中医药治疗抽动秽语综合征的疗效和安全性：一项随机对照试验的荟萃分析。
Efficacy and safety of traditional Chinese medicine for Tourette's syndrome: A meta-analysis of randomized controlled trials.
机构信息
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
出版信息
Asian J Psychiatr. 2020 Jan;47:101853. doi: 10.1016/j.ajp.2019.101853. Epub 2019 Oct 24.
BACKGROUND
Traditional Chinese medicine (TCM) has been widely used in the treatment of Tourette's Syndrome (TS). However, the efficacy and safety of TCM in treating TS are mixed across studies. This is a meta-analysis of studies on the efficacy and safety of TCM compared to placebo and Western medicine (WM).
METHODS
PubMed, Cochrane Library, PsycINFO, Chinese National Knowledge Infrastructure, SinoMed, and WanFang databases were systematically searched from inception date to October 16, 2018. Randomized Controlled Trials (RCTs) on the efficacy and safety of TCM alone or TCM + WM combination for TS were included.
RESULTS
A total of 15 studies comprising 21 treatment trials (n = 2824) were included. TCM alone was more efficacious than placebo in terms of response rate (Relative Risk, RR: 1.96, 95% CI: 1.55-2.47, P < 0.01, I = 45 %) and the change in the Yale Global Tic Severity Scale total score (Standard mean difference, SMDs: -0.67, 95% CI: -0.81, -0.53, P < 0.01, I = 0 %). The results remained positive when TCM alone was compared with WM alone (RR: 1.06, 95% CI: 1.00-1.12, P = 0.03, I = 29 %), and when TCM + WM were compared with WM alone (RR: 1.24, 95% CI: 1.08-1.43, P < 0.01, I = 0 %). Adverse drug reactions were more frequent in WM than in TCM groups (P < 0.05). WM type (P = 0.02), proportion of males (P = 0.03) and trial duration (P = 0.03) were significantly associated with response rate in TS patients when comparing TCM alone with WM alone.
CONCLUSION
The results of this meta-analysis support the efficacy and safety of TCM alone and TCM + WM in TS patients.
背景
传统中医药（TCM）已广泛应用于抽动秽语综合征（TS）的治疗。然而，TCM 治疗 TS 的疗效和安全性在不同研究中参差不齐。这是一项针对 TCM 与安慰剂和西药（WM）相比的疗效和安全性的研究的荟萃分析。
方法
系统检索了 PubMed、Cochrane 图书馆、PsycINFO、中国国家知识基础设施（CNKI）、中国生物医学文献数据库（SinoMed）和万方数据库，检索时间为从建库至 2018 年 10 月 16 日。纳入 TCM 单独或 TCM+WM 联合治疗 TS 的疗效和安全性的随机对照试验（RCT）。
结果
共纳入 15 项研究，包括 21 项治疗试验（n=2824）。TCM 单独治疗在应答率方面优于安慰剂（相对风险，RR：1.96，95%置信区间：1.55-2.47，P<0.01，I²=45%）和耶鲁总体抽动严重程度量表总分的变化（标准均数差，SMDs：-0.67，95%置信区间：-0.81，-0.53，P<0.01，I²=0%）。当 TCM 单独与 WM 单独比较时，当 TCM+WM 与 WM 单独比较时，结果仍然是阳性的（RR：1.06，95%置信区间：1.00-1.12，P=0.03，I²=29%）。WM 类型（P=0.02）、男性比例（P=0.03）和试验持续时间（P=0.03）与 TCM 单独与 WM 单独比较时 TS 患者的应答率显著相关。
结论
这项荟萃分析的结果支持 TCM 单独和 TCM+WM 治疗 TS 患者的疗效和安全性。
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