中国中药杂志

2020, v.45(21) 5068-5082

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口服中成药治疗偏头痛的网状Meta分析
Network Meta-analysis of oral Chinese patent medicine in treatment of migraine

贾敏;鲁喦;张允岭;廖星;梁晓;申伟;魏竞竞;雷林;陈倩;付国静;
JIA Min;LU Yan;ZHANG Yun-ling;LIAO Xing;LIANG Xiao;SHEN Wei;WEI Jing-jing;LEI Lin;CHEN Qian;FU Guo-jing;Xiyuan Hospital, China Academy of Chinese Medical Sciences;Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences;Graduate School, Beijing University of Chinese Medicine;

摘要(Abstract):

运用网状Meta分析的方法系统评价口服中成药治疗偏头痛的效果。计算机检索四大中文数据库(CNKI,VIP,WanFang,CBM)、三大英文数据库(Medline,EMbase,Cochrane Library)及ClinicalTrials.gov,检索时间为各数据库建库至2020年4月24日,按照预先设定的纳排标准,筛选出口服中成药联合氟桂利嗪治疗偏头痛的随机对照试验。由2名研究者独立进行文献筛选、资料提取。采用"Cochrane偏倚风险评估"工具对所纳入的研究进行质量评价,Stata 16.0软件进行数据分析。最终纳入52个RCTs,涉及11种口服中成药。网状Meta分析结果显示,(1)减少头痛发作频率方面,中成药疗效排序依次为:氟桂利嗪联合通天口服液>联合正天丸>联合头痛宁胶囊>联合养血清脑颗粒>联合天舒胶囊>联合血府逐瘀胶囊>联合丹珍头痛胶囊>联合川芎清脑颗粒>联合松龄血脉康胶囊;(2)减轻头痛程度方面,中成药疗效排序依次为:氟桂利嗪联合通天口服液>联合正天丸>联合丹珍头痛胶囊>联合天舒胶囊>联合头痛宁胶囊>联合川芎清脑颗粒>联合晕痛定胶囊>联合养血清脑颗粒>联合丹七软胶囊;(3)减少头痛持续时间方面,中成药疗效排序依次为:氟桂利嗪联合通天口服液>联合养血清脑颗粒>联合头痛宁胶囊>联合正天丸>联合丹珍头痛胶囊>联合天舒胶囊>联合血府逐瘀胶囊>联合晕痛定胶囊>联合川芎清脑颗粒>联合松龄血脉康胶囊。在氟桂利嗪治疗基础上,联用中成药可提高偏头痛的临床治疗效果。不同的中成药由于纳入的研究数量及质量存在差异,且缺乏中成药直接比较的研究,中成药排序结果有待今后开展多中心、大样本、随机双盲试验加以论证。
To systemically assess the clinical efficacy of oral Chinese patent medicine for migraine by using network Meta-analysis. Four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Medline, EMbase, Cochrane Library) and ClinicalTrials.gov were systematically and comprehensively retrieved from the establishment of each database to April 24, 2020. Rando-mized controlled trial(RCT) on oral Chinese patent medicine combined with Flunarizine for migraine were screened out according to inclusion criteria and exclusion criteria. Literature screening and data extraction were conducted independently by 2 researchers. The included studies were evaluated with the Cochrane bias risk assessment tool. Data analysis was conducted by using Stata 16.0 software. Finally, a total of 52 RCTs were included, involving 11 kinds of oral Chinese patent medicines. The results of the network Meta-analysis showed that in terms of headache frequency, the order of efficacy was: Flunarizine combined with Tongtian Oral Liquid>combined with Zhengtian Pills>combined with Toutongning Capsules>combined with Yangxue Qingnao Granules>combined with Tianshu Capsules>combined with Xuefu Zhuyu Capsules>combined with Danzhen Toutong Capsules>combined with Chuanxiong Qingnao Granules>combined with Songling Xuemaikang Capsules. In terms of headache intensity, the order of efficacy was: Flunarizine combined with Tongtian Oral Liquid>combined with Zhengtian Pills>combined with Danzhen Toutong Capsules>combined with Tianshu Capsules>combined with Toutongning Capsules>combined with Chuanxiong Qingnao Granules>combined with Yuntongding Capsules>combined with Yang-xue Qingnao Granules>combined with Danqi Soft Capsules. In terms of headache lasting time, the order of efficacy was: Flunarizine combined with Tongtian Oral Liquid>combined with Yangxue Qingnao Granules>combined with Toutongning Capsules>combined with Zhengtian Pills>combined with Danzhen Toutong Capsules>combined with Tianshu Capsules>combined with Xuefu Zhuyu Capsules>combined with Yuntongding Capsules>combined with Chuanxiong Qingnao Granules>combined with Songling Xuemaikang Capsules. The results showed that oral Chinese patent medicines combined with Flunarizine were effective in improving the clinical efficacy for migraine. Due to the differences in the number and quality of studies included in studies of different Chinese patent medicines, and the lack of direct comparison of Chinese patent medicines, the results of the above order of Chinese patent medicines need to be demonstrated in future multi-center, large-sample, and double-blind randomized trial.

关键词(KeyWords): 中成药;偏头痛;网状Meta分析;氟桂利嗪
Chinese patent medicine;migraine;network Meta-analysis;Flunarizine

Abstract:

Keywords:

基金项目(Foundation): 中医药诊疗标准化关键技术研究项目(Z0479);; 国家中医药管理局中医药传承与创新“百千万”人才工程(岐黄学者-国家中医药领军人才支持计划)(国中医药人教发[2018]12号);; 中央级公益性科研院所基本科研业务费专项(ZZ13-024-3);; 国家自然科学基金项目(81774159)

作者(Author): 贾敏;鲁喦;张允岭;廖星;梁晓;申伟;魏竞竞;雷林;陈倩;付国静;
JIA Min;LU Yan;ZHANG Yun-ling;LIAO Xing;LIANG Xiao;SHEN Wei;WEI Jing-jing;LEI Lin;CHEN Qian;FU Guo-jing;Xiyuan Hospital, China Academy of Chinese Medical Sciences;Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences;Graduate School, Beijing University of Chinese Medicine;

Email:

DOI: 10.19540/j.cnki.cjcmm.20200730.503

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