化痰祛瘀法治疗血管性认知功能障碍随机 对照试验的Meta分析

评价化痰祛瘀法治疗血管性认知功能障碍的有效性。按 Cochrane系统评价方法,计算机检索生物医学、CNKI、维普及万方等数据库 (2001-2011),纳入化痰祛瘀法治疗血管性认知功能障碍的随机对照试验,提取有效数据并采用Revman 5.0软件对各研究结果进行Meta分析。共纳入13项有效文献,患者944人。纳入文献大多为低质量文献;Meta分析结果显示:①化痰祛瘀法干预的治疗组在简易智能量表(MMSE),汉密顿抑郁量表(HDS),血管性痴呆中医辨证量表(SDSVD)评分方面优于对照组(P<0.05);②在BBS(Berg Balance Scale)评分方面化痰祛瘀组与对照组相似;③具有较好的安全性。就当前所能获得的临床证据表明,化痰祛瘀法治疗血管性认知功能障碍有较好疗效且药物安全性高,但对临床症状改善的关注较少。鉴于纳入的研究质量较低,且存在发表性偏倚,应该推动开展更多进行设计合理、执行严格、多中心大样本且随访时间足够的具有中医特色的随机双盲对照试验。

Dissipating Phlegm and Removing Blood Stasis for Treatment of Vascular Cognitive Impairment:A Meta-analysis of Randomized Controlled Trials

To evaluate objectively the clinical curative effect of the therapy of dissipating phlegm and removing blood stasis for vascular cognitive impairment(VCI)with Meta-analysis.According to the method of Cochrane Systematic Review,CBM,CNKI,VIP,Wanfang(2001-2011),etc were searched.Randomized controlled trials of treatment by dissipating phlegm and removing blood stasis for vascular cognitive impairment were collected for systematic reviews,extract data and Meta-analysis were analysed with Revman 5.0.A total of 13 trials were included in this study,including 944 cases patients.Those trials were low quality,the results showed that: ①the therapy of dissipating phlegm and removing blood stasis had a better efficacy than the control group by mini-metal state examination(MMSE),Hamton Depression Scale(HDS),Scale for the differentiation of vascular dementia(SDSVD)(P<0.05),②there was no significant difference shown by Berg Balance Scale(BBS),③the therapy had a good safety.Available evidences manifests that dissipating phlegm and removing blood stasis has a better efficacy and safety than the control group,but less attention is paid to clinical symptoms.Due to lower overall quality and potential publication bias of the studies.The rational design,the strict execution,the multi-central and large sampling,long time follow-up and double-blind randomized controlled trials with characteristics of Chinese medicine are needed in the future.