养血清脑颗粒治疗慢性脑供血不足的系统评价

目的: 系统评价养血清脑颗粒治疗慢性脑供血不足的临床疗效和安全性。 方法: 运用系统评价方法,检索国内外养血清脑颗粒治疗慢性脑供血不足的随机对照试验,筛选合格研究,评价纳入研究质量,采用异质性检验、Meta分析、漏斗图分析、敏感性分析等方法统计相关数据。 结果: 12项研究符合选择标准,Meta-分析结果显示,总有效率比较的合并相对危险度(RR)及99%的可信区间(CI值)为1.23(1.14,1.33);经颅多普勒(TCD)检测颈内动脉、椎动脉、基底动脉血流量比较的合并MD(99%CI)分别为8.11(2.29,13.94),2.54(0.21, 4.87),5.60(2.35,8.66);椎体外束症状、胃肠道反应发生率比较的Peto OR(99%CI)分别为0.11(0.01,1.77),8.07(0.77,84.94)。 结论: Meta-分析结果显示,养血清脑颗粒具有增加慢性脑供血不足患者脑血流量、改善患者的认知功能的疗效,但尚不能确定是否存在导致不良反应的危险性,由于纳入研究质量普遍偏低等因素影响,降低了该系统评价结论的可靠性。

Systematic Evaluation of Yangxue Qingnao Granules for Treating Chronic Cerebral Circulation Insufficiency

Objective: To systematically evaluate the clinical efficacy and safety of Yangxue Qingnao granules in treating chronic cerebral circulation insufficiency (CCCI). Method: The systematical evaluation method was adopted to search Chinese and foreign randomized controlled trails (RCTs) of Yangxue Qingnao granules in treating CCCI, screen out eligible studies and evaluate the quality of the included studies. Heterogeneity test, Meta-analysis, funnel plot analysis and sensitivity analysis were adopted in the statistics of relevant data. Result: The 12 RCTs were selected. The Meta-analysis indicated that the ratio between the combined RR of total effective rate and the 99% confidential interval (CI) was 1.23 (1.14, 1.33). The combined MD of transcranial doppler(TCD) detected carotid artery, vertebral artery, basilar artery blood flows (99%CI) respectively were (2.29,13.94), 2.54 (0.21,4.87), 5.60 (2.35,8.66);PetoOR of the incidence rate of extrapyramidal symptoms and gastrointestinal reaction (99%CI) were 0.11 (0.01,1.77), 8.07 (0.77,84.94), respectively. Conclusion: Meta-analysis shows that Yangxue Qingnao granules has the efficacy in increasing cerebral blood flow of patients with chronic brain and improving their cognitive function, but with uncertain risks in causing adverse reactions. Affected by such factors as lower quality of included studies, the systematic evaluation's conclusion is lowly reliable.