Li Hui-qin, Wei Jing-jing, Xia Wan, Li Ji-huang, Liu Ai-ju, Yin Su-bing, Wang Chen, Song Liang, Wang Yan, Zheng Guo-qing, Fan Ji-ping
Department of Neurology, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Department of Cardiology, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Acta Pharmacol Sin. 2015 Jun;36(6):659-75. doi: 10.1038/aps.2014.139. Epub 2015 May 11.
To conduct a systematic review and meta-analysis to assess the current evidence available regarding the promoting blood circulation and removing blood stasis (PBCRBS) therapy for Chinese patients with acute intracerebral hemorrhage (ICH).
Six databases were searched from their inception to November 2013. The studies assessed in ≥ 4 domains with 'yes' were selected for detailed assessment and meta-analysis. The herbal compositions for PBCRBS therapy for acute ICH patients were also assessed.
From the 6 databases, 292 studies claimed randomized-controlled clinical trials (RCTs). Nine studies with 798 individuals were assessed in ≥ 4 domains with 'yes' by using the Cochrane RoB tool. Meta-analysis showed that PBCRBS monotherapy and adjuvant therapy for acute ICH could improve the neurological function deficit, reduce the volume of hematoma and perihematomal edema, and lower the mortality rate and dependency. Moreover, there were fewer adverse effects when compared with Western conventional medication controls. Xueshuantong Injection and Fufang Danshen Injection, Buyang Huanwu Decoction and Liangxue Tongyu formula, and three herbs (danshen root, sanqi and leech) were the most commonly used Chinese herbal patent injections, herbal prescriptions and single herbs, respectively.
Despite the apparently positive findings, it is premature to conclude that there is sufficient efficacy and safety of PBCRBS for ICH because of the high clinical heterogeneity of the included studies and small number of trials in the meta-analysis. Further large sample-sizes and rigorously designed RCTs are needed.
进行一项系统评价和荟萃分析，以评估目前关于活血化瘀疗法治疗中国急性脑出血（ICH）患者的现有证据。
检索了6个数据库，时间跨度从建库至2013年11月。对在≥4个领域评估为“是”的研究进行详细评估和荟萃分析。还评估了用于急性ICH患者活血化瘀疗法的草药成分。
从这6个数据库中，有292项研究声称是随机对照临床试验（RCT）。使用Cochrane偏倚风险工具，对9项涉及798例个体的研究在≥4个领域评估为“是”。荟萃分析表明，急性ICH的活血化瘀单一疗法和辅助疗法可改善神经功能缺损，减少血肿体积和血肿周围水肿，并降低死亡率和依赖程度。此外，与西方传统药物对照相比，不良反应较少。血栓通注射液和复方丹参注射液、补阳还五汤和凉血通瘀方，以及三种草药（丹参、三七和水蛭）分别是最常用的中药专利注射剂、中药方剂和单味草药。
尽管有明显的阳性结果，但由于纳入研究的临床异质性高且荟萃分析中的试验数量少，现在就得出活血化瘀疗法治疗ICH有足够疗效和安全性的结论还为时过早。需要进一步开展大样本、设计严谨的RCT。
