(CHM)for transient ischemic attack(TIA).Methods The randomized controlled trials(RCTs)were retrieved from PubMed,EMbase,the Cochrane library,CBM,CNKI,and WanFang.Two researchers independently screened literature according to the inclusion and exclusion criteria,and assessed the risk of bias of literature,and extracted data.Finally,the RevMan 5.3 was used for Meta-analysis.Results A total of 19 RCTs with 1980 participants were included.The Meta-analysis results showed that CHM plus conventional therapy could significantly reduce the risk of strokes in patients at long-term follow-up(≥3 months)[RR=0.37,95%CI(0.22,0.62),P=0.0002],however there was no significant difference in reducing the risk of new stroke at treatment or at follow-up between CHM alone and conventional therapy.Subgroup analysis showed that based on conventional therapy,the classic prescription Buyang Huanwu Decoction could significantly reduce the risk of new stroke at long-term follow-up[RR=0.32,95%CI(0.15,0.68)].There were 4 studies reported the adverse events,but no serious adverse events were reported.Conclusion CHM plus conventional therapy can significantly reduce the risk of new strokes without increasing adverse events,but the traditional Chinese medicine alone does not show obvious benefit.
作者
廖映迪
倪小佳
吴梁晖
王睿弘
刘文琛
蔡业峰
LIAO Yingdi;NI Xiaojia;WU Lianghui;WANG Ruihong;LIU Wenchen;CAI Yefeng(The Second Clinical School of Guangzhou University of Chinese Medicine,Guangzhou 510120,Guangdong,China)
出处
《中西医结合心脑血管病杂志》
2021年第10期1634-1644,共11页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
国家中医药管理局中医药循证能力建设项目-专科专病循证能力提升-中医脑病科(No.2019XZZX-NB002)
广州市科技创新委员会第三批广州市临床医学研究与转化中心试点建设项目-广州市中医药防治脑血管病临床医学研究与转化中心(No.201604020003)
广州中医药大学一流学科研究项目(No.XK2019025)。
关键词
短暂性脑缺血发作
中药
新发卒中
META分析
transient ischemic attack
Chinese herbal medicine
new stroke
Meta-analysis
