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养血清脑颗粒治疗偏头痛的系统评价
引用本文:赵锋辉,马彬,移康,于建宏,葛玮,朱亮亮,刘雅莉,杨克虎,田金徽.养血清脑颗粒治疗偏头痛的系统评价[J].中国循证医学杂志,2008,8(10):887-891.
作者姓名:赵锋辉  马彬  移康  于建宏  葛玮  朱亮亮  刘雅莉  杨克虎  田金徽
作者单位:1. 兰州大学循证医学中心;兰州大学公共卫生学院,兰州,730000
2. 兰州大学循证医学中心;兰州大学基础医学院,兰州,730000
3. 兰州大学循证医学中心;
4. 兰州大学第一临床医学院,兰州,730000
基金项目:甘肃兰州大学本科教学质量工程专项经费支持计划,兰州大学循证医学中心本科教学创新项目
摘    要:目的系统评价养血清脑颗粒治疗偏头痛的疗效及安全性。方法计算机检索Cochrane图书馆(2007年第3期)、EMbase(1974—2007.6)、PubMed(1966~2007.6)、VIP(1989~2007.6)、CNKI(1979~2007.6)和CBMdisc(1978~2007.6),收集养血清脑颗粒与西比灵(氟桂利嗪)比较治疗偏头痛的所有临床随机对照试验(RCT)或半随机对照试验,按Cochrane系统评价的方法评价纳入研究质量,并使用RevMan4.2.7软件对纳入研究进行Meta分析。结果最终纳入8个研究,包括5个RCT,3个半随机对照试验。Mata分析结果显示,养血清脑颗粒与西比灵比较,其总有效率RR=1.07,95%CI(1.00,1.15),P=0.06]、头痛持续时间WMD=1.33,95%CI(-0.87,3.52),P=0.24]、头痛发作次数WMD=0.93,95%CI(-1.00,2.86),P=0.35]差异均无统计学意义。一个研究报告,养血清脑颗粒与西比灵比较,两组脑部ACAWMD=3.70,95%CI(-3.46,10.86)]、MCAWMD=0.60,95%CI(-10.37,11.57)]、ICAWMD=3.40,95%C1(-4.35,11.15)]、DCAWMD=-2.30,95%CI(-9.52,4.92)]差异均无统计学意义。结论养血清脑颗粒治疗偏头痛有效,在总有效率、头痛持续时间、脑部血流量方面与西比灵疗效相似,但按现有证据,尚不能认为养血清脑颗粒治疗偏头痛优于西比灵。由于本系统评价纳人研究的方法学质量较低,且例数较少,因此尚需开展更多设计合理、执行严格的多中心大样本且随访时间足够长的随机对照试验验证其疗效及安全性。

关 键 词:养血清脑颗粒  偏头痛  西比灵  系统评价

Yangxue Qingnao Grain for Migraine: A Systematic Review
ZHAO Feng-hui,MA Bin,YI Kang,YU Jian-hong,GE Wei,ZHU Liang-liang,LIU Ya-li,YANG Ke-hu,TIAN Jin-hui.Yangxue Qingnao Grain for Migraine: A Systematic Review[J].Chinese Journal of Evidence-based Medicine,2008,8(10):887-891.
Authors:ZHAO Feng-hui  MA Bin  YI Kang  YU Jian-hong  GE Wei  ZHU Liang-liang  LIU Ya-li  YANG Ke-hu  TIAN Jin-hui
Institution:ZHAO Feng-hui, MA Bin, YI Kang, YU Jian-hong, GE Wei, ZHU Liang-liang, LIU Ya-li,YANG Ke-hu. TIAN Jin-hui(1. Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China; 2. School of Public Health, Lanzhou University, Lanzhou 730000, China; 3. School of Basic Medical Science of Lanzhou University, Lanzhou 730000, China; 4. The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China)
Abstract:Objective To evaluate the efficacy ofYangxue Qingnao Grain for migraine. Methods We searched The Cochrane Library (Issue 3, 2007), EMBASE (1974 to June 2007), PubMed (1966 to June 2007), VIP (1989 to June 2007), CNKI (1979 to June 2007) and CBM (1978 to June 2007) to identify randomized controlled trials or quasirandomized controlled trials comparing Yangxue Qingnao Grain versus sibeline for migraine. The quality of included studies was critically assessed and data analyses were performed with The Cochrane Collaboration's RevMan 4.2.7. Results Eight studies were included, involving 5 randomized trials and 3 quasi-randomized trials. Meta-analyses showed that the total response rate (RR 1.07, 95%CI 1.00 to 1.15, P=0.06), the duration of headache (WMD 1.33, 95%CI - 0.87 to 3.52, P=0.24), and the frequency of headache episodes (WMD 0.93, 95%CI -1.00 to 2.86, P=0.35) were similar between Yangxue Qingnao Grain and sibeline. One study reported that the changes of ACA (WMD 3.70, 95%CI -3.46 to 10.86), MCA (WMD 0.60, 95%CI -10.37 to 11.57), ICA (WMD 3.40, 95%CI -4.35 to 11.15) and DCA (WMD - 2.30, 95%CI -9.52 to 4.92) revealed by transcranial doppler sonography were also comparable between the two groups. Conclusion Yangxue Qingnao Grain is effective in the treatment of migraine, but its superiority over sibeline is not demonstrated. Due to the poor quality and small sample of the included trials, more large-scale multi-center randomized trials are needed.
Keywords:Yangxue Qingnao Grain  Migraine  Sibeline  Systematic review
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