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一种用于偏头痛的中药方剂川芎茶调散:随机对照试验的系统评价和荟萃分析

A Chinese Prescription Chuanxiong Chatiao San for Migraine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Wang Yu, Shi Yajun, Zhang Xiaofei, Zou Junbo, Liang Yulin, Tai Jia, Wang Mei, Cui Chunli, Guo Dongyan

机构信息

Department of Pharmaceutics, College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.

Key Laboratory of Basic and New Drug Research of Traditional Chinese Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.

出版信息

Evid Based Complement Alternat Med. 2019 Jul 31;2019:2301680. doi: 10.1155/2019/2301680. eCollection 2019.

Abstract

BACKGROUNDS

Chuanxiong Chatiao san (CXCT) is a famous Chinese classical prescription. It has a favorable effect in treating migraine. It is reported that CXCT combined with Western conventional medicine (WCM) could increase the therapeutic efficacy on migraine. The purpose of this paper is to systematically assess the clinical efficacy, safety, and some indexes of CXCT for migraine.

METHODS

PubMed, Embase Database, China National Knowledge Infrastructure (CNKI), Wanfang Database, the Cochrane Library, and the CBM were searched from January 2000 to February 2019. We made a detailed record of outcome measurements. Meta-analysis was performed using RevMan 5.3 software.

RESULTS

A total of 3307 patients were included in the 37 articles. Meta-analysis showed that CXCT significantly increased the total efficiency rate (TER), compared with Western medicine treatment (WMC) (P < 0.00001). When CXCT is combined with WMC, the result showed that P < 0.00001. CXCT was significantly reduced the adverse events (AEs) compared with WMC (P < 0.00001). The levels of VAS, number of migraine episodes (NE), and time of headache duration (TD) were significantly reduced (P < 0.00001). Platelet function and blood rheology level were improved via a significantly decrease in 5-HT and -EP (P < 0.00001). Other indicators such as substance P, CGRP high-cut viscosity, low-cut viscosity, plasma viscosity, and fibrinogen were significantly reduced (P < 0.00001).

CONCLUSION

Our findings provide evidence that CXCT and CXCT combined with WMC have higher efficacy in the treatment of migraine compared with WCM alone. Methodological quality was generally low, so the conclusion of this paper has some limitations and it has to be carefully evaluated.

摘要

背景

川芎茶调散是著名的中医经典方剂。它在治疗偏头痛方面有良好效果。据报道,川芎茶调散联合西药可提高偏头痛的治疗效果。本文旨在系统评价川芎茶调散治疗偏头痛的临床疗效、安全性及一些指标。

方法

检索2000年1月至2019年2月的PubMed、Embase数据库、中国知网、万方数据库、考克兰图书馆和中国生物医学文献数据库。我们详细记录了结局指标。使用RevMan 5.3软件进行荟萃分析。

结果

37篇文章共纳入3307例患者。荟萃分析表明,与西药治疗相比,川芎茶调散显著提高了总有效率(P<0.00001)。当川芎茶调散与西药联合使用时,结果显示P<0.00001。与西药相比,川芎茶调散显著降低了不良事件(P<0.00001)。视觉模拟评分(VAS)、偏头痛发作次数(NE)和头痛持续时间(TD)显著降低(P<0.00001)。通过5-羟色胺(5-HT)和内啡肽(-EP)的显著降低,血小板功能和血液流变学水平得到改善(P<0.00001)。其他指标如P物质、降钙素基因相关肽(CGRP)、高切粘度、低切粘度、血浆粘度和纤维蛋白原显著降低(P<0.00001)。

结论

我们的研究结果表明,与单纯西药相比,川芎茶调散及其联合西药在治疗偏头痛方面具有更高的疗效。方法学质量普遍较低,因此本文的结论有一定局限性,必须谨慎评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/560d/6699287/58fd9ac70944/ECAM2019-2301680.001.jpg

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