补阳还五汤治疗不同类型中风疗效的系统评价研究

Systematic Evaluation of Therapeutic Effect Buyanghuanwu Decoction in Treating Different Types of Stroke

关键词:  补阳还五汤  中风  随机对照试验  系统评价

Key words:  Buyanghuanwu decoction  stroke  randomized controlled trail  systematic review

摘要:

[目的] 系统评价并比较补阳还五汤治疗不同类型中风各期的临床疗效。[方法] 检索补阳还五汤治疗中风的随机对照试验文献,筛选合格研究,应用Jadad评分法进行质量评价,运用异质性检验、荟萃分析(Meta分析)、敏感性分析等方法统计比较相关数据。[结果] 纳入24项研究,研究对象为出血性中风急性期患者2篇,其余22篇为缺血性中风急性期,Jadad评分所有研究得分均低于3分,属低质量文献。Meta分析结果显示,补阳还五汤治疗缺血性中风急性期总有效率比较的相对危险度(RR)99%可信区间(CI)为1.19(1.10,1.30),神经功能缺损评分比较的加权均数差(WMD)(99%CI)为-2.34(-3.61,-1.08);补阳还五汤治疗出血性中风急性期总有效率比较的RR(99%CI)为1.35(1.03,1.76),神经功能缺损评分比较的WMD(99%CI)为-6.73(-13.71,0.25)。[结论] 补阳还五汤对出血性与缺血性中风急性期患者均有效,且对于缺血性中风急性期的疗效优于出血性中风急性期。

Abstract:

[Objective] To evaluate the clinical efficacy of Buyanghuanwu decoction in treating different types of stroke.[Methods] The literatures of randomized controlled trails(RCTs) of Buyanghuanwu decoction in treating stroke were reviewed and the satisfied studies were selected. The quality evaluation was carried out with Jadad score method. Heterogeneity test,Meta-analysis and sensitivity analysis were to used statistically compare the related data.[Results] Twenty-four RCTs were enrolled,among them two were the articles about acute hemorrhagic stroke in acute stage,the other twenty-two were acute ischaemic stroke in acute stage,The results of Jadad score revealed that all the researches were lower than 3 and belonged to literature with lower quality. The results of the Meta-analysis indicated that the comparative RR(99%CI) of the total effective rate of Buyanghuanwu decoction for treating acute ischemic stroke in acute stage was 1.19(1.10,1.30). The comparative WMD(99%CI) of the score of the deficiency of nervous function was -2.34(-3.61,-1.08); The compared RR(99%CI) of the total effective rate of Buyanghuanwu in treating the hemorrhagic stoke in acute stage was 1.35(1.03,1.76) and the compared WMD(99%CI) of the score for the deficiency of nervous function was -6.73(-13.71,0.25).[Conclusions] Buyanghuanwu decoction is effective for hemorrhagic and ischemic stroke in acute stage and the effect in treating ischemic stroke was better than the hemorrhagic one.